1.Long-term outcomes of laparoscopic gastrectomy for locally advanced gastric cancer with serosa-invasion
Ping′ang LI ; Fan ZHANG ; Zhengyan LI ; Yan SHI ; Feng QIAN ; Yongliang ZHAO ; Jun CHEN ; Chenjun TAN ; Zongwen WANG ; Yan WEN ; Peiwu YU
Chinese Journal of Surgery 2024;62(8):744-750
Objective:To evaluate the long-term outcomes and prognostic factors of locally advanced gastric cancer with serosa-invasion.Methods:This study is a retrospective cohort study. The clinical and pathological data of 495 patients with locally advanced gastric cancer with serosa-invasion who underwent laparoscopic radical gastrectomy in Department of General Surgery, the First Hospital Affiliated to Army Medical University from October 2012 to October 2018 was analyzed retrospectively. There were 356 males and 139 females with an age ( M(IQR)) of 59 (16) years (range: 18 to 75 years). Observation indicators included postoperative results and long-term prognosis. The survival curve was drawn by the Kaplan-Meier method. Univariate and multivariate prognostic analysis was performed using the Cox proportional hazards model. Results:Among the 495 patients, a total of 57 patients (11.5%) were lost to follow-up, with a follow-up time of 89 (40) months (range: 23 to 134 months). The 5-year disease-free survival rate (DFS) and the 5-year overall survival rate (OS) were 56.0% and 58.2%, respectively. The 5-year DFS for patients with stage ⅡB, ⅢA, ⅢB, ⅢC were 71.2%, 60.5%, 51.6%, 33.3%, respectively. The 5-year OS for patients with stage ⅡB, ⅢA, ⅢB, ⅢC were 71.2%, 62.2%, 54.1%, 39.3%, respectively. Multivariate analysis showed that age >65 years (DFS: HR=1.402, 95% CI: 1.022 to 1.922, P=0.036; OS: HR=1.461, 95% CI: 1.057 to 2.019, P=0.022), lymph node dissection number less than 25 (DFS: HR=1.348, 95% CI: 1.019 to 1.779, P=0.036; OS: HR=1.376, 95% CI: 1.035 to 1.825, P=0.028), pathological stage Ⅲ (DFS: HR=2.131, 95% CI: 1.444 to 3.144, P<0.01; OS: HR=2.079, 95% CI: 1.406 to 3.074, P<0.01), and no postoperative chemotherapy (DFS: HR=3.127, 95% CI: 2.377 to 4.113, P<0.01; OS: HR=3.768, 95% CI: 2.828 to 5.020, P<0.01) were independent prognostic factors for the decrease in DFS and OS rates. Conclusions:Laparoscopic radical gastrectomy for locally advanced gastric cancer with serosa-invasion could achieve satisfactory long-term oncological outcomes. More lymph node dissection and standardized postoperative adjuvant chemotherapy are expected to further improve the prognosis of patients with locally advanced gastric cancer with serous invasion after laparoscopic radical surgery.
2.Long-term outcomes of laparoscopic gastrectomy for locally advanced gastric cancer with serosa-invasion
Ping′ang LI ; Fan ZHANG ; Zhengyan LI ; Yan SHI ; Feng QIAN ; Yongliang ZHAO ; Jun CHEN ; Chenjun TAN ; Zongwen WANG ; Yan WEN ; Peiwu YU
Chinese Journal of Surgery 2024;62(8):744-750
Objective:To evaluate the long-term outcomes and prognostic factors of locally advanced gastric cancer with serosa-invasion.Methods:This study is a retrospective cohort study. The clinical and pathological data of 495 patients with locally advanced gastric cancer with serosa-invasion who underwent laparoscopic radical gastrectomy in Department of General Surgery, the First Hospital Affiliated to Army Medical University from October 2012 to October 2018 was analyzed retrospectively. There were 356 males and 139 females with an age ( M(IQR)) of 59 (16) years (range: 18 to 75 years). Observation indicators included postoperative results and long-term prognosis. The survival curve was drawn by the Kaplan-Meier method. Univariate and multivariate prognostic analysis was performed using the Cox proportional hazards model. Results:Among the 495 patients, a total of 57 patients (11.5%) were lost to follow-up, with a follow-up time of 89 (40) months (range: 23 to 134 months). The 5-year disease-free survival rate (DFS) and the 5-year overall survival rate (OS) were 56.0% and 58.2%, respectively. The 5-year DFS for patients with stage ⅡB, ⅢA, ⅢB, ⅢC were 71.2%, 60.5%, 51.6%, 33.3%, respectively. The 5-year OS for patients with stage ⅡB, ⅢA, ⅢB, ⅢC were 71.2%, 62.2%, 54.1%, 39.3%, respectively. Multivariate analysis showed that age >65 years (DFS: HR=1.402, 95% CI: 1.022 to 1.922, P=0.036; OS: HR=1.461, 95% CI: 1.057 to 2.019, P=0.022), lymph node dissection number less than 25 (DFS: HR=1.348, 95% CI: 1.019 to 1.779, P=0.036; OS: HR=1.376, 95% CI: 1.035 to 1.825, P=0.028), pathological stage Ⅲ (DFS: HR=2.131, 95% CI: 1.444 to 3.144, P<0.01; OS: HR=2.079, 95% CI: 1.406 to 3.074, P<0.01), and no postoperative chemotherapy (DFS: HR=3.127, 95% CI: 2.377 to 4.113, P<0.01; OS: HR=3.768, 95% CI: 2.828 to 5.020, P<0.01) were independent prognostic factors for the decrease in DFS and OS rates. Conclusions:Laparoscopic radical gastrectomy for locally advanced gastric cancer with serosa-invasion could achieve satisfactory long-term oncological outcomes. More lymph node dissection and standardized postoperative adjuvant chemotherapy are expected to further improve the prognosis of patients with locally advanced gastric cancer with serous invasion after laparoscopic radical surgery.
3.Heterogeneous nuclear ribonucleoprotein H1 and its function in tumor development and metastasis
Zongwen ZHANG ; Li FENG ; Zhisong FAN
Journal of Shanghai Jiaotong University(Medical Science) 2024;44(12):1615-1620
Heterogeneous nuclear ribonucleoprotein(hnRNP)and heterogeneous nuclear RNA(hnRNA)form complexes that regulate RNA splicing and transportation.hnRNPH1 is a member of the hnRNP family of proteins and plays an important role in physiological processes,including embryonic development of the nervous and reproductive systems.hnRNPH1 is highly expressed in various tumor tissues and tumor cells,and its overexpression correlates with poor prognosis in patients.hnRNPH1 enhances tumor cell proliferation and metastasis through the regulation of alternative splicing of genes,modulation of gene expression,formation of fusion genes with other genes,and involvement in epigenetic regulation.Recent studies have shown that hnRNPH1 could serve as a potential biomarker for certain tumors,and hnRNPH1-targeting drugs show preliminary efficacy in a mouse model of melanoma.This article reviews the role and research progress of hnRNPH1 in the initiation and progression of malignant tumors.
4.Heterogeneous nuclear ribonucleoprotein H1 and its function in tumor development and metastasis
Zongwen ZHANG ; Li FENG ; Zhisong FAN
Journal of Shanghai Jiaotong University(Medical Science) 2024;44(12):1615-1620
Heterogeneous nuclear ribonucleoprotein(hnRNP)and heterogeneous nuclear RNA(hnRNA)form complexes that regulate RNA splicing and transportation.hnRNPH1 is a member of the hnRNP family of proteins and plays an important role in physiological processes,including embryonic development of the nervous and reproductive systems.hnRNPH1 is highly expressed in various tumor tissues and tumor cells,and its overexpression correlates with poor prognosis in patients.hnRNPH1 enhances tumor cell proliferation and metastasis through the regulation of alternative splicing of genes,modulation of gene expression,formation of fusion genes with other genes,and involvement in epigenetic regulation.Recent studies have shown that hnRNPH1 could serve as a potential biomarker for certain tumors,and hnRNPH1-targeting drugs show preliminary efficacy in a mouse model of melanoma.This article reviews the role and research progress of hnRNPH1 in the initiation and progression of malignant tumors.
5.Effects of probiotics on intestinal flora, intestinal function and T lymphocyte level in patients with cervical cancer after radiotherapy
Ting CHAI ; Songjie ZHANG ; Rui SONG ; Yanli DUANMU ; Jinjin YUAN ; Ge HOU ; Alan CHU ; Yangyang HUANG ; Shijia LIU ; Zongwen LIU
Chinese Journal of Primary Medicine and Pharmacy 2023;30(7):1012-1017
Objective:To investigate the effects of probiotics on intestinal flora, intestinal function, and T lymphocyte level in patients with cervical cancer after radiotherapy.Methods:A total of 92 patients with cervical cancer who underwent pelvic radiotherapy in The Second Affiliated Hospital of Zhengzhou University from September 2020 to February 2022 were included in this study. They were randomly divided into control and experimental groups ( n = 46/group). The patients in the experimental group took probiotics during radiotherapy, while the patients in the control group did not take probiotics during radiotherapy. The amount of intestinal flora, D-lactic acid, diamine oxidase, and T lymphocyte subset levels pre- and post-radiotherapy were compared between the two groups. Urinary lactulose (L) and mannitol (M) concentrations were determined in each group. Urinary excretion ratios of L to M were calculated. Results:After 10, 15, and 20 times of radiotherapy and after all radiotherapies, the amount of Escherichia coli and Enterococcus in the experimental group was significantly lower than that in the control group ( F = 128.60, 224.99, all P < 0.05). The amount of Bifidobacteria and Lactobacilli in the experimental group was significantly higher than that in the control group ( F = 2 065.46, 948.23, both P < 0.05). After 10, 15, and 20 times of radiotherapy and after all radiotherapies, plasma D-lactic acid level in the experimental group was (9.34 ± 1.63) μg/L, (9.15 ± 1.36) μg/L, (8.68 ± 1.06) μg/L, and (8.05 ± 0.82) μg/L, respectively. After 10, 15, and 20 times of radiotherapy and after all radiotherapies, plasma diamine oxidase level in the experimental group was (86.34 ± 20.25) μg/L, (84.28 ± 17.45) μg/L, (80.40 ± 13.35) μg/L, and (76.85 ± 10.87) μg/L, respectively, and urinary excretion ratio of L to M in the experimental group was (1.84 ± 0.16), (1.55 ± 0.12), (1.26 ± 0.09), (0.98 ± 0.06), respectively, all of which were significantly lower than those in the control group ( F = 121.60, 31.73, 417.84, all P < 0.05). After 10, 15, and 20 times of radiotherapy and after all radiotherapies, CD4 + level in the experimental group was (39.80 ± 4.90)%, (40.92 ± 5.30)%, (42.52 ± 6.14)%, (43.83 ± 6.55)%, respectively, CD4 +/CD8 + was (1.52 ± 0.25), (1.63 ± 0.22), (1.71 ± 0.39), (1.83 ± 0.22), respectively, all of which were significantly higher than those in the control group ( F = 58.69, 31.07, all P < 0.05). Conclusion:Probiotics can improve the status of intestinal flora and intestinal barrier function in patients with cervical cancer after radiotherapy, and simultaneously improve the cellular immune function of patients.
6.The clinical application value of CCL21 and its receptor CCR7 in patients with anti⁃neutrophil cytoplasmic antibody associated vasculitis
Mingming Zhang ; Rui Zhang ; Xiaoke Yang ; Zongwen Shuai
Acta Universitatis Medicinalis Anhui 2023;58(9):1589-1593
Objective :
To investigate the clinical application value of chemokine ligand (CCL)21 and its receptor chemokine(CCR)7 in patients with anti⁃neutrophil cytoplasmic antibody associated vasculitis.
Methods :
The ser⁃ um levels of CCL21 and its receptor CCR7 were measured by ELISA methods in 102 patients with AASV and 70 healthy controls. At the same time , the correlation among the CCL21 , CCR7 , MPO , PR3 and general laboratory index of TNF⁃α , IL⁃6 , BUN , CRE , C3 , C4 ESR , CRP , BVAS in AASV patients was analyzed.
Results :
The serum levels of the CCL21 and CCR7 were significantly higher in AASV patients than that in healthy controls[(276. 95 ± 57. 34) vs ( 179. 91 ± 19. 45) ; (85. 85 ± 18. 77) vs (54. 83 ± 18. 18) pg/ml](P < 0. 05) . The serum levels of the CCL21 and CCR7 in MPO positive patients were higher than those in MPO negative patients[(294. 94 ± 58. 15) vs (244. 35 ± 46. 76) ; (90. 64 ± 18. 38) vs (78. 37 ± 13. 44) pg/ml] ( P < 0. 05 ) . Moreover, The levels of the CCL21 and CCR7 were similar to those of TNF⁃α , IL⁃6 , CRE , BUN , CRP , BVAS and MPO in AASV patients, the levels of the CCL21 and CCR7 in AASV patients were positively correlated. The serum levels of the CCL21 and CCR7 were found to be predictive of AASV activity with ROC.
Conclusion
The serum level of CCL21 and CCR7 in AASV patients increased significantly , especially in MPO positive patients , and related to patients with renal function index and related inflammation index. Serum CCL21 and CCR7 are the influencing factors of BVAS in AASV patients , and have important significance in the diagnosis and judgment of AASV disease.
7.Recommendations for diagnosis and treatment of primary biliary cholangitis in China (2021)
Fengchun ZHANG ; Li WANG ; Zongwen SHUAI ; Zhenbiao WU ; Wen ZHANG ; Zhuoli ZHANG ; Jin LIN ; Yan ZHAO
Chinese Journal of Internal Medicine 2021;60(8):709-715
Primary biliary cholangitis is a chronic autoimmune cholestatic disease with a progressive course. This disease is not rare in China, but standardized diagnosis and treatment for primary biliary cholangitis are insufficient. Based on the evidence and guidelines from China and other countries, Rheumatology Branch of Chinese Medical Association developed the recommendations of diagnosis and treatment for primary biliary cholangitis in China. The aim is to help clinicians recognize clinical characters, therapeutic selection and prognosis judgement of primary biliary cholangitis, which will contribute to make diagnosis in time, to select treatment properly and to manage follow-up scientifically.
8.A preliminary study on the change and clinical significance of peptidylarginine deiminase 4 expression on the neutrophils in the peripheral blood from the patients with anti-neutrophil cytoplasmic myeloperoxidase antibody-associated vasculitis
Bowen PANG ; Sen WANG ; Qian HE ; Meijuan ZHENG ; Mingming ZHANG ; Zongwen SHUAI
Chinese Journal of Rheumatology 2020;24(8):536-540
Objective:To investigate the change of peptidylarginine deiminase 4 (PAD4) expression in the neutrophils of peripheral blood of patients with anti-neutrophil cytoplasmic myeloperoxidase antibody-associated vasculitis (MPO-AAV), and to analyze the relationship between the change and disease activity.Methods:Thirty-nine untreated patients with active MPO-AAV (patient group) and thirty-nine healthy volunteers (control group) were enrolled into this study. The PAD4 expressed on neutrophils was detected by flow cytometry (FCM). The serum neutrophil extracellular traps (NETs), fragments from the activated complement C5 (C5a) and anti-neutrophil cytoplasmic myeloperoxidase antibody (MPO-ANCA) were measured by enzyme-linked immuno sorbent assay (ELISA). Their disease activity was evaluated by Birmingham vasculitis activity score (BVAS). All the detected results were compared between the 2 groups by t test, Spearman correlation analysis and multivariate linear regression analysis were employed to analyze the relationship between BVAS and the Lab test results in patient group. Results:The proportion of neutrophil expressing PAD4, the mean fluorescence intensity (MIF) of PAD4, the levels of NETs and C5a in patient group were significantly higher than those in the control group [(71±11)% vs (26±6)%, t=22.456, P<0.01; (33±4) vs (14±4), t=18.668, P<0.01; (0.62±0.22) vs (0.26±0.15), t=8.466, P<0.01 and (4.6±1.0) vs (2.9±1.0), t=7.697, P<0.01, respectively]. In patient group, BVAS was positively associated with the proportion of PAD4 + neutrophil, MFI of PAD4, the serum level of NETs, C5a and MPO-ANCA ( r=0.843, P<0.01; r=0.821, P<0.01; r=0.411 1, P<0.01; r=0.613, P<0.01 and P=0.790, P<0.01, respectively), however, the results of multiple linear regression analysis showed only the percentage of PAD4 + neutrophils and the level of MPO-ANCA were independent influencing factors on BVAS ( β=0.324 6, P<0.01 and β=0.796, P<0.01, respectively). Conclusion:The percentage of neutrophils expressed PAD4 in the peripheral blood of patient with active MPO-AAV is significantly increased, and it is an independent factor affecting the disease activity. Intervention on this expression might be a potential new pathway for MPO-AAV treatment.
9.Development and verification of an FLP/FRT system for gene editing in Bacillus licheniformis.
Zongwen LI ; Youran LI ; Zhenghua GU ; Zhongyang DING ; Liang ZHANG ; Sha XU ; Guiyang SHI
Chinese Journal of Biotechnology 2019;35(3):458-471
Few tools of gene editing have been developed in Bacillus licheniformis at present. In order to enrich the tools, an FLP/FRT gene editing system that can repeatedly use a single selectable marker was constructed in Bacillus licheniformis, and the system was verified by knocking out an alpha amylase gene (amyL), an protease gene (aprE) and knocking in an exogenous Vitreoscilla hemoglobin gene (vgb). First, knock-out plasmids pNZTT-AFKF of amyL and pNZTT-EFKF of aprE were constructed using thermosensitive plasmid pNZT1 as a carrier. The two knock-out plasmids contained respective homology arms, resistance genes and FRT sites. Then the knock-out plasmids were transformed into Bacillus licheniformis and the target genes were replaced by respective deletion cassette via twice homologous exchange. Finally, an expression plasmid containing FLP recombinase reading frane was introduced and mediated the excision of resistance marker. In order to expand the practicability of the system, knock-in plasmid pNZTK-PFTF-vgb was constructed, with which knock-in of vgb at pflB site was carried out successfully. The results showed that amyL and aprE were successfully knocked out and the marker kanamycin cassette exactly excised. The activities of amylase and protease of deletion mutants were reduced by 95.3% and 80.4% respectively. vgb was successfully knocked in at pflB site and the marker tetracycline cassette excised. The expression of integrated vgb was verified via real-time PCR. It is the first time to construct an FLP/FRT system for gene editing in Bacillus licheniformis, which could provide an effective technical means for genetic modification.
Bacillus licheniformis
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Gene Editing
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Plasmids
;
Sequence Deletion
10.Isolation and culture of adipose-derived mesenchymal stem cells from inbreed line miniature pig of Wuzhishan and their biological characteristics.
Denggao HUANG ; Hui CAO ; Shunlan WANG ; Linlin ZHENG ; Zongwen CHEN ; Xiaohong WEN ; Shufang ZHANG ; Yang XIANG ; Yuanhui GAO
Journal of Central South University(Medical Sciences) 2019;44(3):297-306
To establish a method for isolation, culture and identification of adipose-derived mesenchymal stem cells (ASCs) from the inbreed line miniature pig of Wuzhishan (ILMW).
Methods: A total of 100 g adipose tissues were obtained from subcutaneous tissues of neck in six-month old healthy ILMW (3 samples, male). ASCs from ILMW (ILMW-ASCs) were isolated from adipose tissues through 0.1% collagenase digestion. The cells at the 3rd, 5th, 8th, 13th passages were collected. Cell morphology, size, phenotype, cell cycle, and apoptosis were monitored. Cell differentiation was induced and cell proliferation curve was drawn.
Results: The ILMW-ASCs, fibroblast-like or whirlpool-like, began the adherence at 36 h and entered a logarithmic phase in the 5th day. Eighty percent of them were fused in the 7th day. The average diameter and volume of ILMW-ASCs were (17.00±0.54) µm and (2.58±0.24)×10-9 L, respectively. The expressions of CD29, CD44 and CD90 were positive, and there was no significant difference between the different passages (all P>0.05). The expressions of CD45, CD8a and HLA-DR were increased with the increase in passages after the 3th passage (all P<0.05). The adipogenic induction of ILMW-ASCs was observed by positive oil red O staining, and the osteogenic induction of ILMW-ASCs was determined by positive alizarin red staining. Apoptosis and senescence occurred in the 13 passage of ILMW-ASCs, and the proportion of S phase of cell cycle was lower than that in lower passages (all P<0.05).
Conclusion: ILMW-ASCs are one of the best choice for porcine ASCs, which might provide a source of candidate stem cells for therapy of large animal disease models and tissue or organ repairment.
Adipose Tissue
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Animals
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Cell Differentiation
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Cells, Cultured
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Male
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Mesenchymal Stem Cells
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Swine
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Swine, Miniature


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