Surgical management strategy for leiomyosarcoma of Zone I-II inferior vena cava: A case series

Objectives:Leiomyosarcoma of inferior vena cava (IVC) is a rare clinical entity with severe vascular involvement. Surgical management of leiomyosarcoma is still challenging.Methods:This a retrospective study of consecutive patients referred to our hospital from January 2017 to June 2019. Depending on the anatomical site of affected IVC, leiomyosarcomas were categorized into zone I-II. The clinical data including baseline information, surgical parameters, peri-operative management, short- and mid-term outcomes were observed.Results:Four patients with leiomyosarcoma of zone I-III underwent radical resection without intraoperative mortality. Prosthetic grafts were interpositioned in all patients to instruct vena cava. Renal vein reconstruction was perfumed in two patients due to involvement to renal veins. Median blood loss was 450 mL (200–600 mL), median operative time was 215 minutes (150–240 minutes). No Clavien-Dindo IIIa or higher complication was observed. No organ dysfunction and recurrence were observed with median follow-up of 25.5 months.Conclusions:Curative resection of zone I-II leiomyosarcoma is associated with longer survival in selected cases, en-bloc resection with complex vascular reconstruction could be considered.     

Clinical course and outcomes of COVID-19 patients with chronic obstructive pulmonary disease: A retrospective observational study in Wuhan,China

Information about coronavirus disease 2019 (COVID-19) patients with pre-existing chronic obstructive pulmonary disease (COPD) is still lacking. The aim of this study is to describe the clinical course and the outcome of COVID-19 patients with comorbid COPD.This retrospective study was performed at Wuhan Huoshenshan Hospital in China. Patients with a clear diagnosis of COVID-19 who had comorbid COPD (N = 78) were identified. COVID-19 patients without COPD were randomly selected and matched by age and sex to those with COPD. Clinical data were analyzed and compared between the two groups. The composite outcome was the onset of intensive care unit admission, use of mechanical ventilation, or death during hospitalization. Multivariable Cox regression analyses controlling for comorbidities were performed to explore the relationship between comorbid COPD and clinical outcome of COVID-19.Compared to age- and sex-matched COVID-19 patients without pre-existing COPD, patients with pre-existing COPD were more likely to present with dyspnea, necessitate expectorants, sedatives, and mechanical ventilation, suggesting the existence of acute exacerbations of COPD (AECOPD). Greater proportions of patients with COPD developed respiratory failure and yielded poor clinical outcomes. However, laboratory tests did not show severer infection, over-activated inflammatory responses, and multi-organ injury in patients with COPD. Kaplan–Meier analyses showed patients with COPD exhibited longer viral clearance time in the respiratory tract. Multifactor regression analysis showed COPD was independently correlated with poor clinical outcomes.COVID-19 patients with pre-existing COPD are more vulnerable to AECOPD and subsequent respiratory failure, which is the main culprit for unfavorable clinical outcomes. However, COPD pathophysiology itself is not associated with over-activated inflammation status seen in severe COVID-19.     

Comparison of the safety and prognosis of sequential regorafenib after sorafenib and lenvatinib treatment failure in patients with unresectable hepatocellular carcinoma: a retrospective cohort study

BackgroundThere is lack of studies on sequential regorafenib after sorafenib and lenvatinib treatment failure in patients with unresectable hepatocellular carcinoma (HCC). This study was to explore the safety and prognosis of sequential regorafenib after sorafenib and lenvatinib failure in HCC patients.MethodsThis study was a retrospective, real-world study that included 50 HCC patients who received sequential regrafinib after sorafenib and lenvatinib failure. The safety and prognosis of two groups were compared.ResultsThe incidence of all grade and III/IV adverse events were 68% and 24%. According to Response Evaluation Criteria in Solid Tumours (RECIST) 1.1 and modified (m) RECIST standards, the objective response rates (ORRs) after receiving regorafenib were 14.0% and 22.0%, respectively. The disease control rates (DCRs) were 62.0% and 60.0%, respectively. Based on different first-line targeted drugs, 50 patients were divided into sorafenib (n=22) and lenvatinib group (n=28). There was no differences between two groups except age and bilirubin. And there was no differences in other treatments before or after regorafenib. The baseline between two groups was basically same and had good comparability. There was no difference in incidence of all grade and III/IV adverse events, ORR and DCR between two groups (P>0.05). On long-term prognosis, total overall survival (TOS) in sorafenib and lenvatinib group were 23.0 (95% CI: 15.1–30.9) vs. 29.7 (95% CI: 21.4–38.1) months. The difference was statistically significant (P=0.041). Besides, regorafenib overall survival (ROS) in sorafenib and lenvatinib group were 11.7 (95% CI: 7.1–16.3) vs. 15.9 (95% CI: 8.3–23.5) months. The difference was statistically significant ( P=0.045). The regorafenib progression-free survival (RPFS) was 5.6 (95% CI: 1.9–9.2) vs. 8.0 (95% CI: 5.1–10.9) months in sorafenib and lenvatinib group, respectively, and difference was not statistically significant (P=0.380).ConclusionsRegorafenib is an effective drug for second-line treatment of HCC, with fewer severe adverse events, ORR and DCR was 14–22% and 62–60%, respectively. Both TOS and ROS in lenvatinib group were better than those in sorafenib group. For HCC patients whose first-line targeted drug is lenvatinib, it is safe and effective to accept regorafenib after disease progresses.     

河南省汝南县艾滋病流行状况调查

目的 调查分析汝南县艾滋病流行状况。方法 利用汝南县疾病预防控制中心系统收集的汝南县艾滋病的发病数据报告,进行描述性流行状况分析;设计一般资料调查表,记录艾滋病患者居住地、性别、年龄等信息。结果 2020年汝南县新发现艾滋病病例共42例,比前一年同期新发现病例（39例）增加7.69%;2020年全年共死亡51例,与前一年同期死亡人数（56例）相比增加41.67%;42例新发现艾滋病病例中,处于艾滋病期的占比高于HIV感染期,男性占比高于女性,主要集中于初中及以下文化程度,初中程度发病率最高;主要集中于无配偶人群,未婚人群发病率最高,其次为离异或丧偶人群;多集中于20～59岁年龄段,20～29岁年龄段发病率最高;农民占71.43%。结论 汝南县艾滋病发病率及死亡率呈上升趋势,新发现病例多处于艾滋病期,多集中于男性、初中及以下文化程度,无配偶及农民群体,且20～59岁年龄段发病率较高。     

Research on Design and Performance of Self-Compacting Cement Emulsified Bitumen Mixture (CEBM)

To meet the needs of the road industry for maintenance operations, a new cement emulsified bitumen mixture (CEBM) with early-strength, self-compacting, and room-temperature construction characteristics was designed. The strength formation mechanism of CEBM was revealed with a scanning electron microscope (SEM) and the surface free energy (SFE) theory. The mechanical properties and road performance of the CEBM were investigated extensively. The results show that before the demulsification of emulsified bitumen, the SFE of the bitumen–aggregate–water three-phase system was reduced due to the replacement of the bitumen–aggregate interface with water. The adhesion work between the emulsified bitumen and the aggregate is negative, which means the adhesion between the emulsified bitumen and the aggregate will not occur spontaneously due to the existence of water. The liquid emulsified bitumen improves the workability of the mixture and ensures that the mixture can be evenly mixed and self-compacted. After demulsification, the work of adhesion between the residual bitumen and the aggregate is positive, which means residual bitumen and aggregate can bond spontaneously. In addition, the hydration products of cement and aggregate form a skeleton, and the emulsified bitumen film wraps and bonds the cement and aggregate together, creating strength. The emulsified bitumen, cement content, and curing conditions have significant effects on the stability of CEBM. The recommended dosage of emulsified bitumen and cement is 8% and 8–10%, respectively. This material integrates the hardening effect of cement and the viscoelastic performance of bitumen and has good workability, mechanical properties, and road performance. Therefore, the CEBM is technically feasible for application to bitumen pavement.     

灵芪胶囊对H22荷瘤小鼠p53和bcl-2蛋白表达的影响

目的：探讨灵芪胶囊对H22荷瘤小鼠的抑瘤作用及其抑瘤作用机制。方法：采用体内实验法,于无菌条件下抽取传代7d、生长良好的H22荷瘤小鼠腹水,无菌0．9％氯化钠溶液1：3稀释（约含瘤细胞2×10^6／ml）,按0．2ml／7,接种于消毒后的小鼠右前肢腋部皮下,制成肿瘤模型,灌胃给药灵芪胶囊11d后,称取小鼠体重,脱椎处死小鼠,取脾脏及胸腺称重并计算胸腺指数和脾脏指数。用免疫组化法检测各组凋亡相关基因突变型p53和bcl-2基因的表达。结果：灵芪胶囊在明显抑制肿瘤生长的同时不降低体重,在一定剂量对荷瘤动物的免疫器官指数无明显影响;灵芪胶囊三个剂量组突变型p53基因和bcl-2基N的表达均低于模型组。结论：灵芪胶囊对H22荷瘤小鼠有明显抑瘤作用,其机制可能与抑制突变型p53基N和bcl-2基因表达有关。     

自体脂肪移植在眼科应用

自体脂肪移植在临床应用已有100多年的历史。脂肪移植后组织学变化,脂肪存活机制以及脂肪移植体成活情况已有很多研究报道。在眼科临床主要应用真皮脂肪移植和颗粒脂肪移植,主要用于矫治各种眼球摘除术后眼窝塌陷、眼睑凹陷畸形、眼部皱纹等。本文就脂肪移植后基础研究以及眼科临床应用加以综述。     

角蛋白、波形蛋白、神经细丝蛋白在人胎内耳的定位表达

本文对合法引产9～32周胎龄的人内耳中角蛋白、波形蛋白、神经细丝蛋白的表达进行了免疫组织化学定位研究。结果发现增殖期的前庭器和Corti器始基细胞均有这三种中间纤维的表达。随着内耳分化的进行，用蛋白表达部位限于表皮板、网板、支持细胞、血管纹和前庭壁细胞。波形蛋白的表达部位分布在Corti器始基细胞、一些支持细胞、环绕的结缔组织、软骨细胞、骨组织、血管纹缘细胞、螺旋神经节细胞和神经纤维，前庭感觉上度表达反应弱。神经细丝蛋白除了在神经细胞和神经纤维表达阳性外，在Corti器站基细胞上部、血管纹原始细胞表达明显，软骨细胞和骨组织表达弱。内耳发育成熟期，这三种中间纤维蛋白在感觉毛细胞和听毛细胞的内部都无阳性表达。研究结果提示：这三种中间纤维参与人内耳的发育，可能与人内耳功能的发生有关。     

黄褐毛忍冬总皂苷对卵清蛋白致敏小鼠肠道炎症因子和抗炎因子的影响

目的 观察黄褐毛忍冬总皂苷(Ful)对卵清蛋白(OVA)致敏小鼠肠道炎症因子和抗炎因子的影响.方法 24只雌性BALB/c小鼠随机取16只,采用卵清蛋白致敏和激发构建食物过敏模型,均分为2组,即食物过敏组(FA组)和Ful干预组(Ful组).Ful组小鼠自造模第20天起每日皮下注射Ful 200 mg/kg,共22 d.另8只小鼠作为正常对照组(NS组).采用逆转录-聚合酶链反应(RT-PCR)法检测小鼠空肠组织中转化生长因子β1(TGF-β1)、白细胞介素6(IL-6)、白细胞介素17A(IL-17A)、叉头蛋白3-T细胞转录因子(Foxp3)mRNA表达;免疫组织化学法检测小鼠空肠组织中TGF-β1、IL-6、IL-17A蛋白表达;检测空肠中髓过氧化物酶(MPO)活性代表中性粒细胞活化水平.结果 FA组小鼠空肠组织中TGF-β1、IL-6、IL-17A的mRNA[(0.370±0.013)、(0.475±0.015)]和TGF-β1、IL-6、IL-17A蛋白表达水平[(53 075.70±20 727.06)、(256 881.66±36 561.79)、(435 064.25±69 911.48)]均增高,Foxp3 mRNA(0.231±0.014).经黄褐毛忍冬总皂苷干预后,小鼠空肠组织TGF-β1表达未下降,但IL-6、IL-17A的mRNA[(0.196±0.005)、(0.204±0.008)]和蛋白表达水平[(114 040.30±20 295.25)、(218 200.74±30 077.69)]均明显降低,而Foxp3 mRNA(0.578±0.021)表达明显增高.空肠组织中MPO水平各组间比较差异无统计学意义(P＞0.05)..结论 食物过敏发生时肠道内存在以IL-6、IL-17A表达增高为主的炎症反应.Ful可有效降低OVA致敏小鼠肠道炎症因子IL-6、IL-17A的过度表达,显著增强调节性T细胞特异性转录因子Foxp3的表达,从改善OVA诱导的肠道炎症.     

Safety and efficacy of anti-EGFR monoclonal antibody (SCT200) as second-line therapy in advanced esophageal squamous cell carcinoma

Objective: The mainstay treatment of esophageal squamous cell carcinoma(ESCC) involves chemotherapy and immunotherapy. However, alternative therapies are required for patients who are refractory or intolerant to existing therapies.Methods: In this single-arm, multicenter, open-label phase Ib study, 30 patients received an intravenous infusion of SCT200, an antiepidermal growth factor receptor(EGFR) monoclonal antibody, 6.0 mg/kg once a week for 6 weeks, followed by 8.0 mg/kg once every 2 weeks u...