Early diagnosis, accurate assessment, and localization of peritoneal metastasis (PM) are essential for the selection of appropriate treatments and surgical guidance. However, available imaging modalities (computed tomography [CT], conventional magnetic resonance imaging [MRI], and 18fluorodeoxyglucose positron emission tomography [PET]/CT) have limitations. The advent of new imaging techniques and novel molecular imaging agents have revealed molecular processes in the tumor microenvironment as an application for the early diagnosis and assessment of PM as well as real-time guided surgical resection, which has changed clinical management. In contrast to clinical imaging, which is purely qualitative and subjective for interpreting macroscopic structures, radiomics and artificial intelligence (AI) capitalize on high-dimensional numerical data from images that may reflect tumor pathophysiology. A predictive model can be used to predict the occurrence, recurrence, and prognosis of PM, thereby avoiding unnecessary exploratory surgeries. This review summarizes the role and status of different imaging techniques, especially new imaging strategies such as spectral photon-counting CT, fibroblast activation protein inhibitor (FAPI) PET/CT, near-infrared fluorescence imaging, and PET/MRI, for early diagnosis, assessment of surgical indications, and recurrence monitoring in patients with PM. The clinical applications, limitations, and solutions for fluorescence imaging, radiomics, and AI are also discussed.

In recent years, immunotherapy with immune checkpoint as the target has made revolutionary breakthroughs in the treatment of a variety of advanced solid tumors. Notwithstanding the impressive long-term therapeutic benefits, their efficacy is limited to a small subset of cancer patients. Some patients experienced drug resistance and immune-related adverse events (irAEs). Immune checkpoint inhibitors (ICIs) primarily include antibodies targeting CTLA-4 and antibodies targeting PD-1 and its ligands. Thus, it is of utmost importance to screen potential biomarkers in populations that may benefit from immunotherapy, to maximize therapeutic benefits. This review summarizes the mechanism of ICIs and its related efficacy biomarker, to better guide the application of immunotherapy in clinical practice.

Objective    To evaluate the feasibility and safety of da Vinci robotic surgery for elderly patients with radical surgery of lung cancer. Methods    We retrospectively analyzed the clinical data of 59 patients aged over 70 years who underwent radical surgery of lung cancer in our hospital between 2016 and 2019. These patients were divided into two groups including a da Vinci robot group and a single-utility port video-assisted thoracoscopic surgery (VATS) group according to the patients’ selection of the treatments. There were 32 patients with 20 males and 12 females aged 73.1±2.3 years in the da Vinci robot group and 27 patients with 16 males and 11 females aged 71.2±1.3 years in the VATS group. The clinical data of the two groups were compared. Results    There was no statistical difference in surgery time between the two groups (t=–0.341, P=0.484). Compared with the VATS group, the da Vinci robot group had more number of lymph nodes dissected (t=1.635, P=0.015), less intraoperative blood loss (t=–2.569, P <0.001), less postoperative drainage amount within 3 days after surgery (t=–6.325, P=0.045), lower visual analogue scale (VAS) scores at postoperative 3rd day (t=–7.214, P=0.021). Conclusion    The da Vinci robot system is safe and efficient in the treatment for elderly patients with radical surgery of lung cancer with less trauma.

Objective: To explore the safety, feasibility and advantages of Da Vinci robot "3+ 2" mode in radical gastrectomy. Methods: Clinical data of 30 patients received radical gastrectomy at our department under the "3+ 2" mode of Da Vinci robot from Jan. 2018 to Oct. 2018 were retrospectively analyzed. 30 patients who received classical robot mode in the same period were randomly selected as control group. Results: Compared with the control group, the observation group had a shorter operative time (174±16)min vs.(197±19)min, t=-3.275, P<0.01) , a lower operation costs[(22 794±3 660)yuan vs.(29 307±3 220)yuan, t=-3.316, P<0.01; and inhospital costs (70 910±6 399)yuan vs.(78 180±6 636)yuan), t=-7.316, P<0.01]. Conclusion The "3+ 2" mode of Da Vinci robot in radical gastrectomy is beneficial to enhance the exposure of the surgical field, improve the cooperation of assistants, reduce the costs of surgery, shorten the operative time and the learning curves. In addition, it has similar clinical efficacy to radical gastrectomy under the classical robot mode.

OBJECTIVETo investigate the effects of polyunsaturated fatty acids (PUFA) ω-3 and ω-6, and their middle metabolites PGE2 and PGE3 on angiogenesis formation of gastric cancer, and to explore associated mechanism.

METHODSThe effects of ω-3, ω-6, PGE2, PGE3 on the proliferation and migration of human umbilical vein endothelial cell (HUVEC) were measured by proliferation and migration assay respectively. The angiogenesis assay in vivo was used to measure the effects of ω-3, ω-6, PGE2 and PGE3 on neovascularization. In all the assays, groups without ω-3, ω-6, PGE2 and PGE3 were designed as the control.

RESULTSWith the increased concentration of ω-6 from 1 μmol/L to 10 μmol/L, the proliferation ability of HUVECs enhanced, and the number of migration cells also increased from 28.2±3.0 to 32.8±2.1, which was higher than control group (21.2±3.2) respectively (both P<0.05). With the increased concentration of ω-3 from 1 μmol/L to 10 μmol/L, the proliferation ability of HUVECs was inhibited, and the number of migration cells decreased from 15.8±2.0 to 11.0±2.1, which was lower than control group (22.1±3.0) respectively (both P<0.05). In the angiogenesis assay, compared with control group (standard number: 43 721±4 654), the angiogenesis ability of HUVECs was significantly enhanced by ω-6 in concentration-dependent manner (1 μmol/L group: 63 238±4 795, 10 μmol/L group: 78 166±6 123, all P<0.01). Meanwhile, with the increased concentration of ω-3 from 1 μmol/L to 10 μmol/L, the angiogenesis ability was significantly decreased from 30 129±3 102 to 20 012±1 541(all P<0.01). The proliferation and migration ability of HUVECs were significantly promoted by ω-6 metabolites PGE2 (P<0.05) in a concentration-dependent manner. In contrast, ω-3 metabolites PGE3 significantly inhibited the proliferation and migration ability of HUVECs in a concentration-dependent manner (all P<0.05). After rofecoxib (a COX-2 specific inhibitor) inhibited the expression of COX-2, the expression level of PGE2 was significantly decreased in a dose-dependent manner. In co-culture system, whose gastric cancer cells expressed positive COX-2, ω-6 could increase angiogenesis of gastric cancer cells(P<0.01), but ω-3 could inhibit such angiogenesis(P<0.01). In co-culture system, whose gastric cancer cells did not express COX-2, ω-3 could inhibit the angiogenesis of gastric cancer cells (P<0.05), but ω-6 had no effect on angiogenesis.

CONCLUSIONSThe PUFA ω-6 can enhance the angiogenesis via the promotion of proliferation and migration of HUVECs, and COX-2 and PGE2 may play an important role in this process, whereas, the ω-3 can inhibit the angiogenesis through its middle metabolites PGE3 to inhibit the proliferation and migration of HUVECs. Results of this experiment may provide a new approach to inhibit and prevent the spread of gastric cancer.

Alprostadil ; analogs & derivatives ; pharmacology ; Angiogenesis Inducing Agents ; metabolism ; pharmacology ; Angiogenesis Inhibitors ; pharmacology ; Cell Count ; methods ; Cell Line, Tumor ; drug effects ; physiology ; Cell Migration Assays ; Cell Movement ; drug effects ; Cell Proliferation ; drug effects ; Coculture Techniques ; Cyclooxygenase 2 ; pharmacology ; Dinoprostone ; metabolism ; pharmacology ; Fatty Acids, Omega-3 ; pharmacology ; Fatty Acids, Omega-6 ; metabolism ; pharmacology ; Fatty Acids, Unsaturated ; pharmacology ; Human Umbilical Vein Endothelial Cells ; drug effects ; physiology ; Humans ; Lactones ; pharmacology ; Neovascularization, Pathologic ; physiopathology ; Stomach Neoplasms ; physiopathology ; Sulfones ; pharmacology

BACKGROUND: Insulin-like growth factor 1(IGF-1) plays an important role in regulating osteocyte function and bone metabolism. The association of insulin-like growth factor 1 receptor (IGF-1R) gene polymorphisms with osteoporosis in postmenopausal women has not yet been reported.OBJECTIVE: To investigate the correlation between IGF-1R gene rs2229765 single nucleotide polymorphism and osteoporosis in postmenopausal women.METHODS: IGF-1R gene rs2229765 SNPs were detected using PCR-RFLP in 218 patients with postmenopausal osteoporosis and 270 postmenopausal women with normal bone mineral density. The bone mineral density of the lumbar spine, femoral neck and forearm was determined by dual-energy X-ray absorptiometry. Serum IGF-1 level was investigated by ELISA.RESULTS AND CONCLUSION: The AA genotype (29% vs. 17%, P=0.001) and A allele (51% vs. 40%, P=0.000)distributions of the rs2229765 polymorphism in the osteoporosis group were significantly higher than those in the control group. Compared with GG genotype of rs2229765, AA genotype was significantly associated with an increased risk of osteoporosis (OR=2.12, 95%CI=1.27-3.54, P=0.004). The analysis of serum IGF-1 showed that osteoporotic women with rs2229765AA (P=0.007) and GA (P=0.016) genotype were found to have a lower serum IGF-1 level than osteoporotic women with GG genotype. Our results indicate that the IGF-1R gene rs2229765 polymorphism capable of regulating serum IGF-1 level is associated with postmenopausal osteoporosis.

Objective To evaluate preoperative multislice CT angiography (MSCTA) in guidance for laparoscopic right colon cancer the complete mesocolon resection (CME).Methods From September 2014 to May 2016 data of 24 patients undergoing laparoscopic CME right colon cancer surgery,were reviewed for the guidance of MSCTA over operative surgery.Results Preoperative MSCTA clearly showed superior mesenteric vascular anatomical variation and its branch,which was in closely consistent with that seen during the operation.The superior mesenteric arteries and veins (SMA/SMV) and the ileum colon arteries and veins (ICA/ICV) were seen in all the 24 cases.There are four main types anatomic variation of gastrocolic trunk (Henle trunk),of which most often consisting of three branchs (type B),accounting for about 46％.The time of completely dissecting anatomical Henle trunk was significantly longer than that for the ileum colon vessels and the middle vessels dissection (P ＜ 0.05).Conclusion Preoperative MSCTA can clearly present anatomic variation of SMV/SMA and its branch,precisely navigate the laparoscopic right colon cancer CME surgery,reducing the incidence of intraoperative vascular complications and improving the quality of surgery.

ObjectiveTostudytheinhibitioneffectof c-mycASODN(antisense oligodeoxynucleotide) and 5-FU (5-fluorouracil) on the expression of c-myc gene and the proliferation of human hepatomacellsHEPG-2. MethodsAfter treatedbyliposomemediatedc-mycantisense phosphorothioate oligodeoxynucleotide (APSODN) and 5-FU, the growth inhibition rate was detected by MTT assay, the expression of c-myc mRNA was detected by RT-PCR and immunohistocehemical methods HEPG-2cells. The cell cycle was analyzed by flow cytometric analysis. The morphological changes were observed by fluorescence staining and cellular genome electrophoresis. ResultsAfter sealing c-myc gene with ASODN,the growth of cells was repressed and the effect was time-dependent and dose-dependent ( P = 0. 02 ). The ability of proliferation decreased, the expression of c-myc gene was inhibited on transcription and translation levels; 5-FU can induce apoptosis of hepatoma cells HEPG-2 dramatically with the dose of 10 μ mol/L, when treated by both c-myc ASODN and 5-FU, HEPG-2 cells was induced apoptosis in a cooperative style ( P =0. 01 ).ConclusionsThe liposome mediated c-myc (APSODN) and 5-FU can inhibit the proliferation of HEPG-2 cells by inhibiting the expression of c-myc gene and can induce apoptosis of hepatoma cells HEPG-2 in a cooperative style. c-myc ( APSODN ) can increase the sensitivity of 5-FU to hepatoma cells and decrease the effective concentration of 5-FU.

Objective To study the effect of survivin anfisense oligonucleotides (ASODN)combined with quercetin on proliferation, apoptosis and cell cycle of a hepatocellular carcinoma cell line SSMC-7721 cells. Methods Human hepatocellular carcinoma cell line SSMC-7721 was cultured in vitro,and cells on logarithmic growth phase were used for this experiment. Cell proliferation was measured by MTT assay. The apoptotic rate and cell cycle were examined by flow cytometer (FCM). Morphological change of apoptotic cells were observed by fluorescent microscope. The expression of survivin gene was detected by the method of immunohistochemistry staining and RT-PCR on the mRNA and protein level. Results After sealing survivin gene with ASODN, the proliferation of SSMC-7721 cells was inhibited markedly. FCM analysis showed that there appeared an obvious apoptosis peak after transfection. The inhibitory effect of combined administration of survivin ASODN and quercetin on cell proliferation was much stronger than that of the single way. The result of immunohistochemical and RT-PCR assays showed that survivin ASODN and quercetin inhibited the expression of survivin gene. Conclusion Combined survivin ASODN with quercetin significantly inhibit cell proliferation, down-regulate survivin gene expression and induce the apoptosis of SSMC-7721 cells.

OBJECTIVE To observe bacterial changing-pattern and drug-resistant pattern for reasonable application of antibiotics.METHODS We reviewed the data of 2002-2005 pathogens tests.RESULTS Of 6041 isolated pathogens,2765(45.8%) were Gram-negative bacilli,1350(22.3%) were Gram-positive cocci and 1926(31.9%) were fungi.Fungi increased almost twice,from 18.4% in 2002 to 36.4% in 2005.The most common Gram-negative bacilli were Escherichia coli,Klebsiella pneumoniae and Pseudomonas aeruginosa.While the most common Gram-positive cocci were Staphylococcus epidermidis,S.aureus and Enterococcus faecium.Compared with that in 2002,MRSA,MRSE,ESBLs-producing and AmpC-producing bacilli were significantly increased.Neither strains of S.epidermidis nor strains of S.aureus were found resistant to vancomycin.Carbapenems were the most active antibiotics tested against Gram-negative organisms.CONCLUSIONS We should recognize drug sensitive test as well as restrict the indication of antibiotics application,in order to reduce the occurrence of bacterial resistance.