Formalin irrigation for hemorrhagic chronic radiation proctitis

AIM: To assess the efficacy and safety of a modified topical formalin irrigation method in refractory hemorrhagic chronic radiation proctitis(CRP). METHODS: Patients with CRP who did not respond to previous medical treatments and presented with grade II-III rectal bleeding according to the Common Terminology Criteria for Adverse Events were enrolled. Patients with anorectal strictures, deep ulcerations, and fistulas were excluded. All patients underwent flexible endoscopic evaluation before treatment. Patient demographics and clinical data, including primary tumor, radiotherapy and previous treatment options, were collected. Patients received topical 4% formalin irrigation in a clasp-knife position under spinal epidural anesthesia in the operating room. Remission of rectal bleeding and related complications were recorded. Defecation, remission of bleeding, and other symptoms were investigated at follow-up. Endoscopic findings in patients with rectovaginal fistulas were analyzed.RESULTS: Twenty-four patients(19 female, 5 male) with a mean age of 61.5 ± 9.5 years were enrolled. The mean time from the end of radiotherapy to the onset of bleeding was 11.1 ± 9.0 mo(range: 2-24 mo). Six patients(25.0%) were blood transfusion dependent. The median preoperative Vienna Rectoscopy Score(VRS) was 3 points. Nineteen patients(79.2%) received only one course of topical formalin irrigation, and five(20.8%) required a second course. No side effects were observed. One month after treatment, bleeding cessation was complete in five patients and obvious in14; the effectiveness rate was 79.1%(19/24). For longterm efficacy, 5/16, 1/9 and 0/6 patients complained of persistent bleeding at 1, 2 and 5 years after treatment, respectively. Three rectovaginal fistulas were found at 1 mo, 3 mo and 2 years after treatment. Univariate analysis showed associations of higher endoscopic VRS and ulceration score with risk of developing rectovaginal fistula. CONCLUSION: Modified formalin irrigation is an effective and safe method for hemorrhagic CRP, but should be performed cautiously in patients with a high endoscopic VRS.

Individualized Chemotherapy in Advanced NSCLC Patients Based on mRNA Levels of BRCA1 and RRM1

Objective： Experimental evidence suggests that the overexpression of breast cancer-specific tumor suppressor protein 1 （BRCA1） gene enhances sensitivity to docetaxel and resistance to cisplatin and ribonucleotide reductase M1 （RRM1） gene overexpression enhances resistance to gemcitabine. To further examine the effect of BRCA1 and RRM1 mRNA levels on outcome in advanced non-small cell lung cancer （NSCLC）, we performed this non-randomized phase II clinical trial which tested the hypothesis that customized therapy would confer improved outcome over non-customized therapy. Methods： RNA was isolated from fresh tumor tissue. Patients received chemotherapy regimen based on their BRCA1 and RRM1 mRNA levels： both low-cisplatin plus gemcitabine （GP）; both high-vinorelbine plus cisplatin （NP）; BRCA1 low and RRM1 high-cisplatin plus docetaxel （TP）; BRCA1 high and RRM1 low-vinorelbine plus gemcitabine （GN）. Results： From Dec 2005 to Nov 2008, 94 metastatic and locally advanced NSCLC patients from our institute were enrolled in this study. The median age was 58 years old. Among them, 21 patients received GP, 30 patients received TP and 43 patients received NP chemotherapy. GP group had a higher response rate, and longer median time to progression （TTP） and median overall survival （OS） time than the other 2 groups. The response rates in the GP, TP and NP groups were 42.9%, 36.7% and 27.9%, respectively （P=0.568）. The median TTP was 5.6, 5.0, 4.8 months （P=0.975）, respectively, and the median OS time was 12.5, 11.0, 9.7 months （P=0.808）, respectively. Conclusion： Chemotherapy customized according to BRCA1 and RRM1 expression levels is associated with higher response rate and longer TTP and OS time in the GP group. This suggests that BRCA1 and RRM1 mRNA levels could be used as biomarkers in individual therapy in NSCLC.

DR患者外周血趋化因子MIP-1α和MIP-1β水平变化的临床意义

目的:观察糖尿病视网膜病变患者外周血趋化因子巨噬细胞炎症蛋白-1α(macrophage inflammatory protein,MIP-1α)、MIP-1β水平变化,并分析其临床意义。方法:选取佛山市第五人民医院和佛山市南海区第四人民医院收治的糖尿病无视网膜病变患者(DM组)、非增殖期糖尿病视网膜病变患者(NPDR组)和增殖期糖尿病视网膜病变患者(PDR组),各50例;选取50例健康体检者作为对照组。观察不同组别患者外周血趋化因子MIP-1α、MIP-1β水平、血糖情况和细胞因子水平的差异,采用Pearson相关分析法分析糖尿病视网膜病变患者外周血趋化因子MIP-1α、MIP-1β水平与血糖和细胞因子水平的相关性。结果:DM组患者的MIP-1α、MIP-1β和平均血糖(mean blood glucose,MBG)水平均高于对照组,差异有统计学意义(t=6. 306、2. 954、3. 617,均P<0. 05); DM组患者的胰岛素样生长因子-1(insulin like growth factor-1,IGF-1)、成纤维细胞生长因子-21 (fibroblast growth factor-21,FGF-21)、血管内皮生长因子(VEGF)水平均高于对照组,差异有统计学意义(t=27. 216、7. 778、3. 214,均P <0. 05)。PDR组患者的MIP-1α、MIP-1β和MBG水平均高于NPDR组,差异有统计学意义(t=6. 620、3. 461、3. 378,均P<0. 05); PDR组患者的IGF-1、FGF-21、VEGF水平高于NPDR组,差异有统计学意义(t=10. 260、12. 611、4. 108,均P <0. 05)。糖尿病视网膜病变患者的MIP-1α、MIP-1β水平与MBG、IGF-1、FGF-21、VEGF水平呈正相关。结论:增殖期糖尿病视网膜病变患者的MIP-1α、MIP-1β水平较高,且与血糖和细胞因子水平呈正相关。

Prediction of early recurrence of hepatocellular carcinoma after liver transplantation based on computed tomography radiomics nomogram

Background:Early recurrence results in poor prognosis of patients with hepatocellular carcinoma(HCC)after liver transplantation(LT).This study aimed to explore the value of computed tomography(CT)-based radiomics nomogram in predicting early recurrence of patients with HCC after LT.Methods:A cohort of 151 patients with HCC who underwent LT between December 2013 and July 2019 were retrospectively enrolled.A total of 1218 features were extracted from enhanced CT images.The least absolute shrinkage and selection operator algorithm(LASSO)logistic regression was used for dimension reduction and radiomics signature building.The clinical model was constructed after the analysis of clin-ical factors,and the nomogram was constructed by introducing the radiomics signature into the clinical model.The predictive performance and clinical usefulness of the three models were evaluated using re-ceiver operating characteristic(ROC)curve analysis and decision curve analysis(DCA),respectively.Cali-bration curves were plotted to assess the calibration of the nomogram.Results:There were significant differences in radiomics signature among early recurrence patients and non-early recurrence patients in the training cohort(P<0.001)and validation cohort(P<0.001).The nomogram showed the best predictive performance,with the largest area under the ROC curve in the training(0.882)and validation(0.917)cohorts.Hosmer-Lemeshow testing confirmed that the nomogram showed good calibration in the training(P=0.138)and validation(P=0.396)cohorts.DCA showed if the threshold probability is within 0.06-1,the nomogram had better clinical usefulness than the clinical model.Conclusions:Our CT-based radiomics nomogram can preoperatively predict the risk of early recurrence in patients with HCC after LT.

结缔组织生长因子对POAG患者Tenon囊成纤维细胞的影响

目的:研究结缔组织生长因子(CTGF)对原发性开角型青光眼(POAG)患者Tenon囊成纤维细胞(Tfb)增殖、移行和转化的影响。方法:POAG患者的Tenon囊组织行组织块法培养出来的Tfb细胞分为2组:(1)对照组;(2)CTGF处理组:DMEM-F12培养液中分别加入终浓度为1.0、10.0、100.0ng/mL的CTGF。细胞处理24h后,分别用MTT法和细胞划痕法分别检测Tfb的增殖和移行,半定量RT-PCR法和免疫组织化学法分别检测Tfb中α-平滑肌肌动蛋白(α-SMA)mRNA水平的变化和蛋白的表达。结果:MTT法测得1.0、10.0、100.0ng/mL CTGF处理组的A值分别是0.436±0.009、0.643±0.009、0.679±0.006,对照组为0.423±0.156。细胞划痕法显示,细胞移行数分别为34.600±3.507、70.400±2.074、80.000±2.915个,对照组为31.000±3.536个。RT-PCR法得出不同浓度CTGF处理组α-SMA/β-actin条带吸光度比值分别为0.873±0.161、1.213±0.312、1.352±0.376,对照组是0.851±0.158。免疫组织化学法得出1.0、10.0、100.0ng/mL CTGF处理组阳性细胞的平均光密度值分别是0.110±0.026、0.141±0.017、0.175±0.027,对照组是0.108±0.020。上述所有观察指标10.0、100.0ng/mL CTGF组与对照组相比较均有差异(P<0.05),而1.0ng/mL CTGF与对照组相比较均无差异(P>0.05)。结论:CTGF能促进POAG患者Tfb的增殖、移行和表型转化,CTGF可能在滤过泡瘢痕化中扮演了重要作用。

Observation on the quality of life before and after the injection of antiangiogenic drug in the vitreous cavity of patients with wet age-related macular degeneration

Objective: To explore the vision-related quality of life ( VRQL) before and after the injection of antiangiogenic drug into the vitreous cavity of patients with wet age-related macular degeneration ( AMD) . Methods: The 2000 edition of the Visual Functioning Questionnaire 25 that was issued by the Na-tional Eye Institute was applied, and the VRQL evaluation was conducted on the initially diagnosed patients with wet-AMD before and after the injection of ranibizumab into the vitreous cavity. Results: Among the wet-AMD patients, patients with better distance visual acuity before the in-travitreal injection had a lower VFQ-25 score. After the vitreous cavity injection, the VFQ-25 questionnaire score was related to patient care and education from the doctors and nurses; specific-ally, the better the nursing, the higher the score. Conclusions: Before the vitreous cavity injection, the degree of distance visual acuity is an im-portant factor affecting the VRQL of wet-AMD patients. In addition, patient care and education from the doctors and nurses toward patients during the pre-, intra-and post-operation of the intrav-itreal injection are also important factors affecting the VRQL.

Identification of potential key molecules and signaling pathways for psoriasis based on weighted gene co-expression network analysis

BACKGROUND Psoriasis is a chronic inflammatory skin disease,the pathogenesis of which is more complicated and often requires long-term treatment.In particular,moderate to severe psoriasis usually requires systemic treatment.Psoriasis is also associated with many diseases,such as cardiometabolic diseases,malignant tumors,infections,and mood disorders.Psoriasis can appear at any age,and lead to a substantial burden for individuals and society.At present,psoriasis is still a treatable,but incurable,disease.Previous studies have found that micro RNAs(mi RNAs)play an important regulatory role in the progression of various diseases.Currently,mi RNAs studies in psoriasis and dermatology are relatively new.Therefore,the identification of key mi RNAs in psoriasis is helpful to elucidate the molecular mechanism of psoriasis.AIM To identify key molecular markers and signaling pathways to provide potential basis for the treatment and management of psoriasis.METHODS The mi RNA and m RNA data were obtained from the Gene Expression Omnibus database.Then,differentially expressed m RNAs(DEm RNAs)and differentially expressed mi RNAs(DEmi RNAs)were screened out by limma R package.Subsequently,DEm RNAs were analyzed for Gene Ontology and Kyoto Encyclopedia of Genes and Genomics functional enrichment.The“WGCNA”R package was used to analyze the co-expression network of all mi RNAs.In addition,we constructed mi RNA-m RNA regulatory networks based on identified hub mi RNAs.Finally,in vitro validation was performed.All experimental procedures were approved by the ethics committee of Chinese PLA General Hospital(S2021-012-01).RESULTS A total of 639 DEm RNAs and 84 DEmi RNAs were identified.DEm RNAs screening criteria were adjusted P(adj.P)value<0.01 and|log Fold Change|(|log FC|)>1.DEmi RNAs screening criteria were adj.P value<0.01 and|logFC|>1.5.KEGG functional analysis demonstrated that DEm RNAs were significantly enriched in immune-related biological functions,for example,tolllike receptor signaling pathway,cytokine-cytokine receptor interaction,and chemokine signaling pathway.In weighted gene co-expression network analysis,turquoise module was the hub module.Moreover,10 hub mi RNAs were identified.Among these 10 hub mi RNAs,only 8 hub mi RNAs predicted the corresponding target m RNAs.97 negatively regulated mi RNA-m RNA pairs were involved in the mi RNA-m RNA regulatory network,for example,hsa-mi R-21-5 pclaudin 8(CLDN8),hsa-mi R-30 a-3 p-interleukin-1 B(IL-1 B),and hsa-mi R-181 a-5 p/hsa-mi R-30 c-2-3 p-C-X-C motif chemokine ligand 9(CXCL9).Real-time polymerase chain reaction results showed that IL-1 B and CXCL9 were up-regulated and CLDN8 was down-regulated in psoriasis with statistically significant differences.CONCLUSION The identification of potential key molecular markers and signaling pathways provides potential research directions for further understanding the molecular mechanisms of psoriasis.This may also provide new research ideas for the prevention and treatment of psoriasis in the future.

Research progress in treatment of severe acute pancreatitis by regulating gut microbiota with traditional Chinese medicine

In recent years,it has been shown that the late development of severe acute pancreatitis is often accompanied by gut microbiota dysbiosis,leading to an increase of pancreatic necrosis and peripancreatic infection.Basic western medicine such as antibiotics can prevent infection but may disrupt the balance of gut microbiota.1As a treasure of traditional Chinese medicine,which has become one of the complementary and alternative therapy for gut microbiota disorder in severe acute pancreatitis.This article reviews the treatment of severe acute pancreatitis by regulating gut microbiota in multiple ways with traditional Chinese medicine,which would provide new approaches and ideas for clinical treatment of severe acute pancreatitis.

Correlation of serum STMN1 and Cath-D levels with the invasive growth of cervical cancer

Objective:To study the correlation of serum stathmin 1 (STMN1) and cathepsin D (Cath-D) levels with the invasive growth of cervical cancer.Methods: The patients with cervical cancer and those with uterine fibroids who underwent surgical resection in the Second People's Hospital of Yichang between January 2013 and November 2017 were selected and enrolled in the malignant group and the benign group of the study respectively;the serum was collected before operation to detect the contents of STMN1 and Cath-D;the cervical cancer lesion tissues were collected from the malignant group and the normal cervical tissues were collected from the benign group to measure the expression of STMN1, Cath-D, invasion genes and invasion signal molecules.Results:STMN1 and Cath-D contents in serum as well as STMN1 and Cath-D mRNA expression in lesion tissue of malignant group were significantly higher than those of benign group, and serum STMN1 and Cath-D contents of malignant group were positively correlated with STMN1 and Cath-D mRNA expression in lesion tissue;RACK1, Twist, MMP9, mTOR, S6K1, Wnt andβ-catenin mRNA expression in lesion tissue of malignant group were significantly higher than those of benign group whereas E-cadherin, GRIM19 and GSK-3β mRNA expression were significantly lower than those of benign group, and serum STMN1 and Cath-D contents of malignant group were positively correlated with RACK1, Twist, MMP9, mTOR, S6K1, Wnt andβ-catenin mRNA expression in lesion tissue, and negatively correlated with E-cadherin, GRIM19 and GSK-3β mRNA expression. Conclusion:The abnormally elevated STMN1 and Cath-D in serum of patients with cervical cancer can evaluate the invasive growth of the lesion.

Structure,nitridation efficiency and magnetic properties of SmFe powders and its nitrides

The effect of annealing temperature(TA) at600-900℃ on structure and magnetic properties of the melt-spun Sm_(8.6)Fe_(85.9)Co_(4.3)Zr_(1.2) alloys and its nitrides was investigated.Results show that the melt-spun powder is TbCu7-type SmFe_(9) single phase.X-ray diffractometer(XRD) Rietveld refinement shows that the lattice parameter a increases,c and c/a decrease with the increase in T_(A) at600-700℃.This is due to the tendency of nitrogen entering into the 3f site(1/2,0,0) during the nitridation process,which is good for the magnetic properties.The phase transforms from TbCu7-type SmFe_(9) to Th_(2)Zn_(17)-type Sm_(2)Fe_(17) at above 800 0C.Scanning electron microscopy(SEM) images show that the amount of surface defects of melt-spun powder which are harmful for magnetic properties decreases at first and then increases as TA increases.The coercivity(H_(cj)) and maximum magnetic energy product((BH)_(max)) of its nitrides increase first and then decrease as a function of TA.And the remanence(B_(r))always shows a decrease.The optimal magnetic properties of H_(cj)=748 kA·m^(-1),B_(r)=0.92 T,(BH)_(max)=118 kJ·m^(-3) are obtained by annealing at 675℃ for 2 h and then nitriding at 460℃ for 10 h.

Microcosm study on fate and dynamics of mangrove tannins during leaf litter leaching

Background Mangrove tannins can participate in wetland biogeochemical cycling.However,their fate and dynamics during leaf litter leaching have yet to be elucidated in coastal aquatic environments.Methods By using a simulated microcosm experiment,changes in leaf litter mass and tannin compounds,including total phenolics(TP),extractable condensed tannins(ECT),and bound condensed tannins(BCT),were examined in the litters and leachates of four common mangrove species:Kandelia obovata(Ko),Aegiceras corniculatum(Ac),Sonneratia apetala(Sa),and Avicennia marina(Am).Results Leaching caused a notable decline in litter mass,TP,and ECT in the leaf litter of Ko,Ac,Sa,and Am,while BCT increased significantly in Ko and Ac.Loss in foliar TP was higher than in leaf litter mass,and loss in foliar ECT was higher than in TP of Ko and Ac,but Sa showed the opposite result.The temporal changes of TP and ECT concentrations in leachates followed a similar trend,with an initial increase followed by a decrease.ECT dynamics in Ko and Ac leachates correlated with their TP concentrations,while in Sa leachate,the peak ECT occurred 72 h later than its TP peak.The leachate ECT concentrations were highest in Ac,followed by Ko,and significantly lower in Sa.The peak TP and ECT proportions in leachates accounted for 9.2-23.9%and 7.7-9.4%of the total decreases in foliar TP and ECT,respectively.Conclusion During the leaching process,tannins’fate was species-specific,while the dynamics were almost similar.