Pretreatment with a modified St. Thomas' solution in patients with severe upper limb injuries: Four case reports.

BACKGROUND: This study aims to describe the application of a modified St. Thomas' solution in patients with severe limb injuries. CASE SUMMARY: Four patients who sustained a high-energy trauma and underwent complete upper limb amputation were pretreated with a modified St. Thomas' solution before upper limb replantation. After the perfusion solution stopped flowing from the blood vessel, the amputated upper limb amputation was replanted. The patients were instructed to perform functional rehabilitation training after the operation. All 4 patients were followed up for 5 years. All the severed upper limbs survived. Routine re-examination after the operation showed that the function of the affected limb was restored. All the patients were satisfied with the sensory and functional recovery of the affected limb. CONCLUSION: The modified St. Thomas' solution can effectively improve the success rate of limb salvage surgery and the recovery of limb function in patients with a severe limb injury.

Preliminary clinical study of personalized neoantigen vaccine therapy for microsatellite stability (MSS)-advanced colorectal cancer.

Immunotherapy based on immune checkpoint inhibitors (ICIs) has provided revolutionary results in treating various cancers. However, its efficacy in colorectal cancer (CRC), especially in microsatellite stability-CRC, is limited. This study aimed to observe the efficacy of personalized neoantigen vaccine in treating MSS-CRC patients with recurrence or metastasis after surgery and chemotherapy. Candidate neoantigens were analyzed from whole-exome and RNA sequencing of tumor tissues. The safety and immune response were assessed through adverse events and ELISpot. The clinical response was evaluated by progression-free survival (PFS), imaging examination, clinical tumor marker detection, circulating tumor DNA (ctDNA) sequencing. Changes in health-related quality of life were measured by the FACT-C scale. A total of six MSS-CRC patients with recurrence or metastasis after surgery and chemotherapy were administered with personalized neoantigen vaccines. Neoantigen-specific immune response was observed in 66.67% of the vaccinated patients. Four patients remained progression-free up to the completion of clinical trial. They also had a significantly longer progression-free survival time than the other two patients without neoantigen-specific immune response (19 vs. 11 months). Changes in health-related quality of life improved for almost all patients after the vaccine treatment. Our results shown that personalized neoantigen vaccine therapy is likely to be a safe, feasible and effective strategy for MSS-CRC patients with postoperative recurrence or metastasis.

[Factors Affecting the Surgical Level of Major Amputations in Patients with Severe Diabetic Foot].

Objective: To investigate the main factors affecting the surgical level of major amputations in patients with severe diabetic foot. Methods: A case-control study was conducted to analyze the clinical data of severe diabetic foot patients who had major amputations and were admitted to the Intensive Care Unit (ICU), Air Force Hospital of PLA Eastern Theater Command between July 2020 and July 2022. According to their surgical level of amputation, patients were divided into transtibial amputation (TT) group and transfemoral amputation (TF) group. Correlation analysis was performed with the clinical data of the patients, and multivariate logistic regression was performed to screen for relevant factors affecting the surgical level of major amputation. Results: The data of 48 patients with major amputations were collected, including 15 patients in the TT group and 33 patients in the TF group. The proportion of patients who had cardiovascular and cerebrovascular complications in the TT group was lower than that in the TF group (26.67% [4/15] vs. 57.58% [19/33], P<0.05), the proportion of patients who had lower extremity arterial intervention history was higher in the TT group than that in the TF group (40% [6/15] vs. 9.09% [3/33], P<0.05), and the proportion of patients who had elevated creatinine level was lower in the TT group than that in the TF group (70.31±22.98 vs. 127.98±108.38, P<0.05). Moreover, the history of lower extremity arterial intervention may be an independent protective factor for determining the surgical level of major amputations (odds ratio [ OR]=0.15, 95% confidence interval [ CI]: 0.03-0.72, P=0.018). Conclusion: History of cardiovascular and cerebrovascular diseases, serum creatinine level and history of lower extremity arterial intervention are the main factors affecting the surgical level of major amputations in patients with severe diabetic foot, and the history of lower extremity arterial intervention may be an independent protective factor.

Gossypol induces cell death by activating apoptosis and autophagy in HT-29 cells.

Gossypol is a polyphenolic, yellowish compound derived from cottonseed extract. The present study examined the effects of gossypol on the apoptosis and autophagy of HT­29 cells. A Cell Counting Kit­8 assay, Annexin V­FITC, JC­1 staining and western blotting were used to identify the viability of cells, stages of apoptosis and the expression levels of the signaling proteins. Gossypol promoted apoptosis and induced the loss of mitochondrial membrane potential. Further investigation of the apoptotic mechanism revealed that gossypol increased the ratio of B­cell lymphoma 2 (Bcl-2)-associated X protein/Bcl­2 protein levels and upregulated the expression of caspase­3. Gossypol also enhanced the activity of microtubule­associated protein light chain 3 LC3­II and Beclin­1 and downregulated LC3­I, in a dose­dependent manner. Together, these finding suggested that gossypol may be a novel and potential antitumor agent.

Cruciferous vegetable consumption and the risk of pancreatic cancer: a meta-analysis.

BACKGROUND: Previous studies regarding the association between cruciferous vegetable intake and pancreatic cancer risk have reported inconsistent results. We conducted a meta-analysis to demonstrate the potential association between them. METHODS: A systematic literature search of papers was conducted in March 2014 using PubMed, EMBASE, and Web of Science, and the references of the retrieved articles were screened. The summary odds ratios (ORs) with 95% confidence interval (CI) for the highest versus the lowest intake of cruciferous vegetables were calculated. RESULTS: Four cohort and five case-control studies were eligible for inclusion. We found a significantly decreased risk of pancreatic cancer associated with the high intake of cruciferous vegetables (OR 0.78, 95% CI 0.64-0.91). Moderate heterogeneity was detected across studies (P = 0.065). There was no evidence of significant publication bias based on Begg's funnel plot (P = 0.917) or Egger's test (P = 0.669). CONCLUSIONS: Cruciferous vegetable intake might be inversely associated with pancreatic cancer risk. Because of the limited number of studies included in this meta-analysis, further well-designed prospective studies are warranted to confirm the inverse association between cruciferous vegetable intake and risk of pancreatic cancer.

[Promoter methylation and expression of Runx3 gene in gastric cancer].

OBJECTIVE: To analyze the relationships among the aberrant methylation of Runx3 gene promoter, the Runx3 protein expression and clinicopathological features in gastric cancer. METHODS: Methylation specific PCR was used to measure the promoter methylation status of Runx3 gene in tumor and the adjacent normal mucosal tissues from 40 patients with gastric cancer. Protein expression of Runx3 was measured by immunohistochemistry. RESULTS: The frequency of promoter methylation of Runx3 gene in gastric cancer tissue(55.0%) was significantly higher compared to the adjacent normal tissues (12.5%)(P<0.01). The positive rate of protein expression of Runx3 in gastric cancer tissue(37.5%) was significantly lower compared to the adjacent normal tissues (100%). There was marked association between hypermethylation and negative protein expression (P<0.05). The frequency of Runx3 promoter methylation was associated with histological type, N grade, and tumor stage. CONCLUSION: The promoter hypermethylation is a main mechanism of reduced or loss expression of Runx3 gene, which may provide molecular diagnosis and stage evaluation of gastric cancer.