Risk factors of lymph node metastasis in early gastric cancer / 中华普通外科杂志

Objective:To investigate the clinical characteristics and risk factors of lymph node metastasis of early gastric cance.Methods:The data of 176 early gastric cancer patients (EGC) undergoing radical gastrectomy were analyzed retrospectively.Results:Lymph node (LN) metastasis occurred in 24 patients. The average harvested LN in the negative group was 23±13, and that in the positive group was 30±16, ( t=0.327, P=0.015). Univariate analysis showed that there were significant differences in the depth of tumor invasion ( χ2=3.997, P=0.046), degree of pathological differentiation ( χ2=9.919, P=0.007), vascular invasion ( χ2=35.145, P=0.000) and nerve invasion ( χ2=13.343, P=0.000). Multivariate analysis showed that vascular infiltration ( OR=16.172, 95% CI: 4.781-55.875), nerve infiltration ( OR=1.365, 95% CI: 1.029-14.897), infiltration depth ( OR=1.859, 95% CI: 1.844-22.711) were independent risk factors for LN metastasis in early gastric cancer ( P<0.05). The overall 3-year survival rate was 96.6%, and the 5-year survival rate was 91.6%. Conclusion:The lymph node metastasis of early gastric cancer is related to the degree of differentiation, the depth of invasion, vascular invasion, nerve invasion and the number of lymph node dissected.

Advances in radiotherapy for extensive-stage cell lung cancer / 中国肿瘤临床

Extensive-stage small cell lung cancer (ES-SCLC) accounts for approximately two-thirds of all SCLCs. Chemotherapy is still the main treatment, supplemented with radiotherapy and other comprehensive treatments. Although sensitive to chemotherapy and radiotherapy, almost all ES-SCLCs are vulnerable to treatment resistance and have high recurrence rates. Therefore, novel therapies are needed to improve treatment efficacy. The recent advances in radiotherapy for ES-SCLC include prophylactic cranial irradiation (PCI) and thoracic radiotherapy (TRT). Moreover, immunotherapy has shown good antitumor activity, and immune-checkpoint inhibi-tors may become an important breakthrough in SCLC treatment. This article briefly reviewed the clinical research on radiotherapy and immunotherapy for advanced-stage SCLC.

Clinical effect of covered stent in the treatment of Stanford type B aortic dissection and the effect on cardiopulmonary function of patients / 中国综合临床

Objective To investigate the effect of covered stent on the treatment of Stanford type B aortic dissection and its effect on cardiopulmonary function. Methods From June 2014 to December 2015, sixty-four AD patients treated in our hospital were selected and were divided into the control group(30 cases) and the observation group ( 32 cases) . The control group was treated with conservative treatment while the observation group was treated with covered stent. After treatment,two groups of patients were followed up for at least 24 months to understand the recovery status after treatment and evaluate the effect. . Results The time of hospitalization of the observation group ((26. 10±8. 14) d) was shorter than that of the control group ((33. 89 ±8. 32) d) (t＝4. 963,P＜0. 05),and there was no statistically significant difference in the mortality and complication rate in 30d after operation between the two groups (χ2＝1. 084,0. 015,P＞0. 05); at 24 months after discharge,the survival rate (93. 75%(30/32)),standard rate of blood pressure 93. 75 (30/32) and treatment compliance rate(90. 63 (29/32)) of the observation group were higher than those of the control group (53.33%(16/30); 60.00(18/32);73.33(22/30)) (χ2 ＝ 13.210、10.088、4.771,P＜0.05) . After treatment,the cardiac output((4. 99±0. 53) L/min) and left ventricular ejection fraction((51. 88±3. 64)%) of the observation group were higher than those of the control group((4. 13±0. 13) L/min,(46. 30 ±9. 63)%). The end systolic diameter of left ventricle (( 55. 75 ± 2. 11) mm) and left ventricular end diastolic diameter ((57. 80± 3. 53) mm) of the observation group were less than those of the control group (( 65. 77 ± 2. 21), (64. 54±2. 67) mm). The differences between the two groups were statistically significant(t＝8. 643、3. 054、8. 436、18. 263,P＜0. 05). Conclusion Covered stent is safe and effective in the treatment of Stanford type B aortic dissection.

Expressions of transient receptor potential cation channel 6 and integrin-linked kinase in glomerular of proteinuric kidney diseases / 中华肾脏病杂志

Objective To observe the expressions and distribution of transient receptor potential cation channel 6 (TRPC6) and integrin-linked kinase (ILK) in the glomeruli of renal biopsytissue of patients with proteinuric kidney diseases,and to investigate the effect of TRPC6 over-expression on ILK in vitro.Methods The archival histological specimens of patients admitted to Tangdu hospital from 2012 to 2013,with 24-hour urinary protein over 1 g,were collected.The expressions and distribution of TRPC6 and ILK in the glomeruli of renal biopsy tissue were observed by immunohistochemistry.MPC5 podocytes were cultured in vitro and they were stimulated with 10-7 mol/L ADR for 12,24 and 36 h.The pcDNA3.1(+)-TRPC6 plasmid and pcDNA3.1(+) were transfected into MPC5 podocytes by liposome 2000 reagent to establish the TRPC6 overexpression group and the negative control group respectively.Western blotting was used to detect the expressions of TRPC6 and ILK protein.Results There were 14 cases of membranous nephropathy,13 cases of focal segmental glomerulosclerosis (FSGS),15 cases of membranoproliferative glomerulonephritis,12 cases of mesangial proliferative glomerulonephritis,10 cases of hyperplastic sclerosis nephritis,15 cases of IgA nephropathy,13 cases of purpura nephritis,15 cases of lupus nephritis,13 cases of hypertensive renal injury,14 cases of diabetic nephropathy and 9 cases of normal renal tissue included.In glomerulus,TRPC6 was expressed mainly in podocytes,and the expressions of TRPC6 in these renal tissues were higher than that in normal renal tissues (all P ＜ 0.05),except for hypertensive nephropathy.ILK was expressed in podocytes and the mesangial areas.The expressions of ILK in FSGS,lupus nephritis and diabetic nephropathy were higher than that in normal kidney tissue (all P ＜ 0.05),while the other renal tissues was high but showed no statistical difference with normal kidney tissue (all P ＞ 0.05).The expressions of TRPC6 and ILK were positively correlated in renal tissues of FSGS and diabetic nephropathy (r=0.906,P ＜ 0.001;r=0.783,P=0.001 respectively).The expressions of TRPC6 and ILK protein in 24 and 36 h stimulating with ADR were significantly higher than that in the control group (all P ＜ 0.05).The expression of ILK in the TRPC6 overexpression group was significantly higher than that in the normal control group (P ＜ 0.05).Conclusions The expressions of TRPC6 and ILK increase in the glomeruli of patients with kidney diseases with proteinuria being the main manifestation,especially in FSGS and diabetic nephropathy.The up-regulation of TRPC6 can increase the expression of ILK protein,which may be involved in podocyte injury.

Long-term and stable correction of uremic anemia by intramuscular injection of plasmids containing hypoxia-regulated system of erythropoietin expression

Relative deficiency in production of glycoprotein hormone erythropoietin (Epo) is a major cause of renal anemia. This study planned to investigate whether the hypoxia-regulated system of Epo expression, constructed by fusing Epo gene to the chimeric phosphoglycerate kinase (PGK) hypoxia response elements (HRE) in combination with cytomegalovirus immediate-early (CMV IE) basal gene promoter and delivered by plasmid intramuscular injection, might provide a long-term physiologically regulated Epo secretion expression to correct the anemia in adenine-induced uremic rats. Plasmid vectors (pHRE-Epo) were synthesized by fusing human Epo cDNA to the HRE/CMV promoter. Hypoxia-inducible activity of this promoter was evaluated first in vitro and then in vivo in healthy and uremic rats (n = 30 per group). The vectors (pCMV-Epo) in which Epo expression was directed by a constitutive CMV gene promoter served as control. ANOVA and Student's t-test were used to analyze between-group differences. A high-level expression of Epo was induced by hypoxia in vitro and in vivo. Though both pHRE-Epo and pCMV-Epo corrected anemia, the hematocrit of the pCMV-Epo-treated rats exceeded the normal (P < 0.05), but that of the pHRE-Epo-treated rats didn't. Hypoxia-regulated system of Epo gene expression constructed by fusing Epo to the HRE/CMV promoter and delivered by plasmid intramuscular injection may provide a long-term and stable Epo expression and secretion in vivo to correct the anemia in adenine-induced uremic rats.

Cloning and expression of GLUT4 cDNA in E.coli / 西安交通大学学报(医学版)

Objective To acquire glucose transporter 4 (GLUT4) cDNA from tissues of human muscle by RT-PCR, and to clone and express GLUT4 cDNA in E.coli. Methods GLUT4 cDNA primers were designed first and ascertained by detecting through Genbank on NCBI and DNA Star, then by using specific primers, the subjective cDNA segment was acquired by RT-PCR from human tissue. After that, it was cloned into cloning vector of pGEM-3zf(-) and sequenced automatically. Finally the subjective cDNA was cloned into vector of pBV220 and expressed in E.coli. Results The desired DNA could be acquired from tissues of human muscle by RT-PCR using special primers, the acquired cDNA fragment could be cloned into vector of pGEM-3zf(-) and sequenced. The GLUT4 cDNA sequence was highly conserved. GLUT4 cDNA could be expressed in E.coli, too. Conclusion The entire GLUT4 cDNA can be acquired from human muscular tissue by RT-PCR, and it can be expressed in E.coli.