Objective:To investigate the current status of endoscopic treatment for gastroesophageal varices in portal hypertension in China, and to provide supporting data and reference for the development of endoscopic treatment.Methods:In this study, initiated by the Liver Health Consortium in China (CHESS), a questionnaire was designed and distributed online to investigate the basic condition of endoscopic treatment for gastroesophageal varices in portal hypertension in 2022 in China. Questions included annual number and indication of endoscopic procedures, adherence to guideline for preventing esophagogastric variceal bleeding (EGVB), management and timing of emergent EGVB, management of gastric and isolated varices, and improvement of endoscopic treatment. Proportions of hospitals concerning therapeutic choices to all participant hospitals were calculated. Guideline adherence between secondary and tertiary hospitals were compared by using Chi-square test.Results:A total of 836 hospitals from 31 provinces (anotomous regions and municipalities) participated in the survey. According to the survey, the control of acute EGVB (49.3%, 412/836) and the prevention of recurrent bleeding (38.3%, 320/836) were major indications of endoscopic treatment. For primary [non-selective β-blocker (NSBB) or endoscopic therapies] and secondary prophylaxis (NSBB and endoscopic therapies) of EGVB, adherence to domestic guideline was 72.5% (606/836) and 39.2% (328/836), respectively. There were significant differences in the adherence between secondary and tertiary hospitals in primary prophylaxis of EGVB [71.0% (495/697) VS 79.9% (111/139), χ2=4.11, P=0.033] and secondary prophylaxis of EGVB [41.6% (290/697) VS 27.3% (38/139), χ2=9.31, P=0.002]. A total of 78.2% (654/836) hospitals preferred endoscopic therapies treating acute EGVB, and endoscopic therapy was more likely to be the first choice for treating acute EGVB in tertiary hospitals (82.6%, 576/697) than secondary hospitals [56.1% (78/139), χ2=46.33, P<0.001]. The optimal timing was usually within 12 hours (48.5%, 317/654) and 12-24 hours (36.9%, 241/654) after the bleeding. Regarding the management of gastroesophageal varices type 2 and isolated gastric varices type 1, most hospitals used cyanoacrylate injection in combination with sclerotherapy [48.2% (403/836) and 29.9% (250/836), respectively], but substantial proportions of hospitals preferred clip-assisted therapies [12.4% (104/836) and 26.4% (221/836), respectively]. Improving the skills of endoscopic doctors (84.2%, 704/836), and enhancing the precision of pre-procedure evaluation and quality of multidisciplinary team (78.9%, 660/836) were considered urgent needs in the development of endoscopic treatment. Conclusion:A variety of endoscopic treatments for gastroesophageal varices in portal hypertension are implemented nationwide. Participant hospitals are active to perform emergent endoscopy for acute EGVB, but are inadequate in following recommendations regarding primary and secondary prophylaxis of EGVB. Moreover, the selection of endoscopic procedures for gastric varices differs greatly among hospitals.

OX40 is a costimulatory receptor that is expressed primarily on activated CD4⁺, CD8⁺, and regulatory T cells. The ligation of OX40 to its sole ligand OX40L potentiates T cell expansion, differentiation, and activation and also promotes dendritic cells to mature to enhance their cytokine production. Therefore, the use of agonistic anti-OX40 antibodies for cancer immunotherapy has gained great interest. However, most of the agonistic anti-OX40 antibodies in the clinic are OX40L-competitive and show limited efficacy. Here, we discovered that BGB-A445, a non-ligand-competitive agonistic anti-OX40 antibody currently under clinical investigation, induced optimal T cell activation without impairing dendritic cell function. In addition, BGB-A445 dose-dependently and significantly depleted regulatory T cells in vitro and in vivo via antibody-dependent cellular cytotoxicity. In the MC38 syngeneic model established in humanized OX40 knock-in mice, BGB-A445 demonstrated robust and dose-dependent antitumor efficacy, whereas the ligand-competitive anti-OX40 antibody showed antitumor efficacy characterized by a hook effect. Furthermore, BGB-A445 demonstrated a strong combination antitumor effect with an anti-PD-1 antibody. Taken together, our findings show that BGB-A445, which does not block OX40-OX40L interaction in contrast to clinical-stage anti-OX40 antibodies, shows superior immune-stimulating effects and antitumor efficacy and thus warrants further clinical investigation.
Mice ; Animals ; Receptors, Tumor Necrosis Factor/physiology* ; Receptors, OX40 ; Membrane Glycoproteins ; Ligands ; Antibodies, Monoclonal/pharmacology* ; Antineoplastic Agents/pharmacology*

Objective To investigate the effect of 3S jejunal interposition anastomosis in digestive tract reconstruction after radical resection for early gastroesophageal junction adenocarcinoma. Methods One hundred and eighteen patients of early gastroesophageal junction adenocarcinoma who were planned to receive radical proximal gastrectomy from February 2011 to August 2015 were prospectively enrolled and randomly divided into two groups by table of random number, including observation group (3S jejunal interposition) and control group (esophageal remnant gastric posterior wall anastomosis), with 59 patients in each group. Postoperative complications, operative time, nutritional parameters and postoperative quality of life were compared between two groups. Results The operation time in observation group was (152.3 ± 13.1) min, in control group was (146.0 ± 12.5) min, and there was no significant difference (P>0.05). The rate of complication in observation group was 8.5%(5/59), in control group was 13.6%(8/59), and there was no significant difference (P>0.05). The levels of total protein, albumin, hemoglobin, and Vitamin B126, 12, and 18 months after operation in observation group were significantly higher than those in control group (P<0.05). The rate of reflux esophagitis 6, 12 and 18 months after operation in observation group was significantly lower than that in control group (P<0.05). The gastric emptying time 6, 12 and 18 months after operation in observation group was significantly prolonged, compared with that in control group (P<0.05). The scores of whole quality of life, emotional function, body function, pain, tired, appetite, nausea and vomiting, diarrhea and constipation 6 and 18 months after operation in observation group were significantly better than those in control group (P<0.05). Conclusions The 3S jejunal interposition anastomosis in digestive tract reconstruction after radical resection for early gastroesophageal junction adenocarcinoma is a better method. The effect of antirelux is better and can improve the nutriture and quality of live for long time.

Objective To observe the effect of external use of Curcuma oil on the hyperplasia of mammary glands in rats and explore the mechanism. Methods Sixty female Wistar rats were randomly divided into following groups:normal con-trol group, model control group, Sanjierubi plaster group, low-, medium- and high-dose curcuma oil emulsion groups ( n=10 each).The models of hyperplasia of mammary glands were established by intramuscular injection of estradiol benzoate and proges-terone into the medial part of the rat hind limb.Different doses of medicines were given for 4 consecutive weeks.Enzyme-linked im-munosorbent assay, HE staining and immunohistochemistry were used to investigate the action mechanism of curcuma oil emulsion against mammary gland hyperplasia. Results Curcuma oil emulsion had preventive and therapeutic effects on the hyperplasia of mammary glands.The diameter of breasts was significantly reduced, the body weight restored, serum estradiol, follicle-stimulating hormone and prolactin levels profoundly decreased, progesterone, testosterone and luteinizing hormone levels markedly increased and the number and diameter of lobular acini obviously reduced in high-dose curcuma oil emulsion group when compared with those in model control group (P<0.05 or P<0.01). Conclusion Curcuma oil emulsion can remarkably improve the disturb-ance of serum hormones and inhibit the occurrence of hyperplasia of mammary glands.

Objective To investigate the antireflux effect of esophagogastrostomy combined with modified Nissen fundoplication after esophageal middle cancer resection.Methods Eighty-two patients with esophageal middle cancer were divided into 2 groups by random digits table method,41 cases underwent esophagogastrostomy with a stapler only (control group),41 cases underwent esophagogastrostomy with stapler combined with modified Nissen undoplication (observation group).Three months after surgery,the patients of the 2 groups completed the research of EORTC QLQ-C30 questionnaire,and examined with esophageal manometry and gastroscopy.Results There was no statistical difference in incidence of postoperative complication between the 2 groups (P ＞ 0.05),death was not found during peroperative period.The scores of heart burn and regurgitation in observation group [(13.2 ± 6.1) and (16.9 ± 3.9) scores] were significantly lower that those in control group [(25.6 ± 7.2) and (26.6 ± 4.2) scores],there were statistical differences (P ＜ 0.05),but there was no statistical difference in score of dysphagia between the 2 groups (P ＞ 0.05).The resting pressure of anastomotic site in observation group [(3.5 ± 2.3) mmHg,1 mmHg =0.133 kPa] was significantly higher than that in the stomach [(2.7 ± 2.1) mmHg],there was statistical difference (P＜ 0.05).The DeMeester score was (54 ± 32) scores,control group was (141 t 84) scores,there was statistical difference (P ＜ 0.05).The incidence of reflux esophagitis in observation group was 48.8％(20/41),in control group was 75.6％(31/41),there was statistical difference (P ＜ 0.05).Conclusions Esophagogastrostomy combined with modified Nissen fundoplication after esophageal middle cancer resection significantly increases the pressure at the anastomotic site,thus reduces the extent of gastroesophageal reflux,which leads to the reduction of the extent of reflux esophagitis and the improvement of the quality of life.

Objective To prepare the hydroxysafflor yellow A (HSY-A)enteric coating pellets,and investigate in vitro release and in vivo pharmacokinetic characteristics.Methods HSY-A enteric coating pellets were prepared by extrude-rounding and fluid bed technique.The micromeritic characteristics,the factors affecting the release properties of enteric coating pellets the release mechanism were explored,and the in vivo pharmacokinetic behaviors were also evaluated.Results The in vitro release behavior of HSY-A from enteric coating pellets could be described by Ritger-peppas equation,and fit diffusion mechanism,in vivo pharmacokinetic test confirmed the argument that pellets have good acid residence and enteric properties. Conclusion HSY-A enteric coating pellets have been successfully prepared and the expected release properties is achieved in the study.

Objective To optimize the extraction process of anti-hepatic fibrosis water-soluble component from Carthamus tinctorius L. via the orthogonal method. Methods The influences of type and content of solvent,extraction time,and extraction frequency on processing were investigated by assessing the content of hydroxysafflor yellow A,yield of extraction and anti-hepatic fibrosis potency via the high performance liquid chromatography and enzyme-linked immunosorbent assay by L9(3)4 orthogonal test. Results The optimum extracting condition for the anti-hepatic fibrosis water-soluble component from carthamus tinctorius L. was as follows: extracting with 10 times the volume of 10% ethanol for twice, 0. 5 h in each. Conclusion The process is scientific and feasible, which serves as a guideline for the production of the anti-hepatic fibrosis water-soluble components.

Objective To study wether dezocine (DZ) can attenuate neuropathic pain in rats and to investigate its mechanism.Methods Neuropathic pain was induced by tight ligation of the left L5 spinal nerve of the male SD rats. 24 Spinal nerve ligation (SNL) model rats were randomly divided into three groups:the first group (saline group, n=8), rats were given intraperitoneal injection of 1ml of saline 14 days after SNL surgery; the second group (dezocine group, n=8), rats were given intraperitoneal injection of 5mg/kg of dezocine in 1ml saline 14 days after SNL surgery;the third group (morphine group,n=8),rats were given intraperitoneal injection of 5 mg/kg of morphine 14 days after SNL surgery. Results Intraperitoneal injection dezocine and morphine had significant analgesic effect in neuropathic pain rats. This analgesic effect lasted for 4-6 hours.Continuous injection of morphine for 3 days produced significant tolerance, while continuous injection of dezocine for 7 days still had significant analgesic effect on neuropathic pain. Conclusion Intraperitoneal injection of dezocine and morphine can attenuate SNL neuropathic pain, continuous injection of morphine for 3 days can produce significant tolerance, while continuous injection of dezocine for 7 days still has significant analgesic effect on neuropathic pain.

ObjectiveTo compare the intraoperative wake-up test in patients undergoing scoliosis surgery with different anesthesia methods.MethodsForty ASA Ⅰ patients aged 13-18 yr with body mass index ＜ 30 kg/m2 scheduled for scoliosis surgery were randomly divided into 2 groups ( n =20 each): propofol combined sufentanil anesthesia group (group P) and sevoflurane combined sufentanil anesthesia group (group S).Anesthesia was induced with target-controlled infusion of sufentanil(target effect-site concentration 0.5 ng/ml),and iv injection of etomidate 0.3 mg/kg in both groups.Tracheal intubation was facilitated with 0.15 mg/kg cisatracurium when patients lost consciousness.The patients were mechanically ventilated.Anesthesia was maintained with target-controlled inhalation of sevoflurane (target end-tidal concentration 0.8％-1.5％ ) in group S,and target-controlled infusion of propofol (target plasma concentration 3-5 μg/ml) in group P,and target-controlled infusion of sufentanil (target effect-site concentration 0.2-0.3 ng/ml),and iv infusion of cisatracurium 0.1 mg· kg-1· h-1 in both groups.BIS value was maintained at 40-60.Cisatracurium administration was terminated and target effect-site concentration of sufentanil decreased to 0.1 ng/ml before wake-up test,5 min later,sevoflurane and propofol administration were terminated,and 5 min later wake-up test was performed.MAP and HR were recoreded during wake-up test.The wake-up time and advers effect (bucking,restlessness and awareness)were recorded.Results The wake-up time was significantly shorter in group S than in group P( P ＜ 0.05).MAP and HR were in normal range during wake-up test in both groups,and bucking,restlessness and awareness were not found in both groups.ConclusionTarget-controlled inhalation of ssvoflurane combined with sufentanil can be safely and effectively used for intraoperative wake-up test in patients undergoing scoliosis surgery,and the wake-up time is shorter than that with propofol combined sufentanil,and it is an apporiate anesthetic technique for the intraoperative wake-up test.

Objective To evaluate the detection of serum pepsinogen (PG) in screening of gastric cancer. Methods (1) To calculate the detection rate of gastric cancer in PG Positive patients from northeastern, noah-western and northern China. (2) To determine the PG positive rate in patients with chronic superficial and atrophic gastritis. (3) To calculate the detection rate of gastric cancer, H. pylori infection and esophageal cancer in PG positive patients from gastric cancer high risk areas. Results (1) The detection rate of gastric cancer in PC, positive patients from Changchun (northeastern China), Xihing (northwestern China) and Beijing ( northern China) was 22. 58%, 25. 2% and 0, respectively. The sensitivity of PG to seeen gastric cancer in Changchun and Xihing was 50. 9% and 35.6%, and the specificity was 82. 56% and 85.69%, respectively. (2) Only 25% of patients with chronic atrophic gastritis were PG positive. (3) The serum PG level was measured in 2346 cases from gastric cancer high risk areas, and PG positive rate was 27.02% (634/2346), in which 496 patients (76. 65%, 496/634) received endoscopy, and gastric cancer was detected in 10 (2. 02%, 10/496), including 9 cases of early gastric caner. The prevalence of gastric cancer was 0. 43% in common population and 1.58% in PG positive population. The infection rate of H. pylori was 70. 73% in 2346 subjects and 2 cases of esophageal cancer, including 1 case of early cancer was diagnosed. Conclusion Serum PG level cannot be used as a marker for gastric cancer or atrophic gastritis, while it may be of value for gastric cancer screening in high risk areas.