Recognition of Peripheral Lung Cancer and Focal Pneumonia on Chest Computed Tomography Images Based on Convolutional Neural Network.

Introduction: Chest computed tomography (CT) is important for the early screening of lung diseases and clinical diagnosis, particularly during the COVID-19 pandemic. We propose a method for classifying peripheral lung cancer and focal pneumonia on chest CT images and undertake 5 window settings to study the effect on the artificial intelligence processing results. Methods: A retrospective collection of CT images from 357 patients with peripheral lung cancer having solitary solid nodule or focal pneumonia with a solitary consolidation was applied. We segmented and aligned the lung parenchyma based on some morphological methods and cropped this region of the lung parenchyma with the minimum 3D bounding box. Using these 3D cropped volumes of all cases, we designed a 3D neural network to classify them into 2 categories. We also compared the classification results of the 3 physicians with different experience levels on the same dataset. Results: We conducted experiments using 5 window settings. After cropping and alignment based on an automatic preprocessing procedure, our neural network achieved an average classification accuracy of 91.596% under a 5-fold cross-validation in the full window, in which the area under the curve (AUC) was 0.946. The classification accuracy and AUC value were 90.48% and 0.957 for the junior physician, 94.96% and 0.989 for the intermediate physician, and 96.92% and 0.980 for the senior physician, respectively. After removing the error prediction, the accuracy improved significantly, reaching 98.79% in the self-defined window2. Conclusion: Using the proposed neural network, in separating peripheral lung cancer and focal pneumonia in chest CT data, we achieved an accuracy competitive to that of a junior physician. Through a data ablation study, the proposed 3D CNN can achieve a slightly higher accuracy compared with senior physicians in the same subset. The self-defined window2 was the best for data training and evaluation.

Real-world outcomes of niraparib treatment in patients with ovarian cancer: the first observational multicenter study in China / 부인종양

Objective@#The objective of this study was to present the real-world patients’ portrait, and the results of niraparib treatment in China. @*Methods@#This study included 142 patients treated with niraparib from 8 hospitals in China between December 2018 and September 2021. Patients’ characteristics were summarized. The efficacy and safety in first-line maintenance (1L-M), platinum-sensitive recurrence maintenance (PSR-M), and treatment for ovarian cancer were evaluated. Survival outcomes and the factors influencing progression-free survival (PFS) were estimated. @*Results@#The 93 patients received Niraparib as 1L-M, 31 as PSR-M and 18 as salvage. BRCA status was wild type or unknown in 87.3% of patients. With a median follow-up time of 8.7 months, the median PFS (mPFS) for 1L-M has not yet been reached, and the mPFS for PSR-M and salvage therapy was 10.5 and 5.7 months, respectively. Responses to last chemotherapy and cancer antigen 125 value before taking niraparib were 2 important factors affecting PFS among 1L and PSR patients. The 12.7% (18/142) of patients experienced grade ≥3 hematologic adverse events and 23.2% experienced dose adjustment. It was noteworthy that when the interval of chemotherapy and niraparib <21 days, the incidence of grade ≥3 adverse events increased significantly (p=0.0355). @*Conclusion@#Generally, niraparib was effective and well tolerated, which was consistent with the results of prospective trials. However, in real world, it was more inclined to use niraparib in late-line treatment without genetic testing.

Effect and Molecular Mechanism of MFG-E8 on Sensitivity of Ovarian Cancer SKOV3 Cells to Cisplatin / 肿瘤防治研究

Objective To investigate the effect of silencing MFG-E8 gene on the sensitivity of SKOV3 cells to anticancer drugs and related mechanisms. Methods SKOV3 cells were transfected with MFG-E8 siRNA (Msi) and NC siRNA (Csi), respectively and the efficiency of transfection was confirmed by Western blot. The sensitivity of SKOV3 cells to cisplatin was observed by CCK-8 assay after transfection. The mRNA expression of ABCB1 and ABCC1 were detected by qRT-PCR. Effect of silencing MFG-E8 on the expression of ETM-related protein was detected by qRT-PCR and Western blot. Results MFG-E8 siRNA could effectively silence the expression of MFG-E8 protein. With the increasing drug concentration, the proliferation inhibition rate of each group also increased, and the cell proliferation inhibition rate of MFG-E8 siRNA group increased significantly (P < 0.01). Compared with NC siRNA group, downregulation of MFG-E8 expression led to decreased SKOV3 cell proliferation at 48h or 72h after 3 μg/ml cisplatin treat ment (P < 0.05). qRT-PCR results showed that the mRNA expression of ABCB1 and ABCC1 in Msi group were significantly lower than those in Csi group. qRT-PCR and Western blot results showed that silencing MFG-E8 gene down-regulated the mRNA and protein expression of N-Cadherin, Vimentin and Snail and up-regulated the expression of E-Cadherin. Conclusion Silencing the MFG-E8 gene can increase the sensitivity of SKOV3 cells against anti-tumor drugs and down-regulate the mRNA expression of ABCB1 and ABCC1, which may be related to the inhibition of EMT progression.

Nuclear Factor I/A Controls A-fiber Nociceptor Development / 神经科学通报·英文版

Noxious mechanical information is transmitted through molecularly distinct nociceptors, with pinprick-evoked sharp sensitivity via A-fiber nociceptors marked by developmental expression of the neuropeptide Y receptor 2 (Npy2r) and von Frey filament-evoked punctate pressure information via unmyelinated C fiber nociceptors marked by MrgprD. However, the molecular programs controlling their development are only beginning to be understood. Here we demonstrate that Npy2r-expressing sensory neurons are in fact divided into two groups, based on transient or persistent Npy2r expression. Npy2r-transient neurons are myelinated, likely including A-fiber nociceptors, whereas Npy2r-persistent ones belong to unmyelinated pruriceptors that co-express Nppb. We then showed that the transcription factors NFIA and Runx1 are necessary for the development of Npy2r-transient A-fiber nociceptors and MrgprD C-fiber nociceptors, respectively. Behaviorally, mice with conditional knockout of Nfia, but not Runx1 showed a marked attenuation of pinprick-evoked nocifensive responses. Our studies therefore identify a transcription factor controlling the development of myelinated nociceptors.

IL6 Receptor Facilitates Adipogenesis Differentiation of Human Mesenchymal Stem Cells through Activating P38 Pathway

Background and Objectives@#Mesenchymal stem cells (MSCs) have the multipotent capacity to differentiate into multiple tissue lineages as well as to self-renew, which is the main origin of adipocytes. IL6/IL6R pathway exerts a significant role in tissue regeneration and cell differentiation. Whereas, the underlying mechanism between IL6/IL6R pathway and MSCs adipogenesis differentiation remains elusive. @*Methods@#MSCs from healthy donors were cultured in adipogenesis differentiation medium for 0∼14 days, during which their adipogenesis differentiation degree was evaluated by Oil Red O staining. The expression of IL6R was detected in MSCs during adipogenesis differentiation. Knockdown and overexpression of IL6R were respectively performed using siRNA and lentivirus to investigate its effect on MSCs adipogenesis differentiation. The adipogenesis marker genes expression and MAPK pathway activation were detected by Western blotting. The role of P38 pathway in the adipogenesis differentiation of MSCs was determined using the specific inhibitor SB203580. @*Results@#The expression of IL6 and IL6R increased during adipogenesis differentiation in MSCs, which were positively correlated with Oil Red O quantification result. Knockdown and overexpression experiments demonstrated a positive correlation between the expressions of IL6R and MSCs adipogenesis differentiation, accompanied by same trend of P38 phosphorylation. Besides, the specific P38 inhibitor SB203580 markedly inhibited the adipogenesis differentiation potential of MSCs. @*Conclusions@#This study reveals IL6R facilitates the adiogenesis differentiation of MSCs via activating P38 pathway.

Preoperative interview mode with Child Life in the management of preschool children′s anxiety / 中国实用护理杂志

Objective:To explore the effect of preoperative visit with Child Life mode in the management of preschool children′s anxiety.Methods:A total of 80 cases of children of pre-school age who were operated from September 2018 to February 2019 were selected by cluster sampling method. The children from September to November 2018 who were given the traditional mode of preoperative visit were set as the control group. Children from December 2018 to February 2019 who were given preoperative visit with Child Life mode were set as the experimental group. The Modified Yale Perioperative Anxiety Scale (m-YPAS) scores, Induction Compliance Checklist (ICC) scores and Pediatric Anesthesia Emergence Delirium (PAED) scores were compared between the two groups at 4 different perioperative time points (6 hours after admission, waiting for surgery, induction of anesthesia, and 6 hours after surgery).Results:Totally three patients were suspended from the study due to surgery. A total of 77 children were studied, 38 in the experimental group and 39 in the control group. The score of m-YPAS in the experimental group was significantly lower than that of the control group(17.57±16.64 vs. 42.04±27.46, t value was 3.85, P<0.01) while waiting for surgery. The score of m-YPAS in the experimental group was significantly lower than control group (31.64±27.95 vs. 62.22±25.13, t value was 4.26, P<0.01) at the anesthesia induction. Compare with the control group, the score of m-YPAS in the experimental group showed no significant difference at both time of 6 hours after admission (18.19±17.83 vs.19.85±17.92, t value was 0.87, P>0.05) and 6 hours after surgery(35.61±15.70 vs. 41.81±17.97, t value was 1.37, P>0.05). Compare with the control group the score of ICC in the experimental group was significantly decreased (1.40±1.39 vs. 3.78±2.60, t value was 4.88, P<0.01) at the anesthesia induction. The score of PEAD in the experimental group and control group, there was no significant difference between the two groups (7.18±2.45 vs. 7.85±3.05, t value was 0.91, P>0.05). Conclusions:Compared with the traditional preoperative visit mode, the preoperative visit mode of Child Life can effectively relieve the anxiety of preschool children undergoing general anesthesia surgery while they are waiting for surgery and during anesthesia induction, and can improve the degree of cooperation during anesthesia induction.

Mindfulness and suicide risk in undergraduates: chain mediating effect of cognitive flexibility and depressive cognition / 中华行为医学与脑科学杂志

Objective@#To explore the chain mediating effect of cognitive flexibility and depressive cognition between mindfulness and suicide risk in undergraduates.@*Methods@#Suicidal Behaviors Questionnaire-revised (SBQ-R), mindful attention awareness scale (MAAS), cognitive flexibility inventory (CFI) and depressive cognition scale (DCS) were used to investigate 2 627 freshmen from a medical university in Guangdong Province.@*Results@#The scores of suicide risk, mindfulness, cognitive flexibility and depressive cognition were (M(QR)): 4.00(2.00), 67.00(15.00), 78.00(13.00), 5.00(7.00), respectively.The results of correlation analysis showed that suicide risk was positively correlated with depressive cognition (r=0.280, P<0.01), and negatively correlated with the level of mindfulness and cognitive flexibility (r=-0.253, r=-0.196, P<0.01). Mindfulness was positively correlated with cognitive flexibility (r=0.539, P<0.01), negatively correlated with depressive cognition (r=-0.518, P<0.01). Cognitive flexibility was negatively correlated with depressive cognition (r=-0.584, P<0.01). Mediation modeling analysis showed that mindfulness had a significant direct effect on suicide risk.The direct effect value was -0.101, accounting for 34.9% of the total effect.The total indirect effect of mindfulness on suicide risk was -0.188, accounting for 65.1% of the total effect.The mediating effect of cognitive flexibility as mediator between mindfulness and suicide risk was -0.063, accounting for 21.8% of the total effect.The mediating effect of depressive cognition as mediator between mindfulness and suicide risk was -0.054, accounting for 18.7% of the total effect.The chain mediating effect of cognitive flexibility and depressive cognition was -0.071, accounting for 24.6% of the total effect.@*Conclusion@#Mindfulness can influence suicide risk, not only through the direct path, but also through the indirect path of cognitive flexibility and depressive cognition, as well as the chain mediating path between these two variables.

Mindfulness and suicide risk in undergraduates:chain mediating effect of cognitive flexibility and de-pressive cognition / 中华行为医学与脑科学杂志

Objective To explore the chain mediating effect of cognitive flexibility and depressive cognition between mindfulness and suicide risk in undergraduates. Methods Suicidal Behaviors Question-naire-revised (SBQ-R),mindful attention awareness scale ( MAAS),cognitive flexibility inventory (CFI) and depressive cognition scale (DCS) were used to investigate 2 627 freshmen from a medical university in Guangdong Province. Results The scores of suicide risk,mindfulness,cognitive flexibility and depressive cognition were (M(QR)):4. 00(2. 00),67. 00(15. 00),78. 00(13. 00),5. 00(7. 00),respectively. The re-sults of correlation analysis showed that suicide risk was positively correlated with depressive cognition ( r=0. 280,P<0. 01), and negatively correlated with the level of mindfulness and cognitive flexibility ( r=-0. 253,r=-0. 196,P<0. 01). Mindfulness was positively correlated with cognitive flexibility (r=0. 539,P<0. 01),negatively correlated with depressive cognition (r=-0. 518,P<0. 01). Cognitive flexibility was nega-tively correlated with depressive cognition (r=-0. 584,P<0. 01). Mediation modeling analysis showed that mindfulness had a significant direct effect on suicide risk. The direct effect value was -0. 101,accounting for 34. 9% of the total effect. The total indirect effect of mindfulness on suicide risk was -0. 188,accounting for 65. 1% of the total effect. The mediating effect of cognitive flexibility as mediator between mindfulness and suicide risk was -0. 063,accounting for 21. 8% of the total effect. The mediating effect of depressive cogni- tion as mediator between mindfulness and suicide risk was -0. 054,accounting for 18. 7% of the total effect. The chain mediating effect of cognitive flexibility and depressive cognition was -0. 071, accounting for 24. 6% of the total effect. Conclusion Mindfulness can influence suicide risk,not only through the direct path,but also through the indirect path of cognitive flexibility and depressive cognition,as well as the chain mediating path between these two variables.

Role of ovarian tumor stem-like cells sorted from human epithelial ovarian cancer SKOV3 cells in vasculogenic mimicry formation / 南方医科大学学报

OBJECTIVE@#To isolate tumor stem-like cells from human epithelial ovarian cancer SKOV3 cells and explore their role in the formation of vascularization mimicry (VM).@*METHODS@#SKOV3 cells were passaged to the 7th generation by suspension culture in serum-free medium, and the percentages of CD133- and CD117-positive cells in the 1st, 3rd, 5th and 7th generations were analyzed using flow cytometry. The proliferative activity of the cells sorted from the 7th generation SKOV3 cells was assessed with colony formation assay. A three-dimensional cell culture model was established to compare the ability of VM formation between the sorted cells and the parental SKOV3 cells. The expression levels of matrix metalloproteinases-2 (MMP-2) and MMP-9 in the two groups were detected using real-time PCR and Western blotting.@*RESULTS@#Some SKOV3 cells formed typical cell spheres with suspension growth in serum-free medium and were passaged to the 7th generation. Flow cytometry revealed that the percentage of CD133-positive cells increased with cell passaging. The cloning efficiency of the sorted cells was significantly higher than that of the parental SKOV3 cells (50.33% 5.33%, < 0.001). The VM formation ability of the sorted cells was stronger than that of the parental SKOV3 cells in the three-dimensional cell culture system. RT-PCR and Western blotting showed that the expression levels of MMP-2 and MMP-9 were significantly higher in the 7th passage cells than in the parental cells ( < 0.05).@*CONCLUSIONS@#The sorted cells from SKOV3 cells cultured in serum-free medium exhibit biological properties of tumor stem cells with strong VM formation ability, suggesting their role in VM formation.

Long noncoding RNA NEAT1, regulated by LIN28B, promotes cell proliferation and migration through sponging miR-506 in high-grade serous ovarian cancer.

The aberrant expression of long noncoding RNAs (lncRNAs) has been reported frequently in specific cancers, including high-grade serous ovarian cancer (HGSOC). The purpose of the present study was to explore the clinical significance and underlying mechanisms of a significantly dysregulated lncRNA (NEAT1) in HGSOC. Our results showed that elevated NEAT1 expression in human HGSOC specimens correlated with a poor prognosis. Functional experiments demonstrated that knockdown of NEAT1 significantly prohibited ovarian cancer cell proliferation and invasion in vitro and restrained tumor growth in vivo. LIN28B was identified by bioinformatics analysis along with experimental evidence as a direct actor that enhanced NEAT1 stability. A rescue functional assay confirmed that the LIN28B/NEAT1 axis contributed to oncogenic functions in ovarian cancer cells. Moreover, gene expression profile data and dual luciferase reporter assay results demonstrated that NEAT1 functioned as a competing endogenous RNA (ceRNA) for miR-506 to promote cell proliferation and migration. Taken together, our results showed that NEAT1, stabilized by LIN28B, promoted HGSOC progression by sponging miR-506. Thus, NEAT1 can be regarded as a vital diagnostic biomarker for HGSOC and a therapeutic target.

Constitutional types of Chinese medicine of primary bile reflux gastritis among different season:a cross-sectional study / 国际中医中药杂志

Objective To investigate the constitutional types of Chinese medicine of primary bile reflux gastritis among different seasons. Methods Data of gastroscopy center during August 2015 to July 2016 were analyzed. A total of 603 patients were diagnosed as primary bile reflux gastritis. After gastroscopy, the standardized constitution in Chinese medicine questionnaire was used to evaluation the scores of all kinds of constitutional types. The Constitutional types of Chinese medicine of primary bile reflux gastritis among different seasons were analyzed. Results Among all seasons, the positive detection rate showed significant difference (χ2=13.041, P=0.005), and summer group showed the highest among the four seasons (23.38% vs. 17.63%,χ2=12.414, P<0.001). Among all seasons, constitutional types of Chinese medicine of primary bile reflux gastritis had significant difference (χ2=37.441, P<0.001). Damp-heated type had significant difference among seasons (χ2=8.472, P=0.037), especially during the summer (χ2=5.847, P=0.016). Conclusions The summer may have more primary bile reflux gastritis chance to be diagnosed as primary bile reflux gastritis. Yang-deficiency type, Gentleness type, Qi-deficiency type and damp-heat type were more common in primary bile reflux gastritis patients.

A triage strategy in advanced ovarian cancer management based on multiple predictive models for R0 resection: a prospective cohort study / 부인종양

OBJECTIVE: To present the surgical outcomes of advanced epithelial ovarian cancer (AEOC) since the implementation of a personalized approach and to validate multiple predictive models for R0 resection. METHODS: Personalized strategies included: 1) Non-invasive model: preoperative clinico-radiological assessment according to Suidan criteria with a predictive score for all individuals. Patients with a score 0–2 were recommended for primary debulking surgery (PDS, group A), or otherwise were counseled on the choices of PDS, neoadjuvant chemotherapy (NAC, group B) or staging laparoscopy (S-LPS). 2) Minimally invasive model: S-LPS with a predictive index value (PIV) according to Fagotti. Individuals with a PIV < 8 underwent PDS (group C) or otherwise received NAC (group D). Intraoperative assessment (with Eisenkop, peritoneal cancer index [PCI], and Aletti scores) and surgical results were prospectively collected. RESULTS: Between September 2015 and August 2017, 161 pathologically confirmed epithelial ovarian cancer patients were included. A total of 52 (32.3%) patients had a predictive score of 0–2, and 109 (67.7%) patients had a score ≥ 3. Among these individuals, 41 (25.5%) patients received S-LPS. Finally, 110 (68.3%) patients underwent PDS (A+C), and 51 (31.7%) patients received NAC (B+D). The R0 resection rates in PDS and NAC patients were 56.4% and 60.8%, respectively. The area under the curve (AUC) of Suidan criteria was 0.548 for group (A+C). The AUC of Fagotti score was 0.702 for group C. The AUC of Eisenkop, PCI, and Aletti scores were 0.808, 0.797, and 0.524, respectively. CONCLUSION: The Suidan criteria were not effective in these AEOC patients. S-LPS was helpful in decision-making for PDS and should be endorsed in the future.

Comparison of CTV-PTV setup margins during IMRT for cervical cancer patients with different body mass index by bladder volume measurement device-assisted CBCT / 中华放射肿瘤学杂志

Objective To investigate the clinical target volume (CTV)-planned target volume (PTV) setup margins during intensity-modulated radiotherapy (IMRT) for cervical cancer patients with different body mass index (BMI),aiming to provide reference for precise individual therapy.Methods Forty patients diagnosed with cervical cancer undergoing IMRT in Cancer Hospital of Fudan University between March and September 2017 were recruited and assigned into the BMI ≤ 18.4,18.5-23.9,24.0-27.9 and ≥ 28 kg/m2 groups according to the BMI classification criteria proposed by National Health and Family Planning Commission (NHFPC) of the People's Republic of China.Assisted with the bladder volume measurement device,9 cycles of kilo-voltage cone beam computed tomography (CBCT) images were subject to online registration and imaging analysis.CTV-PTV setup margins were calculated based on the formula of MPTV =2.5∑+0.7σamong four groups.Single factor variance analysis was performed.LSD test was utilized for two-group comparison.Results Among four groups,the CTV-PTV setup margins in the x,y and z directions were (6.87 mm,6.06 mm,8.49 mm),(3.13 mm,3.02 mm,3.14 mm),(4.70 mm,4.86 mm,5.31 mm) and (7.63 mm,8.28 mm,8.54 mm),respectively (P=0.038,0.048 and 0.004).Conclusions The setup errors in the BMI ≤ 18.4 and ≥28 kg/m2 groups are significantly larger compared with those in the remaining groups Consequently,CTV-PTV setup margins should be enlarged to certain extent for patients with BMI≤ 18.4 and ≥≥28 kg/m2.

Establishment of evaluationpediatrics nursing- sensitive quality indicatorssystembasedon Donabedian structure-process-outcome theory / 中国实用护理杂志

ObjectiveA preliminary study on pediatrics nursing-sensitive qualityindicators was carried out to construct a systematic, scientific and sensitive quality system. Methods Delphi method was used to conduct two rounds of questionnaires for 55 pediatric nursing experts, used SPSS20.0 statistical software for data analysis. Analytic hierarchy process method was used to determine the weight of the indicators. Results The final determination agreed rate of experts equal to 75 percent, the importance of assignment mean was>3.5 and the variation coefficient<0.25, which including 5 structure indicators, 17 process indicators and 18 outcome indicators. Conclusion The evaluation system of pediatrics nursing-sensitive quality indicators was constructed in preliminary which could provide the reference and basis for pediatric nursing managers.

Prognostic value of programmed death-ligand 1 (PD-L1) expression in ovarian clear cell carcinoma / 부인종양

OBJECTIVE: Programmed death-ligand 1 (PD-L1) was expressed in various tumors and antibodies targeting its receptor programmed cell death-1 (PD-1) are emerging cancer therapeutics. This study was designed to evaluate the expression of PD-L1 and its correlation with clinicopathologic features and clinical outcomes in ovarian clear cell carcinoma (OCCC). METHODS: The PD-L1 expression was measured by tissue-microarray-based immunohistochemistry from 122 eligible patients diagnosed with OCCC. The associations of clinicopathologic features with progression-free survival (PFS) and overall survival (OS) were analyzed by Kaplan-Meier method and multivariate analysis was further performed by Cox regression model. RESULTS: Overall, high PD-L1 expression (PD-L1(high)) was observed in 44.7% (55/123) of OCCC patients, and was strongly associated with advanced stages (p=0.020), positive ascitic fluid (p=0.016), platinum-resistant (PR) disease (p=0.045), and recurrence (p=0.038). Moreover, patients with PD-L1(high) were associated with poorer OS (hazard ratio [HR]=2.877; p=0.001) and PFS (HR=1.843; p=0.021) than those with low PD-L1 expression (PD-L1(low)). In subgroup analysis, PD-L1(high) patients experienced a poorer PFS (HR=1.926; p=0.044) and OS (HR=2.492; p=0.021) than PD-L1(low) cases among advanced stages (III–IV), but this difference was not observed in stage I–II patients. Meanwhile, PD-L1(high) was associated with poorer prognosis than PD-L1(low) in PR patients (OS, HR=2.253; p=0.037; PFS, HR=1.448; p=0.233). Multivariate analysis revealed that PD-L1(high) and advanced stages (III–IV) were adverse independent prognosticators for both PFS (HR(PD-L1)=2.0; p(PD-L1)=0.038; HR(stage)=10.2; p(stage)<0.001) and OS (HR(PD-L1)=3.0; p(PD-L1)=0.011; HR(stage)=14.3; p(stage)<0.001). CONCLUSION: PD-L1(high) might serve as a risk factor for PFS and OS in patients with OCCC. It is possible that immunotherapy targeting PD-L1 pathway could be used in OCCC.

Clinical effect of probiotics combined with triple therapy in the treatment of helicobacter pylori infection in children / 中国基层医药

Objective To discuss the application of combined probiotics pretreatment and late triple therapy with helicobacter pylori infection in children.Methods 300 children with helicobacter pylori infection were randomly divided into three groups according to the way of random table.Group A was treated with standard triple therapy, omeprazole,amoxicillin and clarithromycin treatment,and 10 d was 1 treatment course.B group was given probiotic pretreatment,prior to the triple therapy using compound lactobacillus acidophilus piece 1 piece /time,cold water to take after meals,taking 2 weeks,follow -up treatment with triple therapy for 10d.In group C,triple therapy before using compound lactobacillus acidophilus piece 1 piece /time,cold water to take after meals,taking 2 weeks,follow -up treatment with triple therapy for 10d.To take one week after the completion of compound lactobacillus acidophilus piece 1 piece /time,cold water after meals.The clinical therapeutic effects were recorded.Results The helicobacter pylori clearance rate of group A was 55.00%,that of group B was 86.00%,that in group C was 89.00%,the helico-bacter pylori clearance rate of group B and group C was significantly higher than that in group A,the difference was statistically significant (χ2 =23.103 7,28.670 6,all P 0.05 ).In A group,nausea and vomiting occurred in 5 cases,2 cases of diarrhea,abdominal distension abdominal pain in 4 cases,skin rash in 5 cases.In group B,nausea and vomiting occurred in 2 cases,0 cases of diarrhea,abdominal distension abdominal pain in 1 case,skin rash in 1 case.In group C,nausea and vomiting occurred in 1 case,0 cases of diarrhea,abdominal distension abdominal pain 0 cases,skin rashes in 1 case.The incidence rate of adverse reactions in group B and group C was lower than that in group A,the difference was statistically significant (χ2 =11.965 8,8.000 0,all P 0.05). Conclusion Joint probiotics pretreatment and late triple therapy application in helicobacter pylori in children can promote helicobacter pylori clearance,reduce the triple therapy drug adverse reactions,it is worthy of popularization and application in clinic.

Elevated TRAF4 expression impaired LPS-induced autophagy in mesenchymal stem cells from ankylosing spondylitis patients

Ankylosing spondylitis (AS) is a type of autoimmune disease that predominantly affects the spine and sacroiliac joints. However, the pathogenesis of AS remains unclear. Some evidence indicates that infection with bacteria, especially Gram-negative bacteria, may have an important role in the onset and progression of AS. Recently, many studies have demonstrated that mesenchymal stem cells (MSCs) dysfunction may contribute to the pathogenesis of many rheumatic diseases. We previously demonstrated that MSCs from AS patients exhibited markedly enhanced osteogenic differentiation capacity in vitro under non-inflammatory conditions. However, the properties of MSCs from AS patients in an inflammatory environment have never been explored. Lipopolysaccharide (LPS), a proinflammatory substance derived from the outer membrane of Gram-negative bacteria, can alter the status and function of MSCs. However, whether MSCs from AS patients exhibit abnormal responses to LPS stimulation has not been reported. Autophagy is a lysosome-mediated catabolic process that participates in many physiological and pathological processes. The link between autophagy and AS remains largely unknown. The level of autophagy in ASMSCs after LPS stimulation remains to be addressed. In this study, we demonstrated that although the basal level of autophagy did not differ between MSCs from healthy donors (HDMSCs) and ASMSCs, LPS-induced autophagy was weaker in ASMSCs than in HDMSCs. Specifically, increased TRAF4 expression in ASMSCs impaired LPS-induced autophagy, potentially by inhibiting the phosphorylation of Beclin-1. These data may provide further insight into ASMSC dysfunction and the precise mechanism underlying the pathogenesis of AS.

Advances in diagnosis and treatment of metastatic cervical cancer / 부인종양

Cervical cancer is one of the most common cancers in women worldwide. The outcome of patients with metastatic cervical cancer is poor. We reviewed the relevant literature concerning the treatment and diagnosis of metastatic cervical cancer. There are two types of metastasis related to different treatments and survival rates: hematogenous metastasis and lymphatic metastasis. Patients with hematogenous metastasis have a higher risk of death than those with lymphatic metastasis. In terms of diagnosis, fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) and PET-computed tomography are effective tools for the evaluation of distant metastasis. Concurrent chemoradiotherapy and subsequent chemotherapy are well-tolerated and efficient for lymphatic metastasis. As for lung metastasis, chemotherapy and/or surgery are valuable treatments for resistant, recurrent metastatic cervical cancer and chemoradiotherapy may be the optimal choice for stage IVB cervical cancer. Chemotherapy and bone irradiation are promising for bone metastasis. A better survival is achieved with multimodal therapy. Craniotomy or stereotactic radiosurgery is an optimal choice combined with radiotherapy for solitary brain metastases. Chemotherapy and palliative brain radiation may be considered for multiple brain metastases and other organ metastases.

Advances in diagnosis and treatment of metastatic cervical cancer / 부인종양

Cervical cancer is one of the most common cancers in women worldwide. The outcome of patients with metastatic cervical cancer is poor. We reviewed the relevant literature concerning the treatment and diagnosis of metastatic cervical cancer. There are two types of metastasis related to different treatments and survival rates: hematogenous metastasis and lymphatic metastasis. Patients with hematogenous metastasis have a higher risk of death than those with lymphatic metastasis. In terms of diagnosis, fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) and PET-computed tomography are effective tools for the evaluation of distant metastasis. Concurrent chemoradiotherapy and subsequent chemotherapy are well-tolerated and efficient for lymphatic metastasis. As for lung metastasis, chemotherapy and/or surgery are valuable treatments for resistant, recurrent metastatic cervical cancer and chemoradiotherapy may be the optimal choice for stage IVB cervical cancer. Chemotherapy and bone irradiation are promising for bone metastasis. A better survival is achieved with multimodal therapy. Craniotomy or stereotactic radiosurgery is an optimal choice combined with radiotherapy for solitary brain metastases. Chemotherapy and palliative brain radiation may be considered for multiple brain metastases and other organ metastases.

Bone marrow mesenchymal stem cells derived from patients with ankylosing spondylitis show abnormal immunoregulation capability on macrophages / 中国组织工程研究

BACKGROUND:Ankylosing spondylitis is an autoimmune disease at high inflammatory state, and its pathogenesis is stil unclear. Besides, there is a lack of entirely satisfactory curative strategies. OBJECTIVE: To explore the immunoregulation capability of bone marrow mesenchymal stem cels from ankylosing spondylitis patients on macrophages and the potential therapeutic use of bone marrow mesenchymal stem cels from healthy donors on ankylosing spondylitis. METHODS: Bone marrow mesenchymal stem cels were extracted from 21 healthy donors and 25 ankylosing spondylitis patients respectively, and passage 4 cels were used in subsequent experiments. A human monocytic cel line was induced to differentiate into macrophages. The phenotypic markers of bone marrow mesenchymal stem cels and macrophages were detected by flow cytometry. Expressions of tumor necrosis factor-α and tumor necrosis factor-α-stimulated gene 6 (TSG-6) proteins in the supernatant of co-culture system were detected by ELISA. Quantitative real-time PCR was applied to detect the mRNA level of cytokines secreted by bone marrow mesenchymal stem cels and macrophages. RESULTS AND CONCLUSION:The typical mesenchymal stem cel surface markers were expressed in both bone marrow mesenchymal stem cels from healthy donors and patients with ankylosing spondylitis, and CD68 was detected positively in induced macrophages. The protein and mRNA levels of tumor necrosis factor-α secreted by macrophages co-cultured with bone marrow mesenchymal stem cels from patients with ankylosing spondylitis were obviously higher than those from healthy donors (P < 0.05). TSG-6 secreted by bone marrow mesenchymal stem cels from patients with ankylosing spondylitis was lower than that by bone marrow mesenchymal stem cels from healthy donors in both RNA transcriptional and protein levels (P < 0.05). Our study demonstrates that bone marrow mesenchymal stem cels from patients with ankylosing spondylitis shows abnormal immunoregulatory function on inhibiting the tumor necrosis factor-α secretion from macrophages, which reveals a mechanism of immune disorder in ankylosing spondylitis. The therapeutic mechanism of bone marrow mesenchymal stem cels from healthy donors may work by secreting enough TSG-6 to inhibit the activation of macrophages in patients with ankylosing spondylitis, and thereby to decrease the secretion of tumor necrosis factor-α. Cite this article:Sun SH, Wang P, Su CY, Xie ZY, Li YX, Li D, Wang S, Su HJ, Wu XH, Deng W, Wu YF, Shen HY. Bone marrow mesenchymal stem cels derived from patients with ankylosing spondylitis show abnormal immunoregulation capability on macrophages. Zhongguo Zuzhi Gongcheng Yanjiu. 2016;20(1):13-19.