Objective To explore the value of surgical treatment in rectal small cell neuroendocrine carcinoma (RSCC). Method The clinical data of patients with pathologically diagnosed as RSCC from 2000 to 2019 were extracted from the Surveillance, Epidemiology and End Results (SEER) database, to explore the effect of surgical treatment on cancer-specific survival (CSS) and overall survival (OS). Results A total of 348 cases were included with the median follow-up of 8 months (IQR: 3–16 months). Of the 101 patients in the operation group, 84 died (83.2%), including 56 tumor-related deaths (55.4%). Of the 247 patients in the non-operation group, 215 died (87.0%), including 131 tumor-related deaths (53.0%). The estimated 1-year OS of the operation group and the non-operation group were 49.6% and 34.4%, respectively, and the estimated 1-year CSS of those were 62.2% and 49.2%, respectively. There were significant differences between the two groups (both P<0.05). Results of multivariate prognostic analysis by Cox proportional hazard model showed that differentiation, SEER stage, receiving operative treatment or not, receiving chemotherapy or not, and receiving radiotherapy or not were independent influencing factors for OS, and SEER stage, receiving operative treatment or not, receiving chemotherapy or not, and receiving radiotherapy or not were independent influencing factors for CSS (all P<0.05). The OS [RR=0.61, 95%CI was (0.45, 0.81), P<0.001] and CSS [RR=0.67, 95%CI was (0.47, 0.95), P=0.025] in RSCC patients were significantly improved by surgical treatment. Conclusion Surgical treatment can improve the OS and CSS in RSCC patients.
Objective To evaluate the prognostic value of surgical treatment in gallbladder squamous cell carcinoma (GSCC) by using real-world data with a large sample in the Surveillance, Epidemiology and End Results (SEER) database. Methods The clinical data of patients with pathologically diagnosed GSCC from 2000 to 2019 were extracted from the SEER database. According to the inclusion and exclusion criteria, a total of 257 patients were included after strict screening. The patients were divided into operation group and non-operation group according to whether they underwent surgery. The cancer-specific survival (CSS) and the overall survival (OS) between the two groups were compared, and the influencing factors for the CSS and the OS were analyzed by using Cox proportional hazard model. Results Of 257 patients, 127 (49.4%) were in the operation group, and 130 (50.6%) in the non-operation group. The average follow-up ranged from 0 to 220 months, with the median follow-up time of 3 months. Of the 127 patients in the operation group, 105 died (82.7%), including 88 tumor-related deaths (69.3%). Of the 130 patients in the non-operation group, 124 died (95.4%), including 115 tumor-related deaths (88.5%). The median survival time for OS in the operation group and the non-operation group were 6 months and 3 months, respectively, and that for CSS were 7 months and 3 months, respectively. The estimated 1-year OS of the operation group and the non-operation group were 30.1% and 4.6% respectively; the estimated 1-year CSS were 35.1% and 5.8%, respectively. There were significant differences between the two groups on OS and CSS (χ2=41.400, P<0.001; χ2=42.750, P<0.001). That the OS [HR=0.44, 95%CI (0.25, 0.77), P=0.004] and the CSS [HR=0.46, 95%CI (0.25, 0.84), P=0.011] in GSCC patients were significantly improved by surgical treatment, showed by the results of multivariate prognostic analysis via Cox proportional hazard mode. Conclusions Surgical treatment was an independent factor affecting the prognosis of GSCC, and it could improve the OS and the CSS. As for the modus operandi, R0 resection should be recommended.
Objective To explore the migration and differentiation of bone marrow mesenchymal stem cells（MSCs） in lung . Methods MSCs were harvested from a male Wister rat. Sixty female Wister rats were randomly divided into four groups. The pulmonary fibrosis model was established by intratracheal instillation of bleomycin in group A-D. Immediately and 7 days after bleomycin administration respectively，the rats in group B and C received infusion with 5-bromodeoxynridine （BrdU） labeled MSCs via tail vein. And the rats in group D were infused MSCs without BrdU labeling serving as a negative control. The sry gene of Y chromosome was detected by polymerase chain reaction （PCR）. Double immunofluorescence staining was used to detected BrdU and surfactant associated protein-C （SP-C） expression in lung tissue，fresh bone marrow，and the 5th generation MSCs. Reverse transcriptipon-PCR was used to detect the expressions of SP-C mRNA and AQP-5 mRNA. Results The sry gene was detected in bleomycin induced lung injury tissues of the rats after MSCs infusion immediately and on the 7th day The MSCs in lung tissue could transformed into cells with ACEⅡ morphological features and molecular phenotype. The transformation rate was higher in the rats received MSCs infusion immediately than the rats received on 7th day. The 5th generation MSCs and fresh bone marrow expressed SP-C mRNA，without AQP-5 mRNA and SP-C expression. Conclusions Exogenous MSCs can be transplanted into injured lung tissues and transform into AECⅡ，especially in early stage of lung injury. The differentiation potential of MSCs can be activated in injury micro-environment.
ObjectiveTo investigate the therapeutic effect of kinetin on bleomycin A5 (BLM-A5)-induced pulmonary fibrosis in rats. MethodsSixty female Wistar rats were randomly divided into three groups. Group A (n=20) was intratracheally injected with saline as control. Group B (n=20) were intratracheally injected with BLM-A5 to establish pulmonary fibrosis model. Group C (n=20) was intratracheally injected with BLM-A5 and received intraperitoneal injection of kinetin at 0.5 mL/100 g once daily. The rats were sacrificed on the 3rd,7th,14th and 28th day respectively. HE and Masson staining were performed to observe lung pathological changes. The contents of hydroxyproline (HYP),urokinase-type plasminogen activator (u-PA),tissue-type plasminogen activator (t-PA),and PAI-1 in lung and plasma were measured by ELISA. ResultsAlveolitis was most obvious on the 7th day and pulmonary fibrosis was most severe on the 28th day in group B compared with other two groups (P<0.05). Alveolitis and pulmonary fibrosis in group C were significantly alleviated compared with group B (P<0.05),but still more severe than group A (P<0.05). The HYP contents in group B,coincided with fibrosis,began to increase on the 7th day and reached the peak on the 28th day,significantly higher than those in other two groups (P<0.05). The u-PA contents of lung tissue in group B began to decline on the 3rd day,reached the minimum on the 7th day,and was still significantly lower than those in other two groups (P<0.05).On the 14th day, the u-PA contents had no significant difference among three groups. The u-PA plasma contents in group B began to decline on the 3rd day,reached the minimum and had significant difference compared with other two groups on the 7th day (P<0.05),and there was no significantly difference among three groups after the 14th day. The t-PA contents change of lung tissue and plasma in three groups were generally consistent with u-PA,but the t-PA plasma contents in group B were still significantly lower than those in group A on the 14th day (P<0.05). The PAI-1 contents of lung tissue in group B began to increase on the 3rd day,reached the maximum on the 7th day,was still significantly higher than those in other two groups (P<0.05),and there was no significant difference among three groups on the 14th day. The PAI-1 contents in group C decreased compared with those in group B (P<0.05),but still higher than those in group A (P<0.05),and there was no difference among them on the 14th day. The PAI-1 plasma contents in group B began to increase on the 3rd day,reached the maximum and was significantly higher than other two groups on the 7th day (P<0.05),and there was no significant difference among three groups on the 14th day. ConclusionThe contents of u-PA and t-PA are increased by inhibiting PAI-1 generation in lung tissue through kinetin treatment,so that,kinetin can suppress pulmonary fibrosis induced by BLM-A5.
Objective To investigate the expression of heme oxygenase-1 (HO-1) by high glucose treatment in human lung epithelial A549 cells. Methods The effect of high glucose on the expression of HO-1 in A549 cells was investigated with Western blot and reverse transcription PCR. HO-1 enzymic activity and reactive oxygen species (ROS) production were investigated with enzyme-linked immunosorbent test. Results Treatment with 25 mmol/L high glucose for 0, 24 h, 48 h, 72 h and in concentrations of 5 mmol/L, 10 mmol/L, 25 mmol/L, 40 mmol/L for 48 h induced increased expression on protein and mRNA level of HO-1 in a concentration- and time-dependent manner in A549 cells. High glucose treatment increased production of ROS and transforming growth factor-β1 (TGF-β1) in A549 cells, which thus mediated HO-1 expression. Following the increase in HO-1 expression, the enzymatic activity of HO-1 also increased in high glucose-treated cells. Pretreatment with N-acetyl-L-cysteine (NAC) and PI3K/Akt inhibitors attenuated the high glucose-induced increased HO-1 expression. Conclusions High glucose increases ROS and TGF-β1 production in A549 cells, which mediates HO-1 expression and increases HO-1 enzymic activity.
ObjectiveTo investigate the effect of diammonium glycyrrhizinate (DG) plus bone marrow mesenchymal stem cells (MSCs) transplantation in the treatment of acute exacerbation of pulmonary fibrosis induced by bleomycin (BLM) in rats.MethodsMSCs were isolated from male Wistar rats and cultured in vitro. Twenty-four female Wistar rats were randomly divided into 4 groups. The NC group was intratracheally injected with normal saline; the BLM group, the MSC group and the DGMSC group were intratracheally injected with BLM for 7 days; then the MSC group was injected with 0.5 mL of MSCs solution (2.5×106 cells) into the tail vein; the DGMSC group was intraperitoneally injected with DG for 21 days in a dose of 150 mg·kg–1·d–1 on the base of the MSCs injection. The rats were sacrificed on the 28th day and the lung tissue was extracted. Pathological examination was performed to determine the degree of alveolitis and pulmonary fibrosis. Immunofluorescence was used to detect the number and distribution of alveolar type Ⅱ epithelial cells. Alkali hydrolysis method was used to determine the content of hydroxyproline (HYP) in lung tissue; thiobarbituric acid method was used to measure the content of malondialdehyde (MDA) in lung tissue; colorimetric method was used to determine the superoxide dismutase activity (SOD) and total antioxidant capacity (T-AOC); enzyme linked immunosorbent assay was used to detect the expression levels of tumor necrosis factor-α (TNF-α ) and transforming growth factor-β1 (TGF-β1) in lung tissue homogenates.ResultsThe DG combined with MSCs injection can reduce the degree of alveolitis and pulmonary fibrosis in BLM model rats. The content of HYP and TGF-β1 in lung tissue homogenate of the DGMSC group were significantly lower than those in the MSC group (P<0.05). Meanwhile, DG combined with MSCs injection significantly increased the antioxidant capacity of the BLM model rats. MDA content decreased, SOD activity and T-AOC ability improved significantly in the DGMSC group compared with the MSC group (P<0.05). The alveolar type Ⅱ epithelial cells were significantly increased and the cell morphology was maintained in the DGMSC group compared with the MSC group.ConclusionsDG has a synergistic effect with MSCs in treatment of acute exacerbation of pulmonary fibrosis. The mechanism may be related to reducing inflammatory factors during pulmonary fibrosis, attenuating oxidative stress and promoting MSCs migration into lung tissue and transformation to alveolar type Ⅱ epithelial cells.
ObjectiveTo investigate the impact of surgical treatment on the prognosis of patients with gastric signet-ring cell carcinoma (GSRC). MethodsThe clinicopathologic and prognosis data of patients pathologically diagnosed with GSRC from 2000 to 2019 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. The Cox proportional hazards regression model was used to analyze the impact of surgery on overall survival (OS) and cancer-specific survival (CSS) of patients with GSRC. ResultsA total of 3 457 patients with GSRC were included, including 2 048 cases in the operation group and 1 409 cases in the non-operation group. The propensity-score matching by a 1∶1 nearest neighbour algorithm was conducted to control for confounding baseline differences. There were 802 cases in the operation group and 802 cases in the non-operation group after matching. The OS and CSS curves drawn by Kaplan-Meier method of the operation group were better than those of the non-operation group (χ2=434.3 P<0.001; χ2=412.4, P<0.001). The multivariate Cox proportional hazards regression analysis showed that the elderly (≥ 60 years old), late AJCC tumor stage (stage Ⅰ as reference), and patients with bone metastasis of GSRC increased the risk of shortening OS and CSS (P<0.05), while patients treated with surgery and chemotherapy decreased the risk of shortening OS and CSS (P<0.05). ConclusionAccording to the analysis results of SEER database in this study, surgical treatment is beneficial to improve the prognosis for patients with GSRC.
ObjectiveTo analyze the causal relationship between the intake of cheese or tea and the risk of gastroesophageal reflux disease (GERD). MethodsUsing a two-sample Mendelian randomization approach, single nucleotide polymorphisms (SNPs) associated with milk or tea intake were used as instrumental variables. The causal effect of milk or tea intake on the risk of GERD was investigated using the MR Egger method, the weighted median method, the inverse-variance weighted (IVW) random-effects model, and the IVW fixed-effects model. Multivariable analysis was conducted using the MR Egger method, and leave-one-out sensitivity analysis was performed to validate the reliability of the data. ResultsCheese intake could reduce the occurrence of GERD [IVW random-effects model β=–1.010, 95%CI (0.265, 0.502), P<0.05], while tea intake could lead to the occurrence of GERD [IVW random-effects model β=0.288, 95%CI (1.062, 1.673), P<0.05]. ConclusionCheese intake may have a positive causal relationship with reducing the risk of GERD occurrence, while tea intake may have a positive causal relationship with increasing the risk of GERD occurrence.