Comparative analysis of two digestive tract reconstruction methods in total laparoscopic radical total gastrectomy

BACKGROUND The incidence of gastric cancer has significantly increased in recent years.Surgical resection is the main treatment,but the method of digestive tract reconstruction after gastric cancer surgery remains controversial.In the current study,we sought to explore a reasonable method of digestive tract reconstruction and improve the quality of life and nutritional status of patients after surgery.To this end,we statistically analyzed the clinical results of patients with gastric cancer who underwent jejunal interposition double-tract reconstruction(DTR)and esophageal jejunum Roux-en-Y reconstruction(RY).AIM To explore the application effect of DTR in total laparoscopic radical total gastrectomy(TLTG)and evaluate its safety and efficacy.METHODS We collected the relevant data of 77 patients who underwent TLTG at the Fourth Hospital of Hebei Medical University from October 2021 to January 2023.Among them,35 cases were treated with DTR,and the remaining 42 cases were treated with traditional RY.After 1:1 propensity score matching,the cases were grouped into 31 cases per group,with evenly distributed data.The clinical characteristics and short-and long-term clinical outcomes of the two groups were statistically analyzed.RESULTS The two groups showed no significant differences in basic data,intraoperative blood loss,number of lymph node dissections,first defecation time after operation,postoperative hospital stay,postoperative complications,and laboratory examination results on the 1st,3rd,and 5th days after operation.The operation time of the DTR group was longer than that of the RY group[(307.58±65.14)min vs(272.45±62.09)min,P=0.016],but the first intake of liquid food in the DTR group was shorter than that in the RY group[(4.45±1.18)d vs(6.0±5.18)d,P=0.028].The incidence of reflux heartburn(Visick grade)and postoperative gallbladder disease in the DTR group was lower than that in the RY group(P=0.033 and P=0.038).Although there was no significant difference in body weight,hemoglobin,prealbumin,and albumin between the two groups at 1,3 and 6 months after surgery,the diet of patients in the DTR group was better than that in the RY group(P=0.031).CONCLUSION The clinical effect of DTR in TLTG is better than that of RY,indicating that it is a more valuable digestive tract reconstruction method in laparoscopic gastric cancer surgery.

Emodin induces apoptosis in human prostate cancer cell LNCaP

Aim： To elucidate effects and mechanisms of emodin in prostate cancer cells. Methods： Viability of emodin-treated LNCaP cells and PC-3 cells was measured by MTT assay. Following emodin treatments, DNA fragmentation was assayed by agarose gel electrophoresis. Apoptosis rate and the expression of Fas and FasL were assayed by flow cytometric analysis. The mRNA expression levels of androgen receptor （AR）, prostate-specific antigen （PSA）, p53, p21, Bcl-2, Bax, caspase-3, -8, -9 and Fas were detected by RT-PCR, and the protein expression levels of AR, p53 and p21 were detected by Western blot analysis. Results： In contrast to PC-3, emodin caused a marked increase in apoptosis and a decrease in cell proliferation in LNCaP cells. The expression of AR and PSA was decreased and the expression of p53 and p21 was increased as the emodin concentrations were increased. In the same time, emodin induced apoptosis of LNCaP cells through the upregulation of caspase-3 and -9, as well as the increase of Bax/Bcl-2 ratio. However, it did not involve modulation of Fas or caspase-8 protein expression. Conclusion： In prostate cancer cell line, LNCaP, emodin inhibites the proliferation by AR and p53-p21 pathways, and induces apoptosis via the mitochondrial pathway.

Imaging findings of primary pulmonary synovial sarcoma with secondary distant metastases:A case report

BACKGROUND Synovial sarcoma(SS)accounting for 6%-10%of primary soft tissue malignancies mainly occurs in deep soft tissue adjacent to joints of the limbs.Primary pulmonary SS(PPSS)is rare and has a poor prognosis.Cases of secondary distant metastases of PPSS occur rarely and there is a lack of corresponding imaging reports.We summarized the imaging findings of PPSS with multiple metastases confirmed by surgery and pathology,and shared valuable information on PPSS.CASE SUMMARY A 43-year-old female patient had a solid space occupying lesion in the right upper lobe of the lung.The results of a hemogram,erythrocyte sedimentation rate(ESR)and tumor markers were all within the normal range,tuberculin skin test(5 TU PPD)was negative(-).Chest computed tomography examination showed similar round soft tissue density in the posterior segment of the right upper lobe.Thoracoscopic-assisted wedge resection of the right upper lobe of the lung,right upper lobe resection and lymph node dissection were performed.Nine months after surgery,ultrasound examination showed multiple metastases on the chest wall and kidney.CONCLUSION PPSS is a rare malignant lung tumor with strong invasiveness,early distant metastasis and poor prognosis.There are very few imaging reports.PPSS is often manifested as irregular tumor and calcification,and the metastases have extremely low echo on ultrasonography.Contrast-enhanced ultrasound indicates that the arterial phase of tumor metastases shows rapid centripetal high enhancement,manifested as“fast forward and fast regression”.

The inhibitory effects of NKX3.1 on IGF- 1R expression and its signalling pathway in human prostatic carcinoma PC3 cells

NKX3.1, which is a prostate-specific homeobox gene, plays an important role in prostate cancer and usually functions as a tumour suppressor gene. In this study, we investigated the inhibitory effect of NKX3,1 on insulin-like growth factor （IGF）- 1R expression and its downstream signalling pathway in PC3 cells, PC3 cells were stably transfected with NKX3.1 expression plasmid （pcDNA3.1-NKX3.1） or vector plasmid （pcDNA3.1＋）. The IGF-IR mRNA and protein expression levels were assessed in PC3-NKX3.1 transfectants by reverse transcriptase-polymerase chain reaction （RT-PCR） and Western blotting. The expression and activation of IGF-1/IGF-1R downstream signalling targets were examined by Western blotting and luciferase reporter assay. The cells were subsequently treated with relevant concentrations of IGF-1. The effect of IGF-1 on cell growth was examined by 3-（4,5）-dimethylthiahiazo（-z-yl）-3, 5-diphenytetrazoliumromide （MTT） assay and flow cytometry analysis. A significant suppression of IGF-1R mRNA and protein expression was observed after forced expression of NKX3.1 in PC3 cells. Correspondingly, the forced expression of NKX3.1 decreased IGF-l-induced phosphorylation of extracellular signal-regulated kinase 1/2 （ERK1/2） and protein kinase B （AKT） and activation of the Elk-1 transcription factor and downregulated the expression of the downstream target genes c-fos and cyclin D1. Furthermore, the forced expression of NKX3.1 inhibited IGF-l-induced cell growth. In conclusion, NKX3.1 could downregulate IGF-1R expression and could inhibit IGF-1R-mediated mitogen-activated protein kinase （MAPK）/ERK and AKT signalling pathways, which might partially leads to the inhibition of IGF-l-induced cell growth. This study provides new insights into the molecular mechanisms that NKX3,1 exerts against prostate cancer and ultimately expands the scope of alternative approaches in advanced prostate cancer therapy.

Work experience of special workers returning to work after the public health emergency:taking ICU nurses who have been infected with COVID-19 as example

Objective:The occurrence of some public health events inevitably endangers medical personnel,and medical personnel,as a special group,have to resume work on time to treat patients.This coronavirus disease-2019(COVID-19)infection is a good example,and what intensive care unit(ICU)nurses experience as the primary caregivers of critically ill patients after COVID-19 infection is our focus.To explore the work experience of ICU nurses after recovery from COVID-19,and to provide a theoretical basis for the intervention to improve the physical and mental health level and work experience of special workers in public health emergencies.Methods:We conducted an explorative descriptive study using an inductive thematic analysis.Using the maximum differential sampling method,a semi-structured interview was conducted among 13 ICU nurses suffered from COVID-19 in a tertiary grade A hospital in Qingdao,Shandong Province.This study carried on the theme analysis according to the inductive content analysis method and used MAXQDA 2020 Analytics Pro(VERBI Software GmbH,Berlin,Germany)to manage and summarize the interview data.Results:After being infected by the virus,SARS-Coronavirus-2(SARS-CoV-2),the pathogen of COVID-19,the work experience of ICU nurses was extracted from the following 5 themes:(1)Stress and challenge caused by the change of work focus;(2)downsizing,overtime,taking up work with illness,and physical discomfort;(3)dedication and family debt;(4)unknown fear and helplessness;and(5)professional responsibility and sense of benefit.Conclusions:Under the pressure of COVID-19,ICU nurses face multiple pressures and challenges,and their emotions are complex.We suggest that nursing managers should take corresponding measures to alleviate nurses'physical and psychological pressure and improve their work experience.

Static Hedging with Uncertain Quantity and Departure from the Cost-of-Carry Valuation

In this paper, we are concerned with the optimal hedge ratio under quantity risk as well as discrepancies between the futures market price and its theoretical valuation according to the cost- of-carry model. Assuming a geometric Brownian motion for forecasting process, we model mispricing as a specific noise corn poncnt in the dynamics of filturcs market prices, based on which the optimal hedging strategy is calculated. Finally, we illustrate optimal strategy and its properties by numerical examples.