[A case of pleural metastasis of malignant peripheral nerve sheath tumor].

Malignant peripheral nerve sheath tumor (MPNST) frequently metastasizes to the lungs, although pleural metastasis is rare. This article reported a case of pleural metastasis of MPNST. The patient was a young man who presented with 1 week of shortness of breath with dry cough. He had a history of malignant peripheral nerve sheath tumor. The patient was diagnosed with MPNST pleural metastasis after a thoracoscopic pleural biopsy, which revealed short spindle cell hyperplasia, immunohistochemical staining for S-100(+), SOX-10(+), Ki-67(+) with a positive index of 20%, and H3K27Me3(-) in the pleural pathology.

[Preliminary report on the use of total lumpectomyconical remnant gastric - esophagus side overlap anastomosis in radical resection of Siewert type II proximal gastric cancer].

Objective: There is no standard method for esophageal remnant gastric reconstruction for proximal gastrectomy. Reflux esophagitis caused by esophagogastrostomy remains a difficult surgical problem. To report the preliminary surgical results of novel esophagus-conical remnant gastric side overlap anastomosis (CGEO) , with particular emphasis on postoperative esophageal reflux. Methods: In June 2022, we developed a novel CGEO for laparoscopic proximal gastrectomy on two patients with Siewert type II esophagogastric junction adenocarcinoma. Surgical procedures for CGEO: (1) Laparoscopic proximal gastrectomy and preparation of conically shaped gastric remnant; (2) Determining anastomotic site of residual stomach and esophagus; (3) Side-to-side anastomosis of right esophageal wall to anterior of conical gastric remnant; (4) Valvuloplasty of esophageal stump. Results: Case 1 was a 71-year-old man with an operation time of 305 minutes and was successfully discharged from the hospital on the 9th day after surgery, and the postoperative pathology was T3N0M0. Case 2 was an 82-year-old man with an operation time of 325 minutes. He was discharged on the 10th day after surgery. In both cases, only mild esophageal mucosal changes were seen in gastroscopy, there were no obvious symptoms of esophageal reflux. There was also no significant weight change at half a year after operation. Conclusion: CGEO is moderately safe in radical surgery for proximal gastric cancer, and may have a preventive effect on the occurrence of postoperative esophageal reflux, but long-term results need to be confirmed by further studies with follow-up.

[Application of SF-36 scale in the survey of quality of life of occupational disease patients].

Objective: To explore the application of the Short Form of Quality of Life (SF-36) scale in the investigation of quality of life of occupational disease patients. Methods: In May 2019, SF-36 scale was used to investigate the occupational disease patients diagnosed in Hangzhou. The reliability of the scale was evaluated by Cronbach's α coefficient, and the validity of the scale was evaluated by exploratory factor analysis. Results: The Cronbach's α coefficients of PF, RP, BP, GH, VT, SF, RE and MH were 0.937, 0.977, 0.870, 0.908, 0.815, 0.701, 0.967 and 0.863 respectively, and the half reliability coefficient α=0.905. The two factor statistics representing physiological and psychological aspects were 0.870, and the approximate chi square value was 1784.337 (P<0.01) . Compared with the national norm, the scores of each dimension of quality of life of occupational disease patients were significantly lower, and the differences were statistically significant (P<0.01) ; Compared with the scores of each dimension of quality of life of pneumoconiosis patients, the scores of PF, RP and GH of occupational disease patients were significantly higher, and the differences were statistically significant (P<0.05) . Conclusion: SF-36 scale has good reliability and validity in measuring the quality of life of patients with occupational diseases, which can be used to evaluate the quality of life of patients with occupational diseases.

[Study on quality of life and influeming factors of occupational disease patients in hangzhou].

Objective: To investigate and analyze the quality of life of occupational patients in Hangzhou and its influencing factors, so as to improve their qol. Methods: From January 2007 to June 2018, patients with diagnosed occupational diseases in Hangzhou City were randomly sampled in October 2019. The patients＇basic condition and quality of life were investigated by self-made questionnaire and SF-36, a total of 303 valid questionnaires were collected and the influencing factors were analyzed by correlation analysis and multiple linear regression. Results: The scores of physiological function, physiological function, physical pain, general health status, energy, social function, emotional function and mental health of the patients with occupational diseases in Hangzhou were lower than those of the general population in China, the differences were statistically significant (P<0.01) . The main factors affecting the score of quality of life of occupational patients are the types of occupational diseases, the level of disability and the duration of illness, the condition of suffering from other diseases, age, educational level, whether they are entitled to Work Injury Insurance, economic income, medical security and social support, the difference was statistically significant (P<0.05) . Conclusion: The quality of life of the patients with occupational diseases in Hangzhou City is poor, and the corresponding measures should be established to improve the qulity of life.

LncRNA MIF-AS1 aggravates the progression of ovarian cancer by sponging miRNA-31-5p.

OBJECTIVE: The aim of this study was to uncover the role of lncRNA MIF-AS1 in influencing the biological phenotypes of ovarian cancer (OC) and the underlying mechanism. PATIENTS AND METHODS: OC tissues and adjacent normal tissues were collected from 50 OC patients. The expression level of lncRNA MIF-AS1 in OC tissues and cells was determined by quantitative Real-Time Polymerase Chain Reaction (qRT-PCR). The prognostic potential of MIF-AS1 in OC patients was assessed by the Kaplan-Meier method. Subsequently, the regulatory effects of MIF-AS1 on proliferative, migratory, and invasive abilities of ES-2 and HO-8910 cells were evaluated by a series of functional experiments. Dual-Luciferase reporter gene assay, qRT-PCR, and Western blot were further conducted to verify the interaction in the regulatory loop MIF-AS1/miRNA-31-5p/PLCB1. RESULTS: MIF-AS1 was significantly upregulated in OC tissues and cell lines (p<0.05). Higher level of MIF-AS1 predicted significantly worse prognosis of OC patients (p<0.05). The knockdown of MIF-AS1 markedly attenuated the proliferative, migratory, and invasive abilities of ES-2 and HO-8910 cells (p<0.05). Dual-Luciferase reporter gene assay verified that MIF-AS1 competed with PLCB1 to bind miRNA-31-5p. In addition, MIF-AS1 negatively regulated miRNA-31-5p expression cells, and miRNA-31-5p negatively regulated PLCB1 expression in OC. CONCLUSIONS: MIF-AS1 was significantly upregulated in OC, which accelerated the proliferative, migratory, and invasive abilities of OC cells. Furthermore, the regulatory loop MIF-AS1/miRNA-31-5p/PLCB1 could be utilized as a therapeutic target for OC.

[A bibliometric analysis on cohort study of liver cancer in China].

Objective: To retrospectively analyze the application trend of cohort study in the field of liver cancer in past 27 years and to look forward to the future development trend. Methods: Chinese and English papers reporting the cohort studies of liver cancer conducted in the mainland of China since 1991 were included. The literature management software was used to analyze the publication time, institution, type and objective of the studies and the follow-up performance. Statistical analysis was carried out by using SPSS 21.0. Results: The number and quality of the papers reporting liver cancer-related cohort studies increased significantly in past 27 years and a core English journal group of this field has formed. The average annual growth rates of Chinese and English papers published were 20.4% and 35.2% respectively. About 52.3% of the Chinese papers and 73.5% of the English papers were published in past five years and the quality of these papers was high. The Chinese papers published on Chinese core journals accounted for 49.2%, and the English papers published on SCI periodicals (IF>3) accounted for 47.3%. For the study objective, those published on the domestic journals mainly focused on the pathogenesis of hepatoma (41.5%), studies with large sample size was the common form. The SCI studies mainly focused on the prognosis of liver cancer (40.7%). High-quality SCI papers are more interested in the studies of prognosis, and survival analysis was the common form. Conclusions: The application of cohort study in the field of liver cancer gradually increased in China. Large-scale study and prognosis analysis were conducted commonly. However, it is necessary to further improve the researchers' understanding of cohort study, improve the follow-up quality, and increase the application of scientific evaluation methods, such as survival analysis, for the better solving of clinical problems.

Mechanism of decorin protein inhibiting invasion and metastasis of non-small cell lung cancer.

OBJECTIVE: To detect the protein level of Decorin in non-small cell lung cancer (NSCLC) patients, and to study the mechanism of Decorin inhibiting invasion and metastasis of non-small cell lung cancer from the perspective of in vitro cells, and provide some theoretical support for the treatment of non-small cell lung cancer. MATERIALS AND METHODS: Immunohistochemical staining was used to detect the expression of Decorin protein in 332 cases of stage I-IIIA clinical NSCLC and 70 cases of adjacent tissues. Then, in vitro cell experiments (cell scratch assay and transwell assay) were used to further study the effects of Decorin on migration and invasion of human lung cancer cell line A549; the effect of transforming growth factor-ß on the expression of Decorin and Ets-1 protein was verified by Western blotting. The binding sites of Ets-1 and Decorin promoter were analyzed by bioinformatics. RESULTS: Exogenous Decorin inhibited invasion and metastasis of lung adenocarcinoma cells in vitro. Immunohistochemical staining showed that Decorin was lowly expressed in non-small cell lung cancer and Decorin had a certain effect on lung fibroblast activation. Western blotting results showed that TGF-ß affects the expression of Decorin and Ets-1. Bioinformatics results showed that Ets-1 and Decorin gene DNA promoter regions have 18 binding sites. CONCLUSIONS: Decorin inhibits invasion and metastasis of non-small cell lung cancer through the TGF-ß signaling pathway.

[The study on behaviour of protective equipment utilization of workers exposed to benzene and factors based on Planned Behavior Theory].

Objective: To investigate and predict the behavioral intention and mode of the protective equipment utilization selection of the workers who used Benzene, the Theory of Planned Behavior (TPB) was applied to establish the behavioral model to enhance the theoretical foundation for long-term intervention. Methods: Questionnaires were used to survey the 707 workers, and all the behaviors of using protective equipment were investigated. Evaluate the relationships between each variable and obtain the influence affects by structural equation model. Results: The investigation showed that 38.47% of the total workers (272 cases) used whole body protection, 13.58% used partially, and 16.69% didn't use any body protection. There were significant difference between the varying degrees in the four dimensions (behavioral attitude, perceived behavior control, subjective norm, and behavioral intention) (P<0.01) . The results of structural equation model revealed that perceived behavior control was the most important influencing factor, subjective norm, positive attitude, negative attitude were the other three respects in sequence. The path co-efficient were 0.600、0.215、0.141 and 0.046 respectively. Conclusion: The study show that the theory of planned behavior can effectively explain the behavioral intention and behavior of protective equipment utilization. Therefore, combining the subjective initiative of individuals with the supervision of enterprises, In order to effectively enhance the protective equipment utilization of benzene workers.

[Response and prognosis of neoadjuvant dose-dense or standard schedule chemotherapy with anthracyclines and taxanes for Luminal B breast cancer].

Objective: To evaluate the efficacy and safety of neoadjuvant dose-dense or standard schedule chemotherapy with anthracyclines and taxanes for Luminal B (HER2-)Breast Cancer. Methods: From January 2010 to December 2014, 168 Luminal B (HER2-) breast cancer patients with stageⅡA-ⅢC confirmed by pathology were randomly assigned to receive one of the following regimens: (group A) concurrent TEC× 4 every 3 weeks, ( group B ) sequential EC× 4-T × 4 every 3 weeks, (group C ) dose-dense TEC× 4 every 2 weeks with G-CSF, (group D) sequential EC× 4(dose-dense)-T × 4 with dose-dense every 2 weeks . Results: A total of 168 patients completed the neoadjuvant chemotherapy as planned. The pathologic complete response (pCR) was 16.8% in the 4 groups.The pCR were 30.9% and 26.1% in the group C and group D respectively, significantly higher than patients with group A and group B(9.5%and 7.1%) ( P<0.05). Median follow-up was 43 months (IQR 3-63). The 3-year disease free survival (DFS) rate was 64.7%, 55.5%, 87.8% and 92.1% and the 3-year overall survival(OS)rate was 79.4%, 77.7%, 95.1%, 97.3% in the 4 groups respectively. Patients in the dose-dense group had better 3-year DFS and 3-year OS than those with the regular group.The side-effects could be evaluated in 154 patients.The incidence of neutropenia was 29.2% and 21.9% in the group C and group D versus 65.7%and 51.3% in the regular group(P<0.05), the incidence of nervous toxicity was 54.2%, 18.9%, 60.0%, 26.8% in the 4 groups respectively. The incidence of nervous toxicity in the dose-dense group was lower than that in the regular regimen group(P<0.05). Conclusion: Neoadjuvant dose-dense chemotherapy with anthracyclines and taxanes for Luminal B (HER2-)Breast Cancer was effective and can improve the pCR, DFS and OS.Comparing the two dose dense regimens, sequentially with anthracyclines and taxanes, the incidence of nervous toxicity were lower.

[Analysis of diagnosis, therapy and prognosis factors of 103 patients with pancreatic neuroendocrine tumors].

Objective: To discuss the clinical pathology characteristics, strategies of diagnosis and therapy, and related prognosis factors of pancreatic neuroendocrine tumors(pNET). Methods: Clinical data of 103 pNET cases in Department of Pancreatic Surgery, Changhai Hospital of Second Military Medical University were collected from January 2006 to December 2015. There were 44 males and 59 females, aged from 21 to 77 years with mean age of 48 years.Of the 103 patients, there were functional type in 21 cases and no functional type in 82 cases. Related factors on diagnosis and treatment were summarized. Moreover, univariate survival analysis was performed by Kaplan-Meier method, and COX proportional hazards model was used for multivariate survival analysis. Results: The detection rates of the B-ultrasound, CT, MRI were 60.2%, 84.6% and 91.3%, respectively, and there were 44 cases located in pancreatic head, 18 cases in pancreatic neck and 41 cases in pancreatic body and tail.G1 was the most common pathological grade, and the positive rates of Chromogranin A, Syn, neuron-specific enolase and CAM5.2 were 97.1%, 97.1%, 91.3% and 93.2%, respectively. The results of statistical analysis showed that tumor grade(χ(2)=26.077, P<0.05), Ki-67 index(χ(2)=25.427, P<0.05), ENETS stage(χ(2)=5.915, P<0.05), AJCC stage(χ(2)=8.411, P<0.05), lymph node metastasis(χ(2)=4.770, P<0.05) and distant metastasis(χ(2)=8.411, P<0.05) were associated with the prognosis of pNET, and the tumor grade was an independent risk factor of the pNET' overall prognositic factors (HR=3.085, P<0.01). Conclusions: The pNET can be located in any part of pancreas, and the combination of laboratory and various imaging examinations can help make early diagnosis. In addition, tumor grade, Ki-67 index, ENETS stage, AJCC stage, lymph node metastasis and distant metastasis were closely related to the prognosis of pNET, and the higher the tumor grade, the worse the prognosis.

[Effects of trabecular metal augments for the reconstruction of Paprosky type â ¢ acetabulum bone defects].

Objective: To investigate the methods and short-time clinical results of reconstruction of Paprosky type Ⅲ acetabulum bone defects by using tantalum augments. Methods: A total of 17 patients (17 hips) with Paprosky type Ⅲ acetabulum bone defects, treated with tantalum augments in revision of total hip arthroplasty at Department of Orthopedics Surgery in General Hospital of Chinese People's Liberation Army were retrospectively analyzed from March 2014 to May 2016.There were 6 males and 11 females aged from 23 to 74 years with an average of (50.2±16.3) years. Tantalum augments or TM-Cup augment (the cup-on-cup technique) were used to reconstruct the defects.The TM-Cup augment was the tantalum revision cup which was removed titanium ring. The cup-on-cup technique combined TM-Cup augment and biological acetabulum cup. Augments were served as the nonresorptive structural allograft in revision of total hip arthroplasty. Harris hip score was used to evaluate clinical effects. The vertical position of the rotation center was measured and analyzed. Radiographic assessments of the acetabular components were performed by DeLee-Charnley and the Anderson criteria and recorded postoperative complications. Results: All the patients were followed up from 3 to 29 months with an average of (16.2±5.4) months, tantalum augments and biological acetabulum cup were used in 13 patients, the TM-Cup augment and biological acetabulum cup were used in 4 patients. At the time of the latest follow-up, the mean Harris hip score increased compared to preoperatively (86.8±8.3 vs. 30.0±12.0) (t=12.78, P<0.01), the average vertical location of the center of rotation was decreased ((25.3±9.8) mm vs.(47.6±10.5)) mm (t=4.95, P<0.01). All the tantalum augments and biological acetabulum cups were stable, there were no infection, dislocation and other complications. Conclusions: The use of tantalum augments could be considered as an effective management of Paprosky type Ⅲ defects providing good clinical and radiographic outcomes in the short term.The cup-on-cup technique which was used in reconstruction of severe superior-invagination acetabular bone defects and restoration relatively normal center of rotation had special application value.

[Experimental observation of hyperbaric oxygen combined with radioactive seed implantation in the treatment of nude mice bearing esophageal squamous cell carcinoma].

Objective: To investigate the effect and mechanism of hyperbaric oxygen combined with radioactive seed implantation in the treatment of esophageal squamous cell carcinoma. Methods: Subcutaneous tumor model of esophageal squamous cell carcinoma using TE-8 cells was established. Tumor bearing Balb/c(nu/nu) mice (60 mice) were divided into four groups, Cont group that treated with normal oxygen level, HBO group that treated with hyperbaric oxygen, RSI group that treated with radioactive seed implantation, and HBO+ RSI group that treated with hyperbaric oxygen combined with radioactive seed implantation. Tumor volume ratio and mean survival time of tumor bearing mice were observed. Pathological changes of tumor tissue after treatment were observed by hematoxylin eosin (HE) staining. Enzyme linked immunosorbent assay kit was used to detect oxidative stress. Apoptosis related proteins were detected by Western blot. Results: After treatment, the tumor volume ratio of HBO+ RSI group was 3.51±0.80 and was significantly lower than that of Cont group, HBO group, and RSI group (P<0.05). The mean survival time of HBO+ RSI group tumor bearing mice was 62 d and was significantly longer than that in Cont group, HBO group, and RSI group (P<0.05). HE staining showed that the pathological changes of tumor tissues were most obvious in HBO+ RSI group. After treatment, the MDA and Bax levels in nude mice of HBO+ RSI group were significantly higher than those in Cont group, HBO group and RSI group, but the levels of GSH, SOD and Bcl-2 were significantly lower than those of Cont group, HBO group and RSI group (P<0.05). Conclusion: Hyperbaric oxygen combined with radioactive seed implantation could slow tumor growth and increase survival time of tumor bearing mice. The possible mechanism is that hyperbaric oxygen combined with radioactive seed implantation can improve the oxidative stress response and the expression of apoptosis protein in tumor bearing nude mice.

Association of genetic variations in miR-146a rs2910164 and miR-149 rs11614913 with the development of classic Kaposi sarcoma.

Classic Kaposi sarcoma is a type of vascular proliferative inflammatory disease. Previous studies have reported significant associations between microRNAs expression and the development of classic Kaposi sarcoma. Here, we conducted a case-control study to investigate the association between miR-146a and miR-149 genetic polymorphisms and risk of classic Kaposi sarcoma in a Chinese population. Both classic Kaposi sarcoma patients and healthy controls were recruited between December 2013 and October 2015. Genotyping of miR-146a and miR-149 was performed by polymerase chain reaction-coupled with restriction fragment length polymorphism. Results showed that the GG genotype of miR-146a was associated with increased risk to classic Kaposi sarcoma (OR = 6.00, 95%CI = 1.19-30.12), as compared with the CC genotype. In the recessive model, we found that the GG genotype carried a 4.55-fold increased risk to classic Kaposi sarcoma as compared with the CC + CG genotype (OR = 2.06, 95%CI = 1.04-20.29). In conclusion, our study demonstrated that miR-146a, but not miR-149 polymorphism, is associated with risk to classic Kaposi sarcoma in the Chinese population.

[A study of the diagnostic value of endobronchial ultrasound guide sheath transbronchial lung biopsy combined with virtual bronchoscopic navigation in peripheral pulmonary lesions].

OBJECTIVE: To evaluate the diagnostic value of endobronchial ultrasound guide sheath transbronchial lung biopsy (EBUS-GS-TBLB) combined with virtual bronchoscopic navigation (VBN) in peripheral pulmonary lesions (PPLs). METHODS: Cases with a PPL identified by computed tomography in Affiliated Hospital of Medical College of Ningbo University underwent EBUS-GS-TBLB with or without VBN randomly between Nov. 2014 to Aug. 2015. X-ray guidance was not performed in these cases. The sensitivity and the operation time were evaluated in the 2 groups. RESULTS: A total of 184 patients were enrolled and completed this study. Among them 117 were males and 67 were females. There were 93 cases in the group of EBUS-GS-TBLB with VBN, and 91 in the group without VBN. The diagnostic sensitivity of VBN group was 72.04%(67/93). Among these positive cases, 64.1% cases (43/67) were malignant tumors, and 35.9% cases (24/67) were benign lesions. The mean operation time was (45±10)min. In the group without VBN, the diagnostic sensitivity was 69.23%(63/91), including 33 malignant tumors(52.4%, 33/63), and 30 benign lesions(47.6%, 30/63). The mean operation time was (55±10)min. There was no significant difference between EBUS-GS-TBLB with VBN group and EBUS-GS-TBLB without VBN group in diagnostic sensitivity (χ(2)=0.175, P=0.747). But there was a significant difference in the mean operation time between the 2 groups (t=6.522, P<0.001). EBUS-GS-TBLB was well tolerated. No severe procedure-related complications such as pneumothorax and hemoptysis were observed. CONCLUSION: VBN cannot improve the diagnostic sensitivity, but it can clear the location of lesion, and shorten the operation time. This technique helps to abandon the X-ray guidance. EBUS-GS-TBLB combined with VBN is a safe and effective technique for PPLs.

Lipid peroxidation and cell death mechanisms in rats and human cells induced by chloral hydrate.

Chloral hydrate (CH) is widely used as a sedative and hypnotic in pediatric medicine. It is also a by-product of water chlorination and a metabolite of trichloroethylene. We examined the toxicological effects and cell death mechanisms of CH in rats and human Chang liver cells and lymphocytes. Monitoring of urinary 8-epi-PGF2alpha and serum levels of TNF-alpha served as index of lipid peroxidation and cytokine stimulation. The results indicated that a single intraperitoneal injection of 100 mg/kg CH in rats led to a nearly five-fold increase in urinary 8-epi-PGF2alpha on day 1, and a mild decrease on day 2 and day 3. The same treatment also induced significantly higher amounts of serum TNF-alpha on day 2 (about seven-fold). When the rats were treated with CH and vitamin E simultaneously, the amount of urinary 8-epi-PGF2alpha and serum TNF- were significantly lower than that in the rats treated with CH alone. CH caused a greater cytotoxic effect in human Chang liver cells than in comparison with lymphocytes. After treatment with CH, apoptosis features were observed in human lymphocytes, but not Chang liver cells. CH-induced cell damage in lymphocytes may offer signals for the induction of caspases activation. Further studies are needed to evaluate the relationship between caspases activation and the cleavage of other death substrates during postmitotic apoptosis in human lymphocytes.