Volume 96  ·  Issue 46  ·  2016

Hepatocellular carcinoma (HCC, hereinafter referred to as liver cancer) is the sixth largest cancer in the world, with about 740,000 new cases every year, half of which are in China. The mortality rate of liver cancer in China ranks third among malignant tumors^[1]。 During the development of hepatocellular carcinoma, portal vein tumor thrombus (PVTT) is easily invaded into the portal vein. The incidence rate of PVTT is 44.0% ~62.2%^[2]。 Once PVTT occurs in patients with liver cancer, the disease progresses rapidly, intrahepatic and extrahepatic metastasis, portal hypertension, jaundice and ascites can occur in a short time, and the mean median survival time is only 2.7 months^[3]It is the main adverse factor affecting the prognosis of liver cancer and the "bottleneck" to improve the curative effect of liver cancer. Therefore, the treatment of PVTT is of great significance in the clinical diagnosis and treatment of liver cancer. Due to the lack of high-level clinical research evidence for the treatment of PVTT, various treatment measures are not effective, and there is no international consensus on the treatment of PVTT. European and American countries take Barcelona (BCLC) staging as the treatment standard, and the main treatment strategy is sorafenib, while Southeast Asian countries including China believe that PVTT patients should be treated comprehensively. In May 2016, the National Collaborative Group on Hepatocellular Carcinoma with Tumor Thrombosis launched the first Chinese Expert Consensus on Multidisciplinary Diagnosis and Treatment of Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis (2016 Edition)^[4]It provides a standardized diagnosis and treatment process and method for the treatment of PVTT, which will further improve the overall efficacy of PVTT patients in China. However, the treatment of PVTT still faces many difficulties, such as the formation mechanism of PVTT is still unclear, the lack of effective clinical treatment, the low surgical resection rate and the high recurrence rate. Colleagues at home and abroad should strengthen the research in these aspects.

The aim of the study was to investigate the dose effect relationship of warm distilled water to remove the exfoliated cancer cells (ECC) in peritoneal cavity in 116 cases of hepatocellular carcinoma.

Positive rates of exfoliated cancer cells in 116 patients with hepatocellular carcinoma were detected before and after the removal of the tumor. The 43 to 45 ℃ distilled water was used by 1 500 ml/time before closing the abdomen, and then 37 ℃ sterile normal saline 200 ml was used for peritoneal lavage and collected for exfoliated cancer cell detection.

Positive rates of ECC had no significant difference before and after resection in groups with tumor diameter ≤10 cm (all P>0.05); positive rates of ECC were significantly increased after tumor resection in groups with tumor diameter>10 cm (≤15 cm, >10 cm,P=0.044; >15 cm, P=0.033). With the increase of tumor volume, ECC positive rates were significantly increased after resection (P<0.001), and the residual rate increased after washing; the residual rates was significantly decreased with the increasing of irrigation times in groups with tumor diameter>10 cm (≤15 cm, >10 cm,P=0.002; >15 cm, P=0.001), and undetectable after four times washing. With the increase of irrigation times, the residual rates were not significantly decreased (all P >0.05) in groups with tumor diameter ≤5 cm, but no residue was detected after three times of washing.

The volume of irrigation needed to eliminate the ECC in the peritoneal cavity during the operation of hepatocellular carcinoma is significantly correlated with the tumor size.

To investigate the situation and its risk factors of nonalcoholic fatty liver (NAFLD) in health population, and to provide the scientific evidence for this disease control and prevention.

The subjects who had health examination in our hospital from Jan 2014 to Jan 2015 were enrolled in this cross-sectional survey study. The medical history, body examination data (height, weight and blood pressure), biochemical data (blood lipid, blood sugar, liver function, etc.) and the ultrasound examination result were recorded. The descriptive analysis method was used to demonstrate the distribution of NALFD, and the single and multi-variable analysis method was conduct to obtain the risk factors of NAFLD.

The overall prevalence rate of NAFLD was 16.92%, while the rate of male group was greater than that of female group. Logistic regression showed that BMI, diastolic pressure, ALT, GGT, fasting blood-glucose, TG, HLD and LDL were the independent risk factors of NAFLD (P<0.05). HDL was negatively correlated with NAFLD and other factors were positively.

The overall prevalence rate of NAFLD of health population was higher in Guangzhou. The factors correlated with metabolism syndrome were the risk factor of NAFLD.

To investigate the value of integrated pancreatic and biliary stents for prevention of post-Endoscopic Retrograde Cholangiopancreatography (ERCP) pancreatitis.

The clinical data of patients whom had pancreatic stents for prevention of post-ERCP pancreatitis from December 2013 to October 2015 were retrospectively analyzed. The clinical effect and complication were compared between straight pancreatic stents group and integrated pancreatic and biliary stents group.

A total of 214 patients had pancreatic stents for prevention of post-ERCP pancreatitis. Among them, 139 of the patients received a straight pancreatic stents with the average operation time of 62.1±9.8 min and 75 patients received the integrated pancreatic and biliary stents with the average operation time of 67.2±12.7 min. The average operation time was statistically significantly different (P=0.001). Straight stents group was found to have higher incidence of pancreatic stents proximal migration and spontaneous abscission than integrated pancreatic and biliary stents group (8.6% vs 0, P=0.009; 12.9% vs 1.3%, P=0.004). There was no significant difference in the incidence of acute pancreatitis or hyperamylasemia between the two groups (3.6% vs 2.7%, P=1.000; 5.0% vs 4.0%, P=1.000). A total of 123 patients in the straight stents group received a second ERCP to remove the pancreatic stents in 1 to 8 weeks after ERCP, and 2 patients had acute pancreatitis and 3 patients had high amylase, while there was no complication happened after the remove of integrated pancreatic and biliary stents in one week after ERCP.

The clinical effect of integrated pancreatic and biliary stents for the prevention of post-ERCP pancreatitis is better than straight pancreatic stents.

To analysis of the possible cause and surgical diagnosis and treatment strategies of acute gangrenous cholecystitis (AGC) after biliary stent drainage.

The clinical data of 273 patients who received biliary stent drainage in Beijing Chaoyang Hospital from January 2015 to March 2016 were analyzed retrospectively. Among them, 22 patients who underwent surgical treatment were divided into two groups: 9 cases of AGC group and 13 cases of non-AGC group. The risk factors of AGC and surgical approach were analyzed.

All 22 patients underwent laparoscopic surgery. In AGC group, 1 patient with toxic shock died of multiple organ viscera function failure caused by infection, and 1 patient with gallbladder triangle inflammatory adhesion suffered from biliary leakage. The postoperative pathology of 2 patients was acute gangrenous cholecystitis. Non-AGC group had no death, bile duct injury and bleeding, with postoperative pathology of chronic cholecystitis. Patients were followed up for 2 month to restore well, without biliary calculi residual. Operation time, intraoperative blood loss, hospitalization days and hospitalization expenses of AGC group were higher than those of non-AGC group.

The advocated AGC after biliary stent drainage should actively surgery after early diagnosis and endoscopic therapy should not be repeated. Laparoscopic surgery is a safe and effective treatment for AGC after carotid stenting.

A 38-year-old male was admitted to the Department of Nephrology, Peking University First Hospital on March 1, 2014 with "hemoptysis for more than 1 year, fatigue, macroscopic hematuria, edema of both lower limbs with rash for 2 months, and aggravation for more than half a month". One year ago, the patient developed fever and chills, with a maximum body temperature of 38.3℃, accompanied by cough, expectoration, and a few dark red blood clots in the sputum. An enhanced chest CT in an external hospital showed that "the right lung occupied space, the lymph nodes in the right hilum and mediastinum were enlarged, some lymph nodes were calcified, and there were multiple lymph nodes in the bilateral axillary, with a high possibility of malignant lesions" (Figure 1)。 After intravenous infusion of antibiotics such as ceftriaxone and azithromycin, phlegm relieving cough, anti-allergy and ready-for-use traditional Chinese medicine, the condition did not improve. The cough was aggravated with asthma, persistent low fever, fatigue, and occasional wrist and ankle joint swelling and pain. One month later, CT reexamination showed that the soft tissue shadow at the right hilar was significantly larger than before, and percutaneous pulmonary puncture was performed, and the pathological results showed "obstructive pneumonia with organizing pneumonia". Bronchoscopy showed no endotracheal new organisms, sputum smear showed no fungi or acid-fast bacilli, and sputum bacterial culture was negative. At that time, there was no proteinuria or hematuria in urine test, serum creatinine was 60 μ mol/L, anti-neutrophil cytoplasmic antibody (ANCA) and anti-nuclear antibody spectra were negative, and C-reactive protein (CRP), immunoglobulin and complement were all normal. Based on the above examination results, it was considered that "right lung cancer is likely", and right pneumonectomy was performed. During the operation, a consolidation area of 6.4 cm ×5.0 cm ×4.0 cm was seen in the right lung tissue, 4 cm away from the main bronchial margin. The postoperative pathological results showed "chronic suppurative inflammation of the bronchi with organizing pneumonia". After operation, bronchial stump was repeatedly infected to form bronchopleural fistula, right empyema, and the pus was cultured as Pseudomonas aeruginosa. The treatment was continuously treated with antibiotics such as ceftazidime and right thoracic cavity closed drainage. The patient developed macroscopic hematuria without trigger 2 months ago, which was bright red and lasted until after admission; At the same time, there was edema of both lower limbs and scattered symmetrical red papules, which could resolve spontaneously after repeated attacks. There was no discomfort such as skin itching, fever, low back pain, urinary tract irritation, etc., and there was no change in urine output, so no special treatment was given. One month ago, serum creatinine was found to be 416 μ mol/L, urine protein + +, and red blood cells were full of visual field. After symptomatic treatment with ready-for-use traditional Chinese medicine, serum creatinine decreased to 180 μ mol/L, but increased to 414 μ mol/L again after one week. Other tests: albumin 31.2 g/L, CRP 56.9 mg/L, peripheral blood leukocytes 5.82×10⁹/L, hemoglobin 81 g/L, platelets 209×10⁹/L, the percentage of eosinophils was normal. The urine volume is about 2 000 ml per day, and there is no fever. Since the onset of the disease, the patient has had good mental sleep, poor appetite, and no obvious change in stool compared with before. In the past two months, the weight has gained about 5 kg, and his vision is consciously blurred, and his vision has decreased significantly. Prior physical health, smoking for 20 years, 10 cigarettes/d. Engaged in automobile maintenance work for more than 10 years. Family history of genetic diseases and similar diseases were denied.

A 54-year-old female was seen 7 months after the discovery of a left submandibular mass. In May 2015, a left submandibular mass appeared without obvious trigger, about 1.5 cm in diameter, hard in texture, non-tender, and without adhesion to surrounding tissues, and was not diagnosed and treated. In August 2015, I felt that the tumor had enlarged to about 4 cm in diameter. B-ultrasound examination in the local hospital suggested that the left submandibular gland cyst was possible (2.8 cm ×1.8 cm) and the left submandibular lymph node was enlarged (2.6 cm ×1.2 cm). Extraction of left submandibular mass was performed in November 2015. Preoperative blood test routine: white blood cells 6.85×10⁹/L, hemoglobin 134 g/L, platelets 204×10⁹/L, coagulation function: prothrombin time (PT) 20.1 s, activated partial thromboplastin time (APTT) 68.1 s, prothrombin activity, fibrinogen and D-dimer were normal. The patient had no previous coagulation tests and had no bleeding or thrombosis-related symptoms. The operation went smoothly, there was no abnormal bleeding after operation, and the wound healed well. Pathological report: (left submandibular mass) Most of the lymph node structure was destroyed, a large number of atypical lymphoid cells diffusely infiltrated, and some areas showed a star-like image. The cells were medium-large, with little cytoplasm and light staining, and the nucleus was round, oval, irregular, with obvious nucleoli and large mitotic images. Immunohistochemistry Results: Immunohistochemistry: CD2 positive (+ + +), CD3 negative (-), CD4+ + +, CD5-, CD7-, CD8-, CD30+ + +, MUM1+ + +, BCL-2+ + +, PD1-, anaplastic lymphoma kinase (ALK) -, CD19-, CD20-, Pax5-, CD56-, CD10-, Ki-67>90% +, BCL6-, CD23-, CD35-, MPO-, CD38-, CD138-, GramB-, Lysozyme-, TDT-, TIA-, CD21-, EBER-. ALK-negative anaplastic large cell lymphoma was diagnosed in pathological consultations in many hospitals. In December 2015, he went to the Institute of Hematology, Peking University. The blood routine was normal, the biochemistry showed normal electrolyte and liver and kidney function, and the lactate dehydrogenase was 170 U/L. Coagulation function : PT 19.4 s, APTT 56.8 s. No lymphoma cells were found in bone marrow smear and immunotyping, and no tumor was found in bone marrow biopsy. After surgical resection, PET-CT showed no clear metabolic active lesions in the whole body. The patient had no fever, night sweats and weight loss since the onset of the disease. He was admitted and diagnosed with ALK-negative anaplastic large cell lymphoma stage Ia with abnormal coagulation function to be investigated.

To investigate the injury and pathological changes of kidney in a rat model of aortic vascular calcification and to explore the expressions of fibroblast growth factor 21 (FGF21).

A total of 14 Spraugue Dawley (SD) rats were randomly divided into two groups: control group and vitamin D3+ nicotine (VDN) group, with 7 rats in each group.The rats in VDN group received vitamin D3 and nicotine to induce vascular calcification.The content of serum creatinine was determined by sarcosine oxidase method.Alkaline phosphatases (ALP) activity was detected by ALP detection kit.The protein levels of FGF21 were measured by radioimmunoassay (RIA). The structure of kidney was observed by hematoxylin and eosin staining.

The serum concentration of creatinine in VDN group was significantly higher than control group[(34.00±4.69) vs (27.17±5.38) μmol/L, P<0.05], and the renal pathological changes in VDN group were more apparent. ALP activity in VDN group was significantly higher than that in control group[(62.59±22.62) vs (29.89±11.78) U/g,P<0.05]. Expression of FGF21 in VDN group increased obviously, compared with that in control group[(0.583±0.340) vs (0.207±0.105) ng/mg,P<0.05]. Meanwhile, the elevated levels of FGF21 were positively correlated with up-regulation of ALP in calcified kidneys (r=0.878, P<0.05).

Flushing dose of vitamin D3 and nicotine can induce the change of pathology and function of the kidney.Meanwhile, the expression of FGF21 in kidney up-regulated significantly, suggesting that FGF21 may be involved in the occurrence and development of vascular calcification and subsequent kidney injury.

To investigate effects of mammalian target of rapamycin (mTOR)- cell division cycle 42 (Cdc42) signaling pathway on phagocytosis of alveolar macrophages (AMs) in chronic obstructive pulmonary disease (COPD) mice.

Forty mice were randomly divided into control group and model group. Each group contained 20 mice. COPD model group were established by cigarette smoking exposure. AMs were isolated from lung tissue by discontinuous density gradient centrifugation. AMs from control group were divided into health control group and rapamycin control group while AMs from model group were divided into COPD group and rapamycin COPD group. The AMs from rapamycin control group and rapamycin COPD group were incubated with a final concentration of 10 nmol/L rapamycin for 24 hours. Mean fluorescence intensity (MFI) and the positive percent of alveolar macrophage engulfed flurescein isothiocyanate-labeled Escherichina coli (FITC-E.coli) AM (AM%) were detected by flow cytometry. Real time PCR (RT-PCR) and Western blot were applied to detect mRNA and protein. The activity of Cdc42 was detected by G-LISA Small GTPase Activation Assays (G-LISA) Cdc42 Kit. The cytoskeleton structure of AM was observed by laser scanning confocal microscopy.

MFI and AM% in COPD group were decreased than those in health control group[4 060±590 vs 9 190±988 and (28.65±1.26)% vs (67.50±4.56)%]; Compared with COPD group, MFI and AM% in rapamycin COPD group[4 856±762, (38.31±1.71)%]were increased (allP<0.05). The expression of mRNA, protein and activity of mTOR in COPD group were increased than those in health control group[(2.62±0.46, 1.30±0.52, 1.46±0.43) vs (1.00±0.00, 0.48±0.27, 0.58±0.26)]; compared with COPD group, the expression of mRNA, protein and activity of mTOR in rapamycin COPD group (1.40±0.36, 0.90±0.66, 0.92±0.28) were decreased (allP<0.05). The Cdc42 mRNA, protein and activity in COPD group were higher than those in health control group[(2.56±0.50, 1.61±0.37, 0.46±0.09) vs (1.00±0.00, 0.67±0.22, 0.30±0.07)](allP<0.01); compared with COPD group, the expression of mRNA, protein and activity of Cdc42 in rapamycin COPD group (1.38±0.34, 0.91±0.48, 0.36±0.06) were decreased (allP<0.01). Filopodia protruding can not be seen in the cytoskeleton of AMs from health control group and rapamycin control group; some filopodia protruding can be seen in AM from COPD group; some long filopodia protruding can be seen in AM from rapamycin COPD group. Negative correlations were existed between the mRNA, protein and activity of mTOR, Cdc42 and MFI in all group.

mTOR-Cdc42 signaling pathway is activated and related to phagocytosis deficiency of AM in COPD. It can be inferred that the pathway is involved in the pathogenesis of COPD.

To detect the effect of brain cytoplasmic RNA 1 (BCYRN1) on the proliferation and migration of airway smooth muscle cells (ASMCs) in rat model of asthma.

Male SD rats were randomly divided into control group and asthma group (n=10 each). The ovalbumin (OVA) model was constructed in asthma group. Real time-qPCR was performed to detect the level of BCYRN1 in the ASMCs separated from the airway tissue of these rats. Then 2-(4-iodophenyl)-3-(4-nitrophenyl)-5-(2, 4-disulfophenyl)-2H-tetrazolium (WST-1) assay, roche real-time cell analyzer assay and Transwell cell migration assay were performed to detect the viability/proliferation and migration of ASMCs which were transfected with Ad-BCYRN1.Platelet-derived growth factor (PDGF)-BB was used to treat ASMCs to induce proliferation and migration, and the level of BCYRN1 was examined.The viability/proliferation and migration of ASMCs treated with PDGF-BB and transfected with si-BCYRN1 were detected. Inspiratory resistance and expiratory resistance were measured in rats with BCYRN1 knockdown.Briefly, rats were randomly divided into four groups: control (group A), sensitization + Ad-GFP (group B), sensitization + AdSM22α-siBCYRN1 (group C), control + Ad-SM22α-siBCYRN1 (group D) (n=10 each). The corresponding adenovirus vectors were sent to lung of group B, group C and group D through nasal spray. The OVA model was constructed in group B and group C. The rats in group A and group D were treated with saline.After 24 h of the last treatment with OVA or saline, rats of each group were given tracheal intubation, connected with breathing machine. Rats were injected with methacholine to measure the inspiratory resistance and expiratory resistance.

The level of BCYRN1 in ASMCs separated from rats in asthma group and in ASMCs treated with PDGF-BB was 3.60±0.45 and 3.53±0.35, respectively, significantly higher than those of the corresponding control (both P<0.01). Ad-BCYRN1 significantly increased the expression of BCYRN1 in ASMCs. The cell viability and proliferation rates of ASMCs transfected with Ad-BCYRN1 increased 1.75-and 1.47-fold compared to those of the control group, respectively (P<0.01); mobility increased 2.42-fold compared to that of the control group (allP<0.01). BCYRN1 knockdown reversed the increasing proliferation and migration of ASMCs induced by PDGF-BB. The cell proliferation rate and cell migration number in the PDGF-BB treatment group were (4.87±0.21)% and 80.00±5.00, respectively, which were significant higher than those in the si-BCYRN1 transfected group ((3.63±0.21)% and 25.33±2.52, allP<0.01). BCYRN1 knockdown reduced the inspiratory resistance and expiratory resistance in sensitization + Ad-SM22α-siBCYRN1 group. When the concentration of acetylcholine reached 1 mg/kg, the inspiratory resistance in the group A, group B, group C, and group D were 8.27±0.21, 25.40±0.56, 12.07±0.67 and 8.40±0.46 cmH₂O·s·ml^-1, and expiratory resistance were 13.30±0.56, 38.37±1.33, 16.40±0.56 and 13.40±0.46 cmH₂O·s·ml^-1, respectively (all P<0.01).

Overexpression of BCYRN1 promotes the proliferation and migration of ASMCs in rat model of asthma.

To evaluate the association of sleep quality with hypertension in the elderly population aged 60 years and older of Jino nationality.

In August 2015, a cross-sectional population-based survey was conducted to investigate the prevalence of hypertension in 805 subjects sampled by multistage stratified and cluster sampling from the elderly population of Jino nationality, the sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI, a poor sleep group was defined as having a global PSQI score>7, a good sleep group was with a score of 7 or less), and the multilevel Logistic regression model was applied to analyze the association of sleep quality with hypertension.

A total of 793 eligible participants were available for analysis. Overall, 118 participants (14.9%) were in the poor sleep group, and 675 participants (85.1%) were in the good sleep group. The prevalence of hypertension, prevalence of isolated systolic hypertension, average systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the poor sleep group were significantly high than those of the good sleep group[73.7%, 22.0%, (139.2±17.7) and (82.5±10.6) mmHg (1 mmHg=0.133 kPa) vs 33.0%, 9.0%, (131.2±15.0) and (78.5±8.9) mmHg, all P<0.05]. The results of covariate-adjusted multilevel Logistic regression model indicated that subjective sleep quality (OR=2.64, 95% CI: 1.08-6.44), sleep latency (OR=2.98, 95% CI: 1.52-5.86), sleep disturbance (OR=2.93, 95% CI: 1.06-8.10), daytime dysfunction (OR=3.86, 95% CI: 1.74-8.58) and poor sleep (OR=3.98, 95% CI: 2.05-7.73) had the positive correlation with hypertension.

The elderly population of Jino nationality with poor sleep have high SBP and DBP. There are positive associations of PSQI and its components with hypertension in the elderly population of Jino nationality.

To detect the mutations in alkaline phosphatase (ALPL) gene of two Chinese families with perinatal hypophosphatasia (HPP), in order to explore the mechanism of this condition.

Next-generation sequencing (NGS) of osteology system panel was carried out for exome sequencing in the mothers of 2 HPP fetuses, who visited Prenatal Diagnosis Center of the First Affiliated Hospital of Zhengzhou University. Further polymerase chain reaction (PCR) and Sanger sequencing validation was performed in the parents, affected fetuses and 200 unrelated healthy individuals to verify the mutation sites.

The mother and father of No.1 family carried ALPL gene c. 333delC (p.Gly112AlafsX10) and c. 568_570delAAC (p.190delAsn) base deletions, respectively. The affected fetus carried compound heterozygotes of the two mutations. Two mutations in ALPL gene known to be associated with hypophosphatasia were found in No.2 family, c. 1250A>G (p.Asn417Ser) in the mother and c. 1166C>A (p.Thr389Asn) in the father, while the fetus was a compound heterozygote carrying both of the two mutations. Both families met the pattern of autosomal recessive inheritance. ALPL gene c. 333delC (p.Gly112AlafsX10) was a novel mutation, and it was not found in the 200 unrelated healthy individuals.

The mutations in ALPL gene may be the cause of HPP in the 2 families. NGS technology combined with Sanger sequencing could be an efficient and accurate diagnostic method.

To investigate the factors correlated to coronary artery calcification (CAC)in maintenance hemodialysis (MHD) patients and observe the effect of sodium thiosulfate (STS) on the progression of vascular calcification and its safety.

Thirty-eight subjects from Fuzhou Genernal Hospital who underwent coronary artery CT scan using Philip′s spiral CT were enrolled and the calcification degree was evaluated by CAC scores from December 2013 to December 2014. The hemodialysis patients were divided into CAC group (CAC scores>10, 27 cases) and non-CAC group (CAC scores≤10, 11 cases)according to the CT scan results.The differences of age, duration of dialysis, blood pressure and other hematological indices between the two groups were analyzed to investigate the factors correlated to CAC. Next, those with CAC (CAC scores≥50) received intravenous 0.18 g/kg STS (dissolved in 100 ml saline) in 30 minutes after each dialysis for 3 months (n=17, only 15 patients completed STS treatment) or received conventional treatment (n=10). Baseline data between the two groups before treatment had no significant statistical difference. All examination indices were evaluated before and after the treatment course. The changes of vascular calcification imaging, CAC scores, biochemical indices and bone mineral density were compared between two groups before and after the treatment. Besides, adverse reactions were observed during the treatment of STS. This study was approved by the Ethics Committee of Fuzhou General Hospital(2013No1).

Twenty-seven out of 38 patients (71.05%) had CAC, and the patients with CAC had significantly higher age, phosphate, the product of calcium and phosphate, intact parathyroid hormone (hPTH), hypersensitive C-reactive protein (hsCRP), and longer duration of dialysis (P=0.017, 0.038, 0.037, 0.012, 0.002, 0.037) and lower serum albumin (P=0.026) than patients without CAC.There was no significant statistical difference in the baseline characteristics. CAC score did not change significantly before and after treatment in the STS treatment group[1 045(47-12 734) vs 797(50-14 094), P=0.053], but increased significantly in the conventional treatment group[221(59-3 843) vs 174(50-3 369), P=0.021]. Difference of CAC score parameters before and after treatment showed statistically significant difference between the two groups[-67.5(-474-8) vs 52(-248-1 361) , P=0.004]. After STS treatment, level of hsCRP and HCO₃^- decreased (P=0.016 and P=0.020, respectively), and level of serum calcium increased (P=0.005). There was no significant statistical difference observed in iPTH, 25(OH)D, bone alkaline phosphatase (bALP), fibroblast growth factor 23 (FGF23) after STS treatment.

STS treatment seems to be feasible, safe and may delay the rate of progression of vascular calcification, reduce inflammation in maintenance hemodialysis patients, but the adverse reactions needs further study.

To explore the expression of erythropoietin (EPO) in neovascular glaucoma (NVG) and its role in the angiogenesis in vitro.

The levels of EPO in aqueous humor and vitreous body of NVG patients (10 cases) and non-NVG patients (10 cases) were detected by enzyme-linked immunosorbent assay (ELISA). Human umbilical vein endothelial cells (HUVECs) were used as the research object, and were divided into EPO 0.1, 1, 10 U/ml group according to EPO concentration, on the basis of treatment of HUVECs cells with 10 ng/ml vascular endothelial growth factor (VEGF). Effect of different concentrations of recombinant human EPO and VEGF on the proliferation, angiogenesis and the formation of capillary like structures of HUVECs in vitro was explored, meanwhile, protein and mRNA expression of hypoxia inducible factor-1α (HIF-1α) was detected by Western blot and RT-PCR.

In the study, no patients discontinued the trial. EPO level of aqueous humor in non-NVG patients was (29.4±0.6) ng/L, while EPO level in aqueous humor of NVG patients reached (307.5±7.6) ng/L, and the difference was statistically significant (t=2.186, P=0.039); vitreous EPO levels in non-NVG patients was (16.7±1.2) ng/L, while vitreous EPO levels in NVG patients reached (267.5±11.4) ng/L, with a statistically significant difference (t=2.517, P=0.019). Compared with control group, 0.1, 1, 10 U/ml EPO and 10 ng/ml VEGF promoted the proliferation of HUVECs, and formation of vascular lumen-like and capillary-like structure in vitro, and up-regulated the protein and mRNA expression of HIF-1α (allP<0.05).

EPO was highly expressed in the NVG patients, and exogenous EPO could significantly promote the proliferation of HUVEC and formation of vascular lumen-like and capillary-like structure, which may be related to up-regulation of HIF-1 expression.

To detect the expression of long noncoding RNA(lncRNA)stomach cancer-associated transcript-3(STCAT3) in gastric cancer tissues, adjacent tissues, human gastric cancer cell lines and normal gastric epithelial cell lines, and to investigate the relationship between STCAT3 expression and clinicopathological features and malignant phenotype of gastric cancer.

Quantitative fluorescent real-time polymerase chain reaction (qRT-PCR) was applied to detect the lncRNA STCAT3 expression levels in gastric cancer tissues, paired adjacent non-tumorous tissues, in order to explore the relationship between STCAT3 expression and clinicopathological features of gastric cancer. lncRNA STCAT3 low-expressing and high-expressing gastric cancer cell lines were transfected with expression plasmid to simulate gain-of-function, or interference plasmid to achieve loss-of-function. Cell proliferation was measured with CCK-8 and colony formation assay, cell migration with scratch assay, and cell invasion with Transwell migration assay. human gastric tumor were also transplanted to nude mice to detect the effect of lncRNA STCAT3 on tumorigenesis.

The expression of lncRNA STCAT3 was generally up-regulated in gastric cancer tissues compared with the adjacent tissues(12.55±0.16 vs 6.52±0.14), with median expression level in gastric cancer tissues being 6.03 higher (P<0.05). Meanwhile, the expression level of lncRNA STCAT3 in gastric cancer tissues was not correlated with age or gender (bothP>0.05), while positively correlated with TNM stage (P<0.05). Interference of lncRNA STCAT3 expression in BGC-823 cells was found associated with significantly suppressed colony formation, proliferation, invasion, and migration (allP<0.05). Over-expression of lncRNA STCAT3 in AGS cells were also founded could promote the gastric cancer cells′ proliferation, colony formation, migration, and invasion (allP<0.05).

lncRNA STCAT3 may participate in the proliferation and invasion of gastric cancer cells, indicating that dysregulation of STCAT3 expression may play a role in occurrence and development of gastric cancer. lncRNA STCAT3 has the potential to be the biomarker of gastric cancer progression and target in treatment. The underlying mechanism is yet to be further studied.

Depression and acute coronary syndromes (ACS) are important causes of global disease burden^[1]。 Epidemiological evidence has shown that depression is closely related to acute coronary syndrome^[2,3,4]。 Patients with cardiovascular disease are more likely to develop depression than the general population; Patients with depression are more likely to develop cardiovascular disease than the general population; When patients have both cardiovascular disease and depression, their prognosis of cardiovascular disease is worse than that of cardiovascular patients who do not have depression. However, the diagnosis rate of depression in patients with ACS combined with depression is low, only less than 1/3. Therefore, whether high-risk patients can be identified through effective early screening and effective treatment for patients with ACS combined with depression can be given to reduce the greater disease burden caused by the interrelationship between the two diseases still needs further exploration and research.

Rapid eye movement sleep period behavior disorder (RBD) refers to dystonia disorder that occurs during rapid eye movement sleep period and manifests as abnormal behaviors associated with dreams^[1]。 These actions can be simple jokes, shouting, excessive twisting of limbs and torso, or complex actions such as slapping, cursing, gesturing, grabbing, punching and kicking, or even sitting up from bed, most of which are obviously aggressive.

Kidney cancer is a malignant tumor that is highly resistant to traditional treatments including chemotherapy and radiation therapy. Scholars have used many immunomodulatory methods to treat kidney tumors. However, at present, traditional immunotherapy is still limited by low efficiency, high toxicity, and effective in some patients^[1]。 In recent years, tumor immunotherapy targeting immune checkpoint receptors has set off a revolution in tumor therapy^[2]。