BACKGROUND Early adenocarcinoma mixed with a neuroendocrine carcinoma(NEC)component arising in the gastroesophageal junctional(GEJ)region is rare and even rarer in young patients.Here,we report such a case in a 29-yea...BACKGROUND Early adenocarcinoma mixed with a neuroendocrine carcinoma(NEC)component arising in the gastroesophageal junctional(GEJ)region is rare and even rarer in young patients.Here,we report such a case in a 29-year-old Chinese man.CASE SUMMARY This patient presented to our hospital with a 3-mo history of dysphagia and regurgitation.Upper endoscopy revealed an elevated nodule in the distal esophagus 1.6 cm above the GEJ line,without Barrett’s esophagus or involvement of the gastric cardia.The nodule was completely resected by endoscopic submu-cosal dissection(ESD).Pathological examination confirmed diagnosis of intra-mucosal adenocarcinoma mixed with an NEC component,measuring 1.5 cm.Immunohistochemically,both adenocarcinoma and NEC components were positive for P53 with a Ki67 index of 90%;NEC was positive for synaptophysin and chromogranin.Next-generation sequencing of 196 genes demonstrated a novel germline mutation of the ERCC3 gene in the DNA repair pathway and a germline mutation of the RNF43 gene,a common gastric cancer driver gene,in addition to pathogenic somatic mutations in P53 and CHEK2 genes.The patient was alive without evidence of the disease 36 mo after ESD.CONCLUSION Early adenocarcinoma with an NEC component arising in the distal esophageal side of the GEJ region showed evidence of gastric origin.展开更多
Pancreatic cancer is among the most lethal malignancies resistant to conventional therapies. The urgent need fornew therapies has turned the spotlights on immunotherapy. In recent years, a growing body of evidence has...Pancreatic cancer is among the most lethal malignancies resistant to conventional therapies. The urgent need fornew therapies has turned the spotlights on immunotherapy. In recent years, a growing body of evidence has alreadybeen gathered regarding the efficacy of genetic engineering modified T-cells, checkpoint inhibitors of T-cells, killercells induced by dendritic cells and cytokine in patients with pancreatic cancer. Cryoimmunotherapy in situ andextra-tumor and immunotherapy combined with chemotherapy could also increase the effectiveness. Research ofpancreatic cancer vaccine has made some progress. The immunity enhancing function of some traditional herbshave been reported, such as Ginsenoside Rg3, which could enhance T-cell subsets and NK cell activity inpancreatic cancer patients with chemotherapy.展开更多
Objective： Debulking surgery （residual disease of less than 1 cm） followed by platinum-taxane chemotherapy isthe current standard therapy for patients with epithelial ovarian cancer, primary peritoneal carcinoma an...Objective： Debulking surgery （residual disease of less than 1 cm） followed by platinum-taxane chemotherapy isthe current standard therapy for patients with epithelial ovarian cancer, primary peritoneal carcinoma and primaryfallopian cancer. But the prognosis remains poor. Several chemotherapy regimens could be selected for patientswith recrudescent cancer. However, the standard second chemotherapy regimen remains a subject of debate. Thepurpose of our study is to carry out a systematic review and network meta-analysis to compare the efficacy andsafety of different regimens for recurrent platinum-resistant ovarian cancer based on existing randomized controlledtrials （RCTs）. Methods and analysis： Medline, EMBASE, Cochrane Library and Cochrane Library databases,Science Citation Index Expanded, Conference Proceedings Citation Index-Science and ClinicalTrials.gov will besystematically searched for eligible studies. Randomized controlled trials （RCT） on chemotherapy, immune therapy,biological therapy, targeted therapy for recurrent platinum-resistant ovarian cancer with multiple outcome measureswill be included. The Cochrane Risk of Bias Tool will be used to assess the quality of included studies. The primaryoutcomes are overall survival and median survival time. The secondary outcomes include the safety and side effectsof these regimens. Direct meta-analysis and network meta-analysis （NMA） will be conducted to compare differentregimens. Conclusion： The results of this network meta-analysis will provide direct and indirect evidence oftreatments for recurrent platinum-resistant ovarian cancer, and it may provide a ranking of the chemotherapyregimens for patients and gynecological oncologists to help them select the best option.展开更多
Objective: To investigate the effects of scalp acupuncture intervention combined with rehabilitation training on the neurotrophy status and nerve injury in patients with convalescent period of cerebral hemorrhage. Met...Objective: To investigate the effects of scalp acupuncture intervention combined with rehabilitation training on the neurotrophy status and nerve injury in patients with convalescent period of cerebral hemorrhage. Methods: A total of 78 patients with convalescent period of cerebral hemorrhage who were treated in West China Hospital between January 2016 and March 2017 were divided into the control group and the experimental group by random number table, each with 39 cases. Control group received the routine rehabilitation training, and the experimental group received scalp acupuncture intervention combined with rehabilitation training. The differences in neurotrophy status and nerve injury were compared between the two groups before and after intervention. Results: Before intervention, there was no statistically significant difference in neurotrophy status and nerve injury between the two groups. After 1 week of intervention and after 2 weeks of intervention, serum neurotrophy indexes NGF and BDNF contents of experimental group were higher than those of control group;serum nerve injury indexes GFAP, NSE and S100B contents were lower than those of control group;serum inflammatory mediators IL-18, HMGB1 and IFN-γ contents were lower than those of control group. Conclusion: scalp acupuncture intervention combined with rehabilitation training can effectively improve the neurotrophy state and reduce the nerve injury in patients with convalescent period of cerebral hemorrhage.展开更多
Background:Effective management of imported cases is an important part of epidemic prevention and control.Hainan Province,China reported 168 coronavirus disease 2019(COVID-19),including 112 imported cases on February ...Background:Effective management of imported cases is an important part of epidemic prevention and control.Hainan Province,China reported 168 coronavirus disease 2019(COVID-19),including 112 imported cases on February 19,2020,but successfully contained the epidemic within 1 month.We described the epidemiological and clinical characteristics of COVID-19 in Hainan and compared these features between imported and local cases to provide information for other international epidemic areas.Methods:We included 91 patients(56 imported and 35 local cases)from two designated hospitals for COVID-19 in Haikou,China,from January 20 to February 19,2020.Data on the demographic,epidemiological,clinical and laboratory characteristics were extracted from medical records.Patients were followed until April 21,2020,and the levels of antibodies at the follow-ups were also analysed by the Wilcoxon matched-pairs signed ranks test.Results:Of the 91 patients,78(85.7%)patients were diagnosed within the first three weeks after the first case was identified(Day 1:Jan 22,2020),while the number of local cases started to increase during the third week No new cases occurred after Day 29.Fever and cough were two main clinical manifestations.In total,15(16.5%)patients were severe,14(15.4%)had complicated infections,nine(9.9%)were admitted to the intensive care unit,and three died.The median duration of viral shedding in feces was longer than that in nasopharyngeal swabs(19 days vs 16 days,P=0.007).Compared with local cases,imported cases were older and had a higher incidence of fever and concurrent infections.There was no difference in outcomes between the two groups.IgG was positive in 92.8%patients(77/83)in the follow-up at week 2 after discharge,while 88.4%patients(38/43)had a reduction in IgG levels in the follow-up at week 4 after discharge,and the median level was lower than that in the follow-up at week 2(10.95 S/Cut Off(S/CO)vs 15.02 S/CO,P<0.001).Conclusion:Imported cases were more severe than local cases but had similar prognoses.The level of IgG antibodies declined from week 6 to week 8 after onset.The short epidemic period in Hainan suggests that the epidemic could be quickly brought under control if proper timely measures were taken.展开更多
The differences in the characteristics of the rapid intensification(RI)during the TCs that form in the SCS(referred as local TCs)and that enter the SCS from the western North Pacific(WNP;referred as entering TCs)have ...The differences in the characteristics of the rapid intensification(RI)during the TCs that form in the SCS(referred as local TCs)and that enter the SCS from the western North Pacific(WNP;referred as entering TCs)have not been well studied,which could contribute the inaccuracy of current TC intensity forecast in the SCS.In this study,we used TC observations,reanalysis data and model experiments to analyze the RI occurrences during local TCs and entering TCs in 1980-2016.We found that the significant interannual and interdecadal variations in RI occurrences during local eastward-moving TCs were related to the strong intraseasonal oscillation(ISO)over the SCS and the WNP under La Niña conditions.RI during local westward-moving TCs showed insignificant variations as a result of the complex interactions among the monsoon trough,ISO and the large-scale circulation.RI during entering TCs showed strong interdecadal variations,with increased RI after 1997,even though the total number of entering TCs has decreased since 1997,which is a result of a higher number of entering TCs in the northwestern quadrant of the WNP,a stronger ISO and weak vertical windshear over the SCS and east of the Philippines under negative phase of Pacific Decadal Oscillation.The different variations and related mechanisms of RI indicates that distinct forecasting factors should be considered for intensity prediction during local eastward-and westward-moving TCs and entering TCs.展开更多
基金Changzhou High-level Medical Talents Training Project of the Health Commission of the Changzhou City,No.2022CZBJ079Changzhou Sci&Tech Program,No.CE20235064.
文摘BACKGROUND Early adenocarcinoma mixed with a neuroendocrine carcinoma(NEC)component arising in the gastroesophageal junctional(GEJ)region is rare and even rarer in young patients.Here,we report such a case in a 29-year-old Chinese man.CASE SUMMARY This patient presented to our hospital with a 3-mo history of dysphagia and regurgitation.Upper endoscopy revealed an elevated nodule in the distal esophagus 1.6 cm above the GEJ line,without Barrett’s esophagus or involvement of the gastric cardia.The nodule was completely resected by endoscopic submu-cosal dissection(ESD).Pathological examination confirmed diagnosis of intra-mucosal adenocarcinoma mixed with an NEC component,measuring 1.5 cm.Immunohistochemically,both adenocarcinoma and NEC components were positive for P53 with a Ki67 index of 90%;NEC was positive for synaptophysin and chromogranin.Next-generation sequencing of 196 genes demonstrated a novel germline mutation of the ERCC3 gene in the DNA repair pathway and a germline mutation of the RNF43 gene,a common gastric cancer driver gene,in addition to pathogenic somatic mutations in P53 and CHEK2 genes.The patient was alive without evidence of the disease 36 mo after ESD.CONCLUSION Early adenocarcinoma with an NEC component arising in the distal esophageal side of the GEJ region showed evidence of gastric origin.
基金This study was supported by National Natural Science Foundation of China （81341068）.
文摘Pancreatic cancer is among the most lethal malignancies resistant to conventional therapies. The urgent need fornew therapies has turned the spotlights on immunotherapy. In recent years, a growing body of evidence has alreadybeen gathered regarding the efficacy of genetic engineering modified T-cells, checkpoint inhibitors of T-cells, killercells induced by dendritic cells and cytokine in patients with pancreatic cancer. Cryoimmunotherapy in situ andextra-tumor and immunotherapy combined with chemotherapy could also increase the effectiveness. Research ofpancreatic cancer vaccine has made some progress. The immunity enhancing function of some traditional herbshave been reported, such as Ginsenoside Rg3, which could enhance T-cell subsets and NK cell activity inpancreatic cancer patients with chemotherapy.
文摘Objective： Debulking surgery （residual disease of less than 1 cm） followed by platinum-taxane chemotherapy isthe current standard therapy for patients with epithelial ovarian cancer, primary peritoneal carcinoma and primaryfallopian cancer. But the prognosis remains poor. Several chemotherapy regimens could be selected for patientswith recrudescent cancer. However, the standard second chemotherapy regimen remains a subject of debate. Thepurpose of our study is to carry out a systematic review and network meta-analysis to compare the efficacy andsafety of different regimens for recurrent platinum-resistant ovarian cancer based on existing randomized controlledtrials （RCTs）. Methods and analysis： Medline, EMBASE, Cochrane Library and Cochrane Library databases,Science Citation Index Expanded, Conference Proceedings Citation Index-Science and ClinicalTrials.gov will besystematically searched for eligible studies. Randomized controlled trials （RCT） on chemotherapy, immune therapy,biological therapy, targeted therapy for recurrent platinum-resistant ovarian cancer with multiple outcome measureswill be included. The Cochrane Risk of Bias Tool will be used to assess the quality of included studies. The primaryoutcomes are overall survival and median survival time. The secondary outcomes include the safety and side effectsof these regimens. Direct meta-analysis and network meta-analysis （NMA） will be conducted to compare differentregimens. Conclusion： The results of this network meta-analysis will provide direct and indirect evidence oftreatments for recurrent platinum-resistant ovarian cancer, and it may provide a ranking of the chemotherapyregimens for patients and gynecological oncologists to help them select the best option.
文摘Objective: To investigate the effects of scalp acupuncture intervention combined with rehabilitation training on the neurotrophy status and nerve injury in patients with convalescent period of cerebral hemorrhage. Methods: A total of 78 patients with convalescent period of cerebral hemorrhage who were treated in West China Hospital between January 2016 and March 2017 were divided into the control group and the experimental group by random number table, each with 39 cases. Control group received the routine rehabilitation training, and the experimental group received scalp acupuncture intervention combined with rehabilitation training. The differences in neurotrophy status and nerve injury were compared between the two groups before and after intervention. Results: Before intervention, there was no statistically significant difference in neurotrophy status and nerve injury between the two groups. After 1 week of intervention and after 2 weeks of intervention, serum neurotrophy indexes NGF and BDNF contents of experimental group were higher than those of control group;serum nerve injury indexes GFAP, NSE and S100B contents were lower than those of control group;serum inflammatory mediators IL-18, HMGB1 and IFN-γ contents were lower than those of control group. Conclusion: scalp acupuncture intervention combined with rehabilitation training can effectively improve the neurotrophy state and reduce the nerve injury in patients with convalescent period of cerebral hemorrhage.
基金This study was funded by the National Science and Technology Major Project(Bing-Liang Lin,2018ZX10302204,Bing-Liang Lin,2017ZX10203201003)the Emergency special program for 2019-nCoV of Guangdong province science and technology project(GDSTP-ESP)(Zhi-Liang Gao,2020B111105001)+1 种基金the Tackling of key scientific and emergency special program of Sun Yat-sen University[SYSU-TKSESP,Bing-Liang Lin]the Emergency special program for 2019-nCov of Bethune Medical Science Research Fund(Biao Wu,2020SG070DS).
文摘Background:Effective management of imported cases is an important part of epidemic prevention and control.Hainan Province,China reported 168 coronavirus disease 2019(COVID-19),including 112 imported cases on February 19,2020,but successfully contained the epidemic within 1 month.We described the epidemiological and clinical characteristics of COVID-19 in Hainan and compared these features between imported and local cases to provide information for other international epidemic areas.Methods:We included 91 patients(56 imported and 35 local cases)from two designated hospitals for COVID-19 in Haikou,China,from January 20 to February 19,2020.Data on the demographic,epidemiological,clinical and laboratory characteristics were extracted from medical records.Patients were followed until April 21,2020,and the levels of antibodies at the follow-ups were also analysed by the Wilcoxon matched-pairs signed ranks test.Results:Of the 91 patients,78(85.7%)patients were diagnosed within the first three weeks after the first case was identified(Day 1:Jan 22,2020),while the number of local cases started to increase during the third week No new cases occurred after Day 29.Fever and cough were two main clinical manifestations.In total,15(16.5%)patients were severe,14(15.4%)had complicated infections,nine(9.9%)were admitted to the intensive care unit,and three died.The median duration of viral shedding in feces was longer than that in nasopharyngeal swabs(19 days vs 16 days,P=0.007).Compared with local cases,imported cases were older and had a higher incidence of fever and concurrent infections.There was no difference in outcomes between the two groups.IgG was positive in 92.8%patients(77/83)in the follow-up at week 2 after discharge,while 88.4%patients(38/43)had a reduction in IgG levels in the follow-up at week 4 after discharge,and the median level was lower than that in the follow-up at week 2(10.95 S/Cut Off(S/CO)vs 15.02 S/CO,P<0.001).Conclusion:Imported cases were more severe than local cases but had similar prognoses.The level of IgG antibodies declined from week 6 to week 8 after onset.The short epidemic period in Hainan suggests that the epidemic could be quickly brought under control if proper timely measures were taken.
基金supported by the Key Special Project for Introduced Talents Team of Southern Marine Science and Engineering Guangdong Laboratory(Guangzhou)(GML2019ZD0306)the National Natural Science Foundation of China(41676017,92158204)+2 种基金Guangzhou City Project(202102080482)the Strategic Priority Research Program of Chinese Academy of Sciences(XDA20060500)the Independent Research Project Program of State Key Laboratory of Tropical Oceanography(LTOZZ2005).
文摘The differences in the characteristics of the rapid intensification(RI)during the TCs that form in the SCS(referred as local TCs)and that enter the SCS from the western North Pacific(WNP;referred as entering TCs)have not been well studied,which could contribute the inaccuracy of current TC intensity forecast in the SCS.In this study,we used TC observations,reanalysis data and model experiments to analyze the RI occurrences during local TCs and entering TCs in 1980-2016.We found that the significant interannual and interdecadal variations in RI occurrences during local eastward-moving TCs were related to the strong intraseasonal oscillation(ISO)over the SCS and the WNP under La Niña conditions.RI during local westward-moving TCs showed insignificant variations as a result of the complex interactions among the monsoon trough,ISO and the large-scale circulation.RI during entering TCs showed strong interdecadal variations,with increased RI after 1997,even though the total number of entering TCs has decreased since 1997,which is a result of a higher number of entering TCs in the northwestern quadrant of the WNP,a stronger ISO and weak vertical windshear over the SCS and east of the Philippines under negative phase of Pacific Decadal Oscillation.The different variations and related mechanisms of RI indicates that distinct forecasting factors should be considered for intensity prediction during local eastward-and westward-moving TCs and entering TCs.
