Gallbladder carcinosarcoma with a poor prognosis: A case report

BACKGROUND Carcinosarcoma of the gallbladder is a rare malignant tumor with a very poor prognosis.To date,only approximately 100 patients have been reported in the English literature.The prognosis of this tumor type is poor,the preoperative diagnosis is difficult,and there is a possibility of a misdiagnosis.We present an unsuccessful case of carcinosarcoma of the gallbladder with a preoperative misdiagnosis and rapid early postoperative recurrence.Therefore,we have a deeper understanding of the poor prognosis of gallbladder carcinosarcoma(GBC)patients.CASE SUMMARY The patient is a 65-year-old male.He was admitted to the hospital because of right upper abdomen distending pain and discomfort for half a month.Abdominal magnetic resonance imaging revealed a polycystic mass in the right lobe of the liver and the fossa of the gallbladder.After admission,the patient was diagnosed with a liver abscess,which was treated by abscess puncture drainage.Obviously,this treatment was unsuccessful.Hepatectomy and cholecystectomy were performed one month after the puncture.Postoperative pathologic examination revealed carcinosarcoma of the gallbladder,and the resected specimen contained two tumor components.One month after surgery,the patient's tumor recurred in situ and started to compress the duodenum,resulting in duodenal obstruction and bleeding.The treatment was not effective.The patient died of gastrointestinal hemorrhage and hypovolemic shock.CONCLUSION Carcinosarcoma of the gallbladder is a rare malignant tumor that is easily misdiagnosed preoperatively and has a poor prognosis.

Artificial intelligence models based on non-contrast chest CT for measuring bone mineral density

Objective To observe the value of artificial intelligence(AI)models based on non-contrast chest CT for measuring bone mineral density(BMD).Methods Totally 380 subjects who underwent both non-contrast chest CT and quantitative CT(QCT)BMD examination were retrospectively enrolled and divided into training set(n=304)and test set(n=76)at a ratio of 8∶2.The mean BMD of L1—L3 vertebrae were measured based on QCT.Spongy bones of T5—T10 vertebrae were segmented as ROI,radiomics(Rad)features were extracted,and machine learning(ML),Rad and deep learning(DL)models were constructed for classification of osteoporosis(OP)and evaluating BMD,respectively.Receiver operating characteristic curves were drawn,and area under the curves(AUC)were calculated to evaluate the efficacy of each model for classification of OP.Bland-Altman analysis and Pearson correlation analysis were performed to explore the consistency and correlation of each model with QCT for measuring BMD.Results Among ML and Rad models,ML Bagging-OP and Rad Bagging-OP had the best performances for classification of OP.In test set,AUC of ML Bagging-OP,Rad Bagging-OP and DL OP for classification of OP was 0.943,0.944 and 0.947,respectively,with no significant difference(all P>0.05).BMD obtained with all the above models had good consistency with those measured with QCT(most of the differences were within the range of Ax-G±1.96 s),which were highly positively correlated(r=0.910—0.974,all P<0.001).Conclusion AI models based on non-contrast chest CT had high efficacy for classification of OP,and good consistency of BMD measurements were found between AI models and QCT.

Unveiling the secrets of gastrointestinal mucous adenocarcinoma survival after surgery with artificial intelligence:A population-based study

BACKGROUND Research on gastrointestinal mucosal adenocarcinoma(GMA)is limited and controversial,and there is no reference tool for predicting postoperative survival.AIM To investigate the prognosis of GMA and develop predictive model.METHODS From the Surveillance,Epidemiology,and End Results database,we collected clinical information on patients with GMA.After random sampling,the patients were divided into the discovery(70%of the total,for model training),validation(20%,for model evaluation),and completely blind test cohorts(10%,for further model evaluation).The main assessment metric was the area under the receiver operating characteristic curve(AUC).All collected clinical features were used for Cox proportional hazard regression analysis to determine factors influencing GMA’s prognosis.RESULTS This model had an AUC of 0.7433[95% confidence intervals(95%CI):0.7424-0.7442]in the discovery cohort,0.7244(GMA:0.7234-0.7254)in the validation cohort,and 0.7388(95%CI:0.7378-0.7398)in the test cohort.We packaged it into Windows software for doctors’use and uploaded it.Mucinous gastric adenocarcinoma had the worst prognosis,and these were protective factors of GMA:Regional nodes examined[hazard ratio(HR):0.98,95%CI:0.97-0.98,P<0.001]and chemotherapy(HR:0.62,95%CI:0.58-0.66,P<0.001).CONCLUSION The deep learning-based tool developed can accurately predict the overall survival of patients with GMA postoperatively.Combining surgery,chemotherapy,and adequate lymph node dissection during surgery can improve patient outcomes.

Gefitinib improves severe bronchorrhea and prolongs the survival of a patient with lung invasive mucinous adenocarcinoma:A case report

BACKGROUND Lung invasive mucinous adenocarcinoma(LIMA),formerly referred to as mucinous bronchioloalveolar carcinoma,is a rare disease that usually presents as bilateral lung infiltration,is unsuitable for surgery and radiotherapy,and shows poor response to conventional chemotherapy.CASE SUMMARY We report a 56-year-old Chinese man with a history of smoking and epidermal growth factor receptor mutation-positivity who was initially misdiagnosed as severe pneumonia,but was ultimately diagnosed as a case of invasive mucinous adenocarcinoma of the lung by computed tomography-guided percutaneous lung biopsy.Bronchorrhea and dyspnea were improved within 24 h after initiation of gefitinib therapy and the radiographic signs of bilateral lung consolidation showed visible improvement within 30 d.After more than 11 months of treatment,there is no evidence of recurrence or severe adverse events.CONCLUSION Although the precise mechanism of the antitumor effects of gefitinib are not clear,our experience indicates an important role of the drug in LIMA and provides a reference for the diagnosis and treatment of this disease.

MiR-183-5p promotes the progression of non-small cell lung cancer through targeted regulation of FOXO1

Objective To investigate miR-183-5p targeting to forkhead box protein O1(FOXO1)and its corresponding effect on the proliferation,migration,invasion,and epithelial-mesenchymal transition(EMT)of non-small cell lung cancer(NSCLC)cells.Methods NSCLC tissues and adjacent normal tissues from 60 patients with NSCLC adenocarcinoma were obtained via pathological biopsy or intraoperative resection.Several cell lines were cultured in vitro,including the human normal lung epithelial cell line BEAS-2B and human NSCLC cell lines A549,SPCA-1,PC-9,and 95-D.miR-183-5p and FOXO1 mRNA expression in tissues and cells were detected by qRT-PCR;the corresponding correlations in NSCLC tissues were analyzed using the Pearson test,and the relationship between miR-183-5p expression and clinicopathological parameters was analyzed.The miR-183-5p-mediated regulation of FOXO1 was verified by bioinformatics prediction alongside double luciferase,RNA-binding protein immunoprecipitation(RIP)assay,and pull-down experiments.A549 cells were divided into control,anti-miR-NC,anti-miR-183-5p,miR-NC,miR-183-5p,miR-183-5p+pcDNA3.1,and miR-183-5p+pcDNA3.1-FOXO1 groups.Cell proliferation,invasion,migration,apoptosis,and cell cycle distribution were detected using an MTT assay,clone formation assay,Transwell assay,scratch test,and flow cytometry,respectively.The expression of EMT-related proteins in the cells was analyzed by western blotting.The effect of miR-185-3p silencing on the development of transplanted tumors was detected by analyzing tumor formation in nude mice.Results miR-183-5p expression was significantly higher in NSCLC tissues and cells than in adjacent normal tissues,whereas FOXO1 mRNA expression was significantly down-regulated.There was a significant negative correlation between miR-183-5p and FOXO1 mRNA in NSCLC tissues(P<0.05).Additionally,the expression of miR-183-5p was significantly correlated with tumor size,tumor differentiation,and tumor-node-metastasis stage in patients with NSCLC(P<0.05).miR-183-5p targeted and inhibited FOXO1 expression.Compared to the anti-miR-NC group,the cell proliferation,scratch healing rate,N-cadherin and vimentin protein expression,and the proportion of S phase cells were significantly lower in the anti-miR-183-5p group,whereas the protein expression of E-cadherin andα-catenin and the proportion of G0/G1 phase cells were significantly higher;additionally,the frequency of colony formation and invasion were significantly lower in the anti-miR-183-5p group(P<0.05).Compared to the miR-NC group,the cell proliferation,scratch healing rate,N-cadherin and vimentin protein expression,and the proportion of S phase cells in the miR-183-5p group were significantly higher,whereas the E-cadherin andα-catenin protein expression and the proportion of G0/G1 phase cells were significantly lower;furthermore,the frequency of colony formation and invasion were significantly higher in the miR-183-5p group(P<0.05).Compared with the miR-183-5p+pcDNA3.1 group,the OD value,scratch healing rate,N-cadherin and vimentin protein expression,and the proportion of S phase cells were significantly lower in the miR-183-5p+pcDNA3.1-FOXO1 group,whereas E-cadherin andα-catenin protein expression and the proportion of G0/G1 phase cells were significantly higher;additionally,the frequency of colony formation and invasion was significantly lower in the miR-183-5p+pcDNA3.1-FOXO1 group(P<0.05).Overall,silencing miR-185-3p inhibited the growth of transplanted tumors and promoted FOXO1 expression.Conclusion Overexpression of miR-183-5p can inhibit apoptosis and promote the proliferation,migration,invasion,and EMT,of NSCLC cells by down-regulating FOXO1 expression.

Intraocular Silicone Oil Removed after 10 Years: A Case Report

Background: Silicone oil (SO) has been demonstrated with concrete efficacy and safety in the therapy of complex vitreoretinal diseases. SO is schemed to be cleared within several weeks or months after tamponade, but it’s inevitable for permanent or residual SO in a fraction of patients under extremely complicated clinical conditions. Here, we presented a case of silicone oil removal after 10 years, mainly to observe the disadvantages of long-term persistence. Case presentation: A 69-year-old female with pathologic myopia denied trauma history who had undergone pars plana vitrectomy (PPV), retinal reattachment, laser, and silicone oil tamponade in 2012 presented to our hospital with eye pain and headache, no light perception of her right eye for six months. The slit-lamp biomicroscopy examination for OD indicated evident conjunctival congestion, new blood vessels invasion to the limbus, foggy edema of corneal epithelium, folds of Descemet’s membrane and corneal endothelial edema. There were obvious emulsified silicone oil particles above the anterior chamber. Goldmann’s applanation tonometry test revealed the intraocular pressure was as high as 45/17mmHg. From ocular ultrasound, we saw that the vitreous cavity was filled with silicone oil in right eye;as for the left eye, it showed marked axial elongation and posterior scleral staphyloma. We were unable to obtain more information from fundus photography and macular optical coherence tomography (OCT) due to edema of the cornea. After the silicone oil was removed successfully from her vitreous cavity, although there was no improvement in the patient’s vision (no light perception), she was still satisfied with the relief from eye pain and headache benefited from the reduction of high intraocular pressure (Goldmann’s intraocular pressure decreased to 19/14mmHg). Conclusion: Patients after PPV should remove silicone oil in time to avoid corneal damage, intraocular hypertension, lens opacity and retinal damage induced by long-term silicone tamponade.

Liver stiffness and serum markers for excluding high-risk varices in patients who do not meet Baveno VI criteria

BACKGROUND The Baveno VI criteria for predicting esophageal varices, i.e., liver stiffness measurement (LSM)< 20 kPa and platelet (PLT) count > 150 × 109/L, identify patients who can safely avoid gastroscopy screening. However, they require further refinement. AIM To evaluate the utility of LSM and serum markers of liver fibrosis in ruling out high-risk varices (HRV) in patients who do not meet Baveno VI criteria. METHODS Data from 132 patients with hepatitis B virus (HBV)-related compensated liver cirrhosis who did not meet the Baveno VI criteria were retrospectively reviewed. MedCalc 15.8 was used to calculate receiver operating characteristic (ROC) curves, and the accuracy of LSM, PLT count, aspartate aminotransferase (AST)- to-PLT ratio index, Fibrosis-4, and the Lok index in predicting HRV were evaluated according to the area under each ROC curve (AUROC). The utility of LSM, PLT, and serum markers of liver fibrosis stratified by alanine transaminase (ALT) and total bilirubin (TBil) levels was evaluated for ruling out HRV. RESULTS In all patients who did not meet the Baveno VI criteria, the independent risk factors for HRV were LSM and ALT. Only the AUROC of Lok index was above 0.7 for predicting HRV, and at a cutoff value of 0.4531 it could further spare 24.2% of gastroscopies without missing HRVs. The prevalence of HRV was significantly lower in patients with ALT or TBil ≥ 2 upper limit of normal (ULN)(14.3%) than in patients with both ALT and TBil < 2 ULN (34.1%)(P = 0.018). In the 41 patients with ALT and TBil < 2 ULN, LSM had an AUROC for predicting HRV of 0.821. LSM < 20.6 kPa spared 39.0% of gastroscopies without missing HRVs. In the 91 patients with ALT or TBiL ≥ 2 ULN, the Lok index and PLT had AUROCs of 0.814 and 0.741, respectively. Lok index ≤ 0.5596 or PLT > 100 × 109/L further spared 39.6% and 43.9% of gastroscopies, respectively, without missing HRVs. CONCLUSION In HBV-related compensated cirrhosis patients who do not meet Baveno VI criteria, the LSM, PLT, or Lok index cutoff stratified by ALT and TBil accurately identifies more patients without HRV.

Ragweed pollen induces allergic conjunctivitis immune tolerance in mice via regulation of the NF-κB signal pathway

AIM:To investigate the feasibility and mechanism of immune tolerance in allergic conjunctivitis.METHODS:The allergic conjunctivitis immune tolerance mice model was established by ragweed pollen(RW)and the related cytokines were detected.The mice were divided into 9 groups and the maslinic acid(MA)or PBS were given for different group after modeling.The expression levels of chemokine ligand 5(CCL5)and P-65 in the conjunctival tissue were analyzed by immunohistochemistry,quantitative reverse transcription polymerase chain reaction(q RT-PCR)and Western blot.The percentage of interleukin-17(IL-17)and CD4+CD25+in the splenocyte supernatant was analyzed by flow cytometry.Fur thermore,the serum and splenocyte supernatant concentration of total-IgE,interleukin-10(IL-10),and IL-17 was analyzed by enzyme linked immune response(ELISA).RESULTS:After the model was established,symptoms of conjunctivitis were alleviated,the level of P-65,CCL5,IL-17,and total-IgE was raised,while the expression of IL-10,CD4+CD25+was decreased.This result fully demonstrated that a typical IL-17/regulatory-T-cells(Treg cells)imbalance and NF-κB activation.When the NF-κB signal pathway was suppressed,it showed that there was a further relief of conjunctivitis in mice.At the same time,the expression of total-IgE,IL-17,and CCL5 was decreased and the expression of anti-inflammatory factor(IL-10,CD4+CD25+)was increased.CONCLUSION:In the state of immune tolerance,symptoms of conjunctivitis in mice are alleviated,the Th-17 cells of allergic conjunctivitis mice are inhibited,and Treg cells activity is enhanced.

Meigs’syndrome caused by granulosa cell tumor accompanied with intrathoracic lesions:A case report

BACKGROUND Meigs’syndrome is regarded as a benign ovarian tumor accompanied by pleural effusion and ascites,both of which resolve after removal of the tumor.Patients often seek treatment in the Department of Respiratory and Critical Care Medicine or other internal medicine departments due to symptoms caused by ascites or hydrothorax.Here,we report a rare case of Meigs'syndrome caused by granulosa cell tumor accompanied with intrathoracic lesions.CASE SUMMARY A 52-year-old women was admitted to the Department of Respiratory and Critical Care Medicine due to coughing and expectoration accompanied with shortness of breath.Chest X-ray and chest computed tomography showed a modest volume of pleural fluid with pleural thickening in the right lung.The carbohydrate antigen 125(CA125)concentration was 150.8 U/mL(normal,0-35 U/mL)and no tumor cells were observed in pleural fluid.Nodules and a neoplasm with a fish meat-like appearance in the parietal pleura and nodules with a‘string of beads’-like appearance in the diaphragm were found by thoracoscopic examination.Furthermore,pelvic magnetic resonance revealed a pelvic mass measuring about 11.6 cm×10.0 cm×12.4 cm with heterogeneous signal intensity and multiple hypointense separations.Total abdominal hysterectomy,bilateral adnexectomy,and separation of pelvic adhesion were performed under general anesthesia.The pathology results showed granulosa cell tumor.At the 2-mo follow-up after the surgery,the hydrothorax subsided,and the CA125 level returned to normal.CONCLUSION For postmenopausal women with unexplained hydrothorax and elevated CA125,in addition to being suspected of having gynecological malignancy,Meigs’syndrome should be considered.

Effect of VIATORR stent in early ultrasound evaluation after transjugular intrahepatic portosystemic shunt(TIPS): A case report

Shunt dysfunction is a major complication of transjugular intrahepatic portosystemic shunt(TIPS). Ultrasonography is a preferred method of shunt follow-up after TIPS, but some misjudgments can occur in cases of shunt dysfunction due to peculiarities of the VIATORR stent. Here we report one case and suggest that the first ultrasound evaluation for patients who received TIPS procedure with VIATORR stent should be performed one month after the procedure.

The impact of chemotherapy on cognitive function of breast cancer patient

Objective:Chemotherapy significantly improved the survival of breast cancer,but also brings various symptoms and psychological distresses.Cognitive dysfunction was usually ignored.This study aimed to investigate the changes in cognitive function during chemotherapy and its influence on the quality of life in breast cancer patients.Methods:Female patients with newly diagnosed breast cancer have prospectively enrolled in this study.Participants investigated and completed questionnaires at four-time points:pre-chemotherapy(T1),post-chemotherapy(T2),6 months(T3)and 12 months(T4)after the completion of chemotherapy.The Functional Assessment of Cancer Therapy-Cognitive scale and the Functional Assessment of Cancer Therapy-Breast Cancer scale used was to assess the cognitive function and the quality of life,respectively.Data were analyzed using descriptive and repeated-measures analysis of variance statistics.Results:One hundred and eighty-three patients participated in the study and completed questionnaires at least 2 times.The mean score of cognitive function and the quality of life were significantly different at a different time point(P<0.05 for all).The trends of cognitive scores shown that the most serious damage of cognitive function appeared after beginning chemotherapy and followed by a slowly turn back after the completion of chemotherapy.The trend of the mean score of the quality of life after chemotherapy was similar to that of the cognitive score.The degree of cognitive dysfunction was significantly associated with the score of the quality of life at each time point after chemotherapy(P<0.05).Conclusion:Chemotherapy is closely associated with a cognitive impairment,which contributes to a significant decrease in the quality of life of patients with breast cancer.

Retroperitoneal tumor finally diagnosed as a bronchogenic cyst:A case report and review of literature

BACKGROUND Retroperitoneal bronchogenic cyst(RBC)is an extremely rare developmental abnormality.Most are benign tumors but malignant transformation is possible.Because of their anatomical position,RBCs are easily misdiagnosed as adrenal or pancreatic solid tumors on radiological evaluation.Here,we report a case of RBC,review the literature,and summarize some important features.CASE SUMMARY A 49-year-old woman was incidentally found to have a retroperitoneal tumor during a physical examination.Enhanced computed tomography and laboratory evaluations,including routine blood examination,blood biochemistry,24-h urine 17 ketones,17 hydroxyls,adrenocortical hormone,serum potassium concentration,serum amylase,lipase,and epithelial tumor markers,revealed a moderate density,54 mm×40 mm mass with a clear boundary near the left adrenal gland.The were no abnormalities in the blood and urine values.Because the patient had a history of hypertension and the location of the mass was adjacent to the adrenal gland,it was initially diagnosed as a left adrenal tumor and was resected by retroperitoneal laparoscopy.However,the pathological examination after surgery confirmed it to be a bronchogenic cyst.CONCLUSION Retroperitoneal laparoscopic surgery can be prioritized for symptomatic RBC patients.Conservative treatment is feasible for selected patients.

Mechanism of lncRNA SNHG19 miR-299-5p MAPK6 signaling axis promoting metastasis of non-small cell lung cancer cells

Objective The aim of this study was to explore the mechanism behind lncRNA small nucleolar RNA host gene 19(lncRNA SNHG19)/microrNA-299-5P(miR-299-5p)/mitogen-activated protein kinase 6(MAPK6)signaling axis promoting metastasis of non-small cell lung cancer(NSCLC).Methods To analyze the abnormal expression of lncRNAs in NSCLC,50 surgically resected NSCLC and adjacent tissue samples were collected from August 2021 to August 2022.The mRNA expression levels of lncRNA SNHG19,Mir-299-5p,and MAPK6 were detected by qRT-PCR.The functions of lncRNA SNHG19,Mir-299-5p and MAPK6 were investigated by CCK-8,clone formation,EdU,scratch,Transwell western blotting(WB)and in vivo xenograft assay.RNA fluorescence in-situ hybridization(FISH),RNA pull-down,dual luciferase reporter,and RNA co-immunoprecipitation assays were used to explore the mechanism of action between lncRNA SNHG19,miR-299-5p,and MAPK6.Results High expression of lncRNA SNHG19 was correlated with poor prognosis,tumor size,lymph node metastasis,and TNM stage in NSCLC patients(P<0.05).Cell function experiments showed that lncRNA SNHG19 could improve the proliferation,clone formation,migration,and invasion ability of A549 cells both in vitro and in vivo(all P<0.05)and increased the relative expression levels of vimentin and MAPK6(P<0.05).The relative expression level of E-cadherin was decreased(P<0.05).lncRNA SNHG19 can interact with Mir-299-5p and regulate the expression level of MAPK6.Conclusion lncRNA SNHG19 is upregulated in NSCLC tissues and cells,and its high expression is associated with tumor progression and poor survival.Moreover,it can act as a molecular sponge for Mir-299-5p to regulate MAPK6 expression and promote the proliferation and metastasis of A549 cells.

Effect of the adjuvant Baogan Jiangzhi decoction therapy on liver function and insulin sensitivity in patients with nonalcoholic fatty liver disease

Objective:To study the effect of the adjuvant Baogan Jiangzhi decoction therapy on liver function and insulin sensitivity in patients with nonalcoholic fatty liver disease.Methods: Patients who were newly diagnosed with nonalcoholic fatty liver disease in Nanchong Central Hospital and Suining Central Hospital between March 2015 and October 2017 were selected and randomly divided into the observation group who accepted Baogan Jiangzhi decoction combined with conventional western medicine treatment and the control group who accepted conventional western medicine treatment. The contents of liver damage indexes, inflammatory response markers and oxidative stress markers in serum as well as the expression of insulin signaling molecules in peripheral blood were measured before treatment and 2 weeks after treatment.Results:ALT, AST,γ-GT, TBIL, Chemerin, Wnt5a,β-catenin, MDA and NO contents in serum of both groups 2 weeks after treatment were lower than those before treatment whereas APN, Ghrelin, T-AOC and SOD contents in serum as well as IRS1, IRS2 and GLUT4 expression in peripheral blood were higher than those before treatment, and compared with those of control group, ALT, AST,γ-GT, TBIL, Chemerin, Wnt5a,β-catenin, MDA and NO contents in serum of observation group 2 weeks after treatment were lower whereas APN, Ghrelin, T-AOC and SOD contents in serum as well as IRS1, IRS2 and GLUT4 expression in peripheral blood were higher.Conclusion: Adjuvant Baogan Jiangzhi decoction therapy for nonalcoholic fatty liver disease can reduce liver function injury and improve insulin sensitivity.

Effect of Zhenwu decoction combined with paclitaxel neoadjuvant chemotherapy on the malignant degree of cervical cancer

Objective:To study the effect of Zhenwu decoction combined with paclitaxel neoadjuvant chemotherapy on the malignant degree of cervical cancer.Methods: Patients with cervical cancer who accepted neoadjuvant chemotherapy in Nanchong Central Hospital and Suining Central Hospital between March 2015 and June 2017 were selected and randomly divided into two groups, the observation group received neoadjuvant chemotherapy combined with Zhenwu decoction therapy, and the control group received neoadjuvant chemotherapy. Before chemotherapy and after 2 courses of chemotherapy, the serum was collected to detect the contents of tumor markers;after chemotherapy, the surgically removed cervical cancer lesion was collected to detect the mRNA expression of proliferation genes, tumor suppressor genes and invasion genes.Results: After 2 course of chemotherapy, CA12-5, bFGF and SCC-Ag levels in serum of both groups were lower than those before treatment, and CA12-5, bFGF and SCC-Ag levels in serum as well as Ki-67, TK-1, SOX-2, CyclinD1, S100A6, N-cadherin, Gal-3, CatL and CatD mRNA expression in cervical cancer lesion of observation group were lower than those of control group whereas p53, p16, FHIT, NF2-1 and LATS1 mRNA expression in cervical cancer lesions were higher than those of control group.Conclusion:Zhenwu decoction combined with paclitaxel neoadjuvant chemotherapy can be more effective than neoadjuvant chemotherapy alone to kill cervical cancer cells and reduce the malignancy of cervical cancer.

The prognostic value of baseline circulating tumor cells in patients with metastatic breast cancer: a meta-analysis

Objective:The prognostic value of circulating tumor cells(CTCs)in metastatic breast cancer(MBC)patients was contentious.A meta-analysis was conducted to evaluate whether MBC patients’clinical outcomes could be predicted by CTCs detection.Methods:Relevant published studies were searched through electronic databases from January 1990 to February 2018,among which,those investigated the correlation between CTCs and clinical outcomes of progression-free survival and overall survival in MBC patients were involved.The hazard ratios(HR)and confidence intervals(CI)in the studies were extracted from the study using random or fixed effects model,and the meta-analysis was conducted.The prognostic value of tumor cells in patients with different subtypes was estimated by subgroup analysis.Results:Twenty-one eligible studies enrolling 3,837 patients were appropriate for pooled analysis.Progression-free survival(HR,1.66;95%CI,1.47–1.87;P=0.000)and overall survival(HR,2.51;95%CI,2.13–2.96;P=0.000)were worse in patients with CTCs-positive.Subtypes of hormone receptor(HorR)positive,human epidermal growth factor receptor-2(HER2)negative and triple negative with presence of CTCs showed a statistically significant worse PFS and OS.However,CTCs detection presented no prognostic value in patients with HorR-negative or HER2-positive subtypes.Conclusion:The enumeration of CTCs at baseline in patients with MBC subtypes of HorR-positive,HER2-negative and triple negative is connected with disease progression and poor survival,but inappropriate for HorR-negative and HER2-positive subtypes.

Association of Overlapped and Un-overlapped Comorbidities with COVID-19 Severity and Treatment Outcomes: A Retrospective Cohort Study from Nine Provinces in China

Objective Several COVID-19 patients have overlapping comorbidities. The independent role of each component contributing to the risk of COVID-19 is unknown, and how some non-cardiometabolic comorbidities affect the risk of COVID-19 remains unclear.Methods A retrospective follow-up design was adopted. A total of 1,160 laboratory-confirmed patients were enrolled from nine provinces in China. Data on comorbidities were obtained from the patients’ medical records. Multivariable logistic regression models were used to estimate the odds ratio(OR) and 95% confidence interval(95% CI) of the associations between comorbidities(cardiometabolic or non-cardiometabolic diseases), clinical severity, and treatment outcomes of COVID-19.Results Overall, 158(13.6%) patients were diagnosed with severe illness and 32(2.7%) had unfavorable outcomes. Hypertension(2.87, 1.30–6.32), type 2 diabetes(T2 DM)(3.57, 2.32–5.49),cardiovascular disease(CVD)(3.78, 1.81–7.89), fatty liver disease(7.53, 1.96–28.96), hyperlipidemia(2.15, 1.26–3.67), other lung diseases(6.00, 3.01–11.96), and electrolyte imbalance(10.40, 3.00–26.10)were independently linked to increased odds of being severely ill. T2 DM(6.07, 2.89–12.75), CVD(8.47,6.03–11.89), and electrolyte imbalance(19.44, 11.47–32.96) were also strong predictors of unfavorable outcomes. Women with comorbidities were more likely to have severe disease on admission(5.46,3.25–9.19), while men with comorbidities were more likely to have unfavorable treatment outcomes(6.58, 1.46–29.64) within two weeks.Conclusion Besides hypertension, diabetes, and CVD, fatty liver disease, hyperlipidemia, other lung diseases, and electrolyte imbalance were independent risk factors for COVID-19 severity and poor treatment outcome. Women with comorbidities were more likely to have severe disease, while men with comorbidities were more likely to have unfavorable treatment outcomes.

Influence of Aidi injection combined with paclitaxel and platinum drugs on malignant molecule expression in malignant ascites of patients with advanced gastric cancer

Objective: To explore the influence of Aidi injection combined with paclitaxel and platinum drugs on malignant molecule expression in malignant ascites of patients with advanced gastric cancer. Methods: A total of 80 patients with advanced gastric cancer complicated by malignant ascites who were treated in the hospital between January 2015 and December 2016 were divided into control group and observation group by random number table, each with 40 cases. Control group were treated with paclitaxel and platinum drugs, and observation group were treated with Aidi injection combined with paclitaxel and platinum drugs. The differences in the malignant molecule expression in malignant ascites were compared between the two groups of patients before and after treatment. Results: Before treatment, the proliferation, invasion and autophagy gene expression in malignant ascites were not statistically different between the two groups of patients. 1 week after treatment, EZH2, I2PP2A, Gal-1, HPA-1, MTA1, TROP2, BNIP3 and LC3 mRNA expression in malignant ascites of both groups of patients were lower than those before treatment while PTPN13, TRIM28, SOX7, Syndecan-1 and Beclin1 mRNA expression were higher than those before treatment, and EZH2, I2PP2A, Gal-1, HPA-1, MTA1, TROP2, BNIP3 and LC3 mRNA expression in malignant ascites of observation group were lower than those of control group while PTPN13, TRIM28, SOX7, Syndecan-1 and Beclin1 mRNA expression were higher than those of control group. Conclusion: Aidi injection combined with paclitaxel and platinum drugs can effectively inhibit the gastric cancer cell proliferation and invasion, and regulate cell autophagy activity in the malignant ascites of patients with advanced gastric cancer.

Effect of hyperbaric oxygen combined with drug therapy on cerebral blood flow characteristics, nerve injury and nerve cytokines in the convalescence of hypertensive cerebral hemorrhage

Objective:To study the effect of hyperbaric oxygen combined with drug therapy on cerebral blood flow characteristics, nerve injury and nerve cytokines in the convalescence of hypertensive cerebral hemorrhage.Methods:A total of 215 patients who were in convalescence of hypertension cerebral hemorrhage and treated in our hospital between January 2013 and January 2017 were collected and divided into the control group (n=109) who received conventional therapy and the observation group (n=106) who received adjuvant hyperbaric oxygen therapy, and both therapies lasted for 1 month. The differences in nerve function and neurotrophic state were compared between the two groups of patients before and after treatment.Results: Before treatment, differences in the levels of cerebral hemodynamic index levels as well as nerve injury index, amino acid neurotransmitter and neurotrophic factor contents were not statistically significant between the two groups of patients. After 1 month of treatment, Vmean and Qmean levels as well as serum GABA, Gly, BDNF, NGF and NTF contents of both groups of patients were higher than those before treatment while R and Wv levels as well as serum S100B, GEAP, NSE, Glu and Asp contents were lower than those before treatment, and Vmean and Qmean levels as well as serum GABA, Gly, BDNF, NGF and NTF contents of observation group were higher than those of control group while R and Wv levels as well as serum S100B, GEAP, NSE, Glu and Asp contents were lower than those of control group.Conclusion: Adjuvant hyperbaric oxygen therapy can effectively reduce the nerve injury and optimize the neurotrophic state of patients in the convalescence of hypertensive cerebral hemorrhage.

Effects of preoperative concurrent radiochemotherapy on the cancer cell infiltration and angiogenesis in local advanced gastric cancer lesions

Objective: To study the effects of preoperative concurrent radiochemotherapy on the cancer cell infiltration and angiogenesis in local advanced gastric cancer lesions. Methods: A total of 68 patients who were diagnosed with locally advanced gastric cancer in this hospital between February 2015 and April 2017 were selected as the research subjects and randomly divided into two groups, the radiochemotherapy group received capecitabine + cisplatin chemotherapy combined with intensity modulated radiation therapy before operation, and chemotherapy group received preoperative capecitabine + cisplatin chemotherapy. The gastric cancer lesions surgically removed from two groups of patients were collected to determine the expression of proliferation-related genes, invasion-related genes and angiogenesis-related genes. Results:Rab27B, Bax, Caspase-3, PTPN13, E-cadherin and THBS2 protein expression in gastric cancer lesions of radiochemotherapy group were greatly higher than those of chemotherapy group whereas EZH2, PRR1, EPHA2, HDAC5, N-cadherin, Twist1, ANGPTL2, ANGPTL5, GOLPH3 and HIF-1 protein expression were greatly lower than those of chemotherapy group. Conclusion: Preoperative concurrent radiochemotherapy has inhibitory effect on the cancer cell infiltration and angiogenesis in local advanced gastric cancer lesions.