Objective: To investigate the clinical features, morphological characteristics, immunophenotype, and differential diagnosis of goblet cell adenocarcinoma (GCA) in the digestive system. Methods: The clinicopathological data, morphological characteristics, immunophenotypes of 22 cases of GCA in the digestive system diagnosed from January 2010 to January 2021 were collected. Meanwhile, 25 cases of neuroendocrine neoplasm (NEN) and 24 cases of adenocarcinoma were used as controls. Relevant literature was also reviewed. Results: There were 16 males and 6 females, aged from 36 to 79 years with an average of 56 years. The anatomical sites of the 22 GCA were mostly appendix (17 cases) and occasionally extra-appendix (5 cases), including 3 cases in stomach, 1 case in duodenum and 1 case in anal. All 17 cases of appendiceal GCA were pure GCA. Among the 5 cases of extra-appendiceal GCA, One case of gastric GCA was pure, two cases of gastric GCA with NEN or adenocarcinoma, duodenal GCA with NEN and adenocarcinoma, anal GCA with NEN.Low-grade GCAs were composed of goblet, Paneth and neuroendocrine cells, which were arranged in intestinal crypt tubular or cluster structures and distributed in the wall of digestive system. The tubular and cluster structures lacked adhesion. Goblet cells were columnar, located in the base, with clear cytoplasm, small nuclei, inconspicuous atypia, and uncommon mitoses. Extracellular mucus and signet-ring cells with nuclear variations could be seen in some cases. Nerve fiber bundle invasion and tumor thrombus in vessels were often present. High-grade GCAs lacked tubular and cluster structures, and their histological structures were more complex. Tumor cells expressed mixed neuroendocrine and glandular epithelial markers. Similar to the expression patterns of synaptophysin and chromogranin A, CD200 and INSM1 were also dot-like or patch-positive in GCA. Conclusions: GCA is an infrequent tumor of the digestive system and shows the bi-directional differentiation characteristics of neuroendocrine and glandular epithelium. Accurate diagnosis and staging are related to its prognosis.
Adenocarcinoma/pathology* ; Appendiceal Neoplasms/surgery* ; Carcinoid Tumor/surgery* ; Chromogranin A ; Female ; Goblet Cells/pathology* ; Humans ; Male ; Neuroendocrine Tumors/pathology* ; Repressor Proteins ; Synaptophysin

Objective:To investigate the effects of Resolvin D1 (RvD1) on the inflammatory response and the expression of Nod-like receptor protein 3(NLRP3) inflammasomes in mice with acute lung injury.Methods:The 30 male BALB/c mice weighing 25-30 g were divided into 3 groups(each group with 10 mice). Mice in the normal control group were given normal saline by tail vein injection.Mice in the lipopolysaccharide (LPS) group were given the same volume of LPS (10 mg/kg) via tail vein injection.Mice in the RvD1 group were injected with RvD1 (5 μg/kg) through the tail vein 30 minutes prior to LPS administration.Mice were humanely sacrificed after 6 hours.Histopatholo-gical changes of lung tissue, the levels of pro-inflammatory cytokines interleukin(IL)-18 and IL-1β, and the expression of NLRP3 inflammasomes in lung tissue were measured.Results:After LPS administration, the lung of mice showed pathological damage.The levels of pro-inflammatory factors IL-18 and IL-1β as well as the expression of NLRP3, apoptosis-associated speck-like protein containing a card(ASC)and Caspase-1 in the LPS group were significantly higher than those in the normal control group (all P<0.05). After pretreatment with RvD1, the pathological damage of lung tissue was alleviated.The levels of pro-inflammatory factors IL-18 and IL-1β as well as the expression of NLRP3, ASC and Caspase-1 in the RvD1 group were significantly lower than those in the LPS group (all P<0.05). Conclusions:RvD1 can attenuate the pulmonary inflammation in acute lung injury and inhibit the release of pro-inflammatory factors, which is possibly related to the suppression of NLRP3.

Objective To systematically evaluate the efficacy and safety between neoadjuvant therapy followed by radical surgery and definite chemoradiotherapy in the treatment of Ⅰ B2-Ⅱ B cervical cancer.Methods A computerized search was performed in PubMed,Embase,Cochrane Library,Web of Science,CBM,Wanfang Data,CNKI and VIP to collect controlled clinical trials related to neoadjuvant therapy followed by radical surgery versus definite chemoradiotherapy in the treatment of ⅠB2-ⅡB cervical cancer.The meta-analysis of survival data and adverse events was performed by Review Manager 5.3 software.Results Nine controlled clinical trials involving 3 914 patients were included in this meta-analysis.There were no significant differences in overall survival (HR =0.83,P =0.31) and progression-free survival (HR=O.85,P=0.57) between two groups.Compared with patients receiving definite chemoradiotherapy,those in the neoadjuvant therapy group had a significantly lower risk of irradiation enteritis (RR=0.27,P=0.03),whereas no significant difference was observed in the risk of irradiation cystitis (RR=0.30,P=0.34) and grade ≥ 3 neutropenia (RR=0.77,P=0.46) between two groups.Conclusion In the treatment of locally advanced ⅠB2-Ⅱ B cervical cancer,two modalities show similar survival benefits.Although the neoadjuvant therapy group yields a lower incidence of irradiation enteritis,the incidence rates of irradiation cystitis and grade ≥3 neutropenia do not significantly differ between two groups.Neoadjuvant therapy followed by radical surgery is not superior to the standard therapeutic regime.

treatment of LS-SCLC, two fractionation modes show similar short-term efficacy and survival benefits. However, hyperfractionated radiotherapy causes a higher incidence of radiation esophagitis than conventionally fractionated radiotherapy. Given that hyperfractionated radiotherapy is not superior to conventionally fractionated radiotherapy,conventionally fractionated radiotherapy is recommended for treating LS-SCLC.

Objective To investigate the effect of liver kinase B1(LKB1) on the radiosensitivity of subcutaneous xenograft tumor of lung cancer H460 cells in nude mice.Methods Human lung cancer H460 cells were implanted into female nude mice (BALB/c-nu) to establish a subcutaneous xenograft tumor model of lung cancer.A total of 24 female nude mice in which the model was successfully established were equally and randomly divided into four groups:pEGFP-Ctrl plasmid (empty vector plasmid) group, irradiation (IR)+pEGFP-Ctrl plasmid group, pEGFP-LKB1 plasmid (overexpressing LKB1) group, and IR+pEGFP-LKB1 plasmid group.The growth of xenograft tumors was observed and the tumor inhibition rate and enhancement factor (EF) were calculated.The expression of LKB1 in each group was measured by immunohistochemistry and Western blot to analyze the relationship between LKB1 and radiosensitivity.Results Compared with the pEGFP-Ctrl plasmid group, the IR+pEGFP-Ctrl plasmid group, pEGFP-LKB1 plasmid group, and IR+pEGFP-LKB1 plasmid group showed varying degrees of inhibition of tumor growth, particularly in the IR+pEGFP-LKB1 plasmid group, and the tumor inhibition rates were 31.30%, 14.78%, and 43.48%, respectively.The EF of LKB1 in the IR+pEGFP-LKB1 plasmid group was 1.18.The immunohistochemistry and Western blot showed that LKB1 could be effectively expressed in the pEGFP-LKB1 plasmid group and IR+pEGFP-LKB1 plasmid group, but not in the other two groups.Conclusions The subcutaneous xenograft tumor model of human lung cancer H460 cells has been successfully established in nude mice.LKB1 has a radiosensitizing effect on the subcutaneous xenograft tumor of lung cancer H460 cells in nude mice.

Objective To evaluate the efficacy of the combined therapy of ReDuNing injection and acyclo-vir on children with infectious mononueleosis(IM). Methods From October 2012 to July 2015 in the emergency ward of Children′s Hospital of Nanjing Medical University ,167 cases diagnosised with infectious mononucleosis were enrolled in this study. Ninety-five cases received acyclovir treatment were recruited in the conventional treat-ment group,72 cases received the combined thrapy of ReDuNing injection and acyclovir of children were recruited in the observation group. The clinical symptoms ,clinical manifestation and blood routine ,liver and kidney func-tion,myocardial enzymes,temperature recovery time,reduce lymph node,liver function recovery time and hospi-talization time of patients were recorded and compared between the two groups. Results No significant differences were observed in the clinical course and general fever,pharyngitis,lymphadenopathy,hepatosplenomegaly,rash and eyelid edema in children of the observation group (ReDuNing + Acyclovir) and routine treatment group (Acyclovir). No significant differences were found in blood routine ,blood biochemical indexes of liver ,kidney function and myocardial enzymes in patients of the two groups before and after treatment. The white blood cells , ALT and LDH were significantly reduced in patients of the two groups after treatment(P<0.05). However,LDH was still high in patients of the two groups before discharge ,with the level of(355.63 ± 116.89)U/L and(347.79 ± 106.74)U/L,respectively. The pyretolysis time(2.97 ± 2.56)d,lymph node reduced time(9.08 ± 1.54)d,liver function recovery time(8.67 ± 2.35)d,white blood cell recovery time(6.76 ± 2.96)d,hospitalization time (11.10 ± 3)d in the observation group were significantly shortened than those in the conventional treatment group ((4.38 ± 2.70)d,(10.48 ± 3.62)d,(11.50 ± 3.71)d,(9.15 ± 3.24)d,12.32 ± 3.62)d,respectively)(P<0.05, respectively). Conclusions The fever,lymphadenopathy,leukocytosis,liver damage and LDH were relieved and reduced at different degrees in patients of both the observation group and the routine treatment group after treat-ments. Reduning combined with acyclovir treatments lead to better clinical efficacy in children ,with shortening the duration of fever,Lymph node reduction time,and white blood cell recovery time. In particularly,the combined therapy can shorten the recovery time of patients with liver function damage ,which is a safe clinical application and can be used as one of the effective treatment measures for children with infectious mononucleosis.

Objective To evaluate the effectiveness of intravenous immunoglobulin (IVIG) in critical hand-foot-mouth disease (HFMD).Methods The data from PubMed, MEDLINE, EMBASE, EBSChost, Cochrane Library, Cochrane Central Register of Controlled Trials, Ovid, China Biology Medicine disc, Wanfang Data, China National Knowledge Infrastructure, Chinese Citation Database, and other references and grey literatures were retrieved, screening out all those related to clinical trials on treating critical HFMD by IVIG.Standard methods of the Cochrane Collaboration were employed to evaluate the methodological quality of the trials.Meta analysis was performed with Rev man 5.3 software.Results Eleven trials including 967 cases were investigated.The meta analysis showed that IVIG had significantly clinical efficacy (OR =6.84,95％ CI:3.74-12.52 ,P ＜ 0.05).IVIG could significantly decrease duration of fever (MD =-1.94,95％ CI:-3.07--0.81 ,P ＜0.05) ,hospitalization time (MD =-4.56,95％ CI:-8.95--0.17,P ＜0.05).There was no significant difference in duration of fever (MD =-0.28,95 ％ CI:-0.59-0.03, P ＞ 0.05), duration of herpes (MD =0.18,95％ CI:-0.22-0.59, P ＞ 0.05), hospitalization time (MD =-0.12,95％ CI:-0.47-0.23, P ＞ 0.05) when the dosage of injection was adjusted.Conclusions IVIG is recommended for treating critical HFMD because it is effective in decreasing the duration of fever and hospitalization.Well designed studies with more sample in multi-center are required in further study to explore the efficacy and safety of IVIG on critical HFMD.

Objective This study intends to explore the impacts of the establishment of chest pain center(CPC) on the door-to-balloon(D-to-B) time in patients with ST-elevation myocardial infarction (STEMI) by different transfer ways to hospital. Methods A regular CPC and a regional cooperative network were established based on the pre-hospital transmitted real-time 12-lead electrocardiogram system. The STEMI patients were divided into the following three groups by the different transfer ways to hospital before and after the establishment of chest pain center:self-referral groups (group A1, n=52, and group A2, n=65), EMS (emergency medical service ) groups (group B1, n=31, and group B2, n=92) and transfer PCI groups (group C1, n=23, and group C2, n=552). The mean D-to-B time and the rate of D-to-B below 90 minutes were compared between before and after the establishment of CPC and the reasons of reperfusion delay were analyzed. Results There were no statistical differences of the average D-to-B time [(123±78) min vs.(140±123)min, P > 0.05] and the rate of D-to-B time below 90 min (44.2%vs. 46.2%) between group A1 and group A2. The average D-to-B time was significantly shortened in group B2 [(89±66)min] while compared with that in group B1 [(155±115)min, P<0.05] and the rate of D-to-B time below 90 min was remarkably elevated in group B2 compared with that of group B1 (69.6%vs. 32.3%, P<0.05). The average D-to-B time was significant shorter in group C2 than in group C1 [(77±43)min vs. (337±662)min, P<0.05] and the rate of D-to-B time below 90 min was remarkable higher in group C2 than in group C1 (75.7%vs. 21.7%, P<0.05). The longer D-to-B time in self-referral groups was mainly due to the delay of getting informed consent before PCI when occupied catheterization laboratory was the major cause of reperfusion delay in EMS groups and transfer PCI groups. Conclusions The establishment of CPC may significantly shorten the D-to-B time and increase the rate of D-to-B time below 90 min for these patients admitted by EMS and transferred from non-PCI hospitals. However, the pathway for the self-referral patients should be further modified.

Objective To evaluate the pre-hospital diagnostic reliability of real-time tele-transmission of 12-lead electrocardiogram of patients with ST-segment elevated acute myocardial infarction (STEMI).Methods The 12-lead electrocardiogram was simultaneously recorded with real-time tele-transmission system and a conventional electrocardiograph in 40 STEMI cases.The width and amplitude of each wave,the deviated amplitude of ST-segment in the same leads were compared by t-test and rank-sum test.Results There were no statistical differences in the width and amplitude of P wave,QRS wave and t wave as well as the deviated altitude of ST-segment between the two separate electrocardiographs (P ＞0.05).There was a significant positive correlation between the two ECG devices in respect of ST-segment elevated altitude (r =0.912,P =0.000).The differential ability of ST-segment elevation between two separate ECG devices kept highly consistent (Kappa value:0.976).Conclusions Real-time tele-transmission of 12-lead electrocardiogram is reliable for the pre-hospital diagnosis of STEMI.

To explore the effects of Qushi Huayu Decoction (QSHYD), a compound traditional Chinese herbal medicine, in prevention and treatment of non-alcoholic fatty liver disease (NAFLD) in rats.