BACKGROUND Intraductal papillary neoplasm of the bile duct(IPNB)is a rare distinct subtype of precursor lesions of biliary carcinoma.IPNB is considered to originate from luminal biliary epithelial cells,typically disp...BACKGROUND Intraductal papillary neoplasm of the bile duct(IPNB)is a rare distinct subtype of precursor lesions of biliary carcinoma.IPNB is considered to originate from luminal biliary epithelial cells,typically displays mucin-hypersecretion or a papillary growth pattern,and results in cystic dilatation[1].IPNB develops anywhere in the intrahepatic and extrahepatic biliary tracts,and can occur in various pathological stages from low-grade dysplasia to invasive carcinoma.IPNBs have similar phenotypic changes in the occurrence and development of all subtypes,and the prognosis is significantly better than that of traditional(nonpapillary)cholangiocarcinoma.AIM To evaluate the clinicopathological features of IPNB to provide evidence-based guidance for treatment.METHODS Invasive IPNB,invasive intraductal papillary mucinous neoplasm of the pancreas(IPMN),and traditional cholangiocarcinoma data for affected individuals from 1975 to 2016 were obtained from the Surveillance,Epidemiology,and End Results(SEER)database.Annual percentage changes(APCs)in the incidence and incidence-based(IB)mortality were calculated.We identified the independent predictors of overall survival(OS)and cancer-specific survival(CSS)in indivi duals with invasive IPNB.RESULTS The incidence and IB mortality of invasive IPNB showed sustained decreases,with an APC of-4.5%(95%CI:-5.1%to-3.8%)and-3.3%(95%CI:-4.1%to-2.6%)(P<0.001),respectively.Similar decreases in incidence and IB mortality were seen for invasive IPMN but not for traditional cholangiocarcinoma.Both OS and CSS for invasive IPNB were better than for invasive IPMN and traditional cholangiocarcinoma.A total of 1635 individuals with invasive IPNB were included in our prognosis analysis.The most common tumor sites were the pancreaticobiliary ampulla(47.9%)and perihilar tract(36.7%),but the mucin-related subtype of invasive IPNB was the main type,intrahepatically(approximately 90%).In the univariate and multivariate Cox regression analysis,age,tumor site,grade and stage,subtype,surgery,and chemotherapy were associated with OS and CSS(P<0.05).CONCLUSION Incidence and IB mortality of invasive IPNB trended steadily downward.The heterogeneity of IPNB comprises site and the tumor’s mucin-producing status.展开更多
目的系统评价推拿治疗2型糖尿病(T2DM)的临床疗效,为T2DM治疗的临床实践提供参考。方法计算机检索中国期刊网、万方、中国生物医学文献库、维普及Pub Med等数据库,所有文献检索时限截止至2016年11月。根据纳入和排除标准,由2位评价者独...目的系统评价推拿治疗2型糖尿病(T2DM)的临床疗效,为T2DM治疗的临床实践提供参考。方法计算机检索中国期刊网、万方、中国生物医学文献库、维普及Pub Med等数据库,所有文献检索时限截止至2016年11月。根据纳入和排除标准,由2位评价者独立进行文献筛选和资料提取,并对纳入文献的质量进行评价,采用Rev Man 5.0软件进行Meta分析。结果纳入8个临床随机对照试验共998例患者。Meta分析结果显示,推拿联合常规药物治疗T2DM(观察组)的总有效率、显效率高于常规药物治疗组(对照组)(P<0.05),观察组无效率低于对照组(P<0.05);观察组与对照组的有效率、改善率比较,差异无统计学意义(P>0.05)。结论推拿治疗T2DM安全有效,但因纳入文献数量较少、质量较低,还需开展大样本、高质量的随机对照试验证实其有效性。展开更多
Objective:To investigate the inhibitory effect of humanized anti-VEGFR-2 ScFv-As_2O_3-stealth nanoparticles conjugate on growth of human hepatocellular carcinoma both in vitro and in vivo,which may be a potential agen...Objective:To investigate the inhibitory effect of humanized anti-VEGFR-2 ScFv-As_2O_3-stealth nanoparticles conjugate on growth of human hepatocellular carcinoma both in vitro and in vivo,which may be a potential agents with sensitivity and targeting ability for human hepatocellular cancer.Methods:Humanized anli-VECFR-2 ScFv-As_2O_3-stealth nanoparticles conjugate was previously constructed using ribosome display technology and antibody conjugate technology.In this combined in vitro and in vivo study,the inhibitory effects of anti-VEGFR-2 ScFv-As_2O_3-stealth nanoparticles conjugate on tumor growth,invasion,and metastasis was observed with human liver carcinoma cell line Bel7402 and normal cell L02 by MTT assay,Tanswell assay,Hochest33258 staining,and DNA ladder analysis.The anticancer activity and distribution of anti-VEGFR-2 ScFv-As_2O_3-stealth nanoparticles was then verified in a mouse model of Bel7402xenografts.Results:Anti-VEGFR-2 ScFv-As_2O_3-stealth nanoparticles significantly inhibited the proliferation of Bel7402 in the 3-(4,5-dimethylthiazol-2-yh-2,5-diphenyltetrazolium bromide assay while had almost no effects on L02 cells.And the apoptosis inducing effects were proved by Hochest33258 staining and DNA ladder analysis.Transwell assay found that the drug also inhibited the metastasis ability of tumor cells.Furthermore,anti-VEGFR-2 ScFv-As^-stealth nanoparticles significantly delayed the growth of Bel7402 xenografts after administration(92.9%),followed by As_2O_3-stealth nanoparticles,anti-VEGFR-2 ScFv,and As203(61.4%,58.8%,20.5%,P<0.05).The concentration of As_2O_3 in anti-VEGFR-2 ScFv-As_2O_3-steallh nanoparticles group was more selectively.Conclusions:Anti-VEGFR-2 ScFv-As_2O_3-stealth nanoparticles is a potent and selective anti-hepatocellular carcinoma agent which could inhibit the growth of liver cancer as a targeting agent both in vitro and in vivo and also significantly inhibit angiogenesis.展开更多
BACKGROUND T1b gallbladder carcinoma(GBC)is defined as a tumor that invades the perimuscular connective tissue without extension beyond the serosa or into the liver.However,controversy still exists over whether patien...BACKGROUND T1b gallbladder carcinoma(GBC)is defined as a tumor that invades the perimuscular connective tissue without extension beyond the serosa or into the liver.However,controversy still exists over whether patients with T1b GBC should undergo cholecystectomy alone or radical GBC resection.AIM To explore the optimal surgical approach in patients with T1b gallbladder cancer of different pathological grades.METHODS Patients with T1bN0M0 GBC who underwent surgical treatment between 2000 and 2017 were included in the Surveillance,Epidemiology,and End Results database.The Kaplan-Meier method and log-rank test were used to analyze the overall survival(OS)and disease-specific survival(DSS)of patients with T1b GBC of different pathological grades.Cox regression analysis was used to identify independent predictors of mortality and explore the selection of surgical methods in patients with T1b GBC of different pathological grades and their relationship with prognosis.RESULTS Of the 528 patients diagnosed with T1bN0M0 GBC,346 underwent simple cholecystectomy(SC)(65.5%),131 underwent SC with lymph node resection(SC+LN)(24.8%),and 51 underwent radical cholecystectomy(RC)(9.7%).Without considering the pathological grade,both the OS(P<0.001)and DSS(P=0.003)of T1b GBC patients who underwent SC(10-year OS:27.8%,10-year DSS:55.1%)alone were significantly lower than those of patients who underwent SC+LN(10-year OS:35.5%,10-year DSS:66.3%)or RC(10-year OS:50.3%,10-year DSS:75.9%).Analysis of T1b GBC according to pathological classification revealed no significant difference in OS and DSS between different types of procedures in patients with grade Ⅰ T1b GBC.In patients with grade Ⅱ T1b GBC,obvious survival improvement was observed in the OS(P=0.002)and DSS(P=0.039)of those who underwent SC+LN(10-year OS:34.6%,10-year DSS:61.3%)or RC(10-year OS:50.5%,10-year DSS:78.8%)compared with those who received SC(10-year OS:28.1%,10-year DSS:58.3%).Among patients with grade Ⅲ or Ⅳ T1b GBC,SC+LN(10-year OS:48.5%,10-year DSS:72.2%),and RC(10-year OS:80%,10-year DSS:80%)benefited OS(P=0.005)and DSS(P=0.009)far more than SC(10-year OS:20.1%,10-year DSS:38.1%)alone.CONCLUSION Simple cholecystectomy may be an adequate treatment for grade Ⅰ T1b GBC,whereas more extensive surgery is optimal for grades Ⅱ-Ⅳ T1b GBC.展开更多
基金Supported by the National Natural Science Foundation of China,No. 81860431 and 82060447the Jiangxi Natural Science Foundation,No. 20181BBG70025
文摘BACKGROUND Intraductal papillary neoplasm of the bile duct(IPNB)is a rare distinct subtype of precursor lesions of biliary carcinoma.IPNB is considered to originate from luminal biliary epithelial cells,typically displays mucin-hypersecretion or a papillary growth pattern,and results in cystic dilatation[1].IPNB develops anywhere in the intrahepatic and extrahepatic biliary tracts,and can occur in various pathological stages from low-grade dysplasia to invasive carcinoma.IPNBs have similar phenotypic changes in the occurrence and development of all subtypes,and the prognosis is significantly better than that of traditional(nonpapillary)cholangiocarcinoma.AIM To evaluate the clinicopathological features of IPNB to provide evidence-based guidance for treatment.METHODS Invasive IPNB,invasive intraductal papillary mucinous neoplasm of the pancreas(IPMN),and traditional cholangiocarcinoma data for affected individuals from 1975 to 2016 were obtained from the Surveillance,Epidemiology,and End Results(SEER)database.Annual percentage changes(APCs)in the incidence and incidence-based(IB)mortality were calculated.We identified the independent predictors of overall survival(OS)and cancer-specific survival(CSS)in indivi duals with invasive IPNB.RESULTS The incidence and IB mortality of invasive IPNB showed sustained decreases,with an APC of-4.5%(95%CI:-5.1%to-3.8%)and-3.3%(95%CI:-4.1%to-2.6%)(P<0.001),respectively.Similar decreases in incidence and IB mortality were seen for invasive IPMN but not for traditional cholangiocarcinoma.Both OS and CSS for invasive IPNB were better than for invasive IPMN and traditional cholangiocarcinoma.A total of 1635 individuals with invasive IPNB were included in our prognosis analysis.The most common tumor sites were the pancreaticobiliary ampulla(47.9%)and perihilar tract(36.7%),but the mucin-related subtype of invasive IPNB was the main type,intrahepatically(approximately 90%).In the univariate and multivariate Cox regression analysis,age,tumor site,grade and stage,subtype,surgery,and chemotherapy were associated with OS and CSS(P<0.05).CONCLUSION Incidence and IB mortality of invasive IPNB trended steadily downward.The heterogeneity of IPNB comprises site and the tumor’s mucin-producing status.
文摘目的系统评价推拿治疗2型糖尿病(T2DM)的临床疗效,为T2DM治疗的临床实践提供参考。方法计算机检索中国期刊网、万方、中国生物医学文献库、维普及Pub Med等数据库,所有文献检索时限截止至2016年11月。根据纳入和排除标准,由2位评价者独立进行文献筛选和资料提取,并对纳入文献的质量进行评价,采用Rev Man 5.0软件进行Meta分析。结果纳入8个临床随机对照试验共998例患者。Meta分析结果显示,推拿联合常规药物治疗T2DM(观察组)的总有效率、显效率高于常规药物治疗组(对照组)(P<0.05),观察组无效率低于对照组(P<0.05);观察组与对照组的有效率、改善率比较,差异无统计学意义(P>0.05)。结论推拿治疗T2DM安全有效,但因纳入文献数量较少、质量较低,还需开展大样本、高质量的随机对照试验证实其有效性。
基金supported by Natural Science Foundation of China(81060187)the Natural Science Foundation of Jiangxi Province(2008GQY0050)
文摘Objective:To investigate the inhibitory effect of humanized anti-VEGFR-2 ScFv-As_2O_3-stealth nanoparticles conjugate on growth of human hepatocellular carcinoma both in vitro and in vivo,which may be a potential agents with sensitivity and targeting ability for human hepatocellular cancer.Methods:Humanized anli-VECFR-2 ScFv-As_2O_3-stealth nanoparticles conjugate was previously constructed using ribosome display technology and antibody conjugate technology.In this combined in vitro and in vivo study,the inhibitory effects of anti-VEGFR-2 ScFv-As_2O_3-stealth nanoparticles conjugate on tumor growth,invasion,and metastasis was observed with human liver carcinoma cell line Bel7402 and normal cell L02 by MTT assay,Tanswell assay,Hochest33258 staining,and DNA ladder analysis.The anticancer activity and distribution of anti-VEGFR-2 ScFv-As_2O_3-stealth nanoparticles was then verified in a mouse model of Bel7402xenografts.Results:Anti-VEGFR-2 ScFv-As_2O_3-stealth nanoparticles significantly inhibited the proliferation of Bel7402 in the 3-(4,5-dimethylthiazol-2-yh-2,5-diphenyltetrazolium bromide assay while had almost no effects on L02 cells.And the apoptosis inducing effects were proved by Hochest33258 staining and DNA ladder analysis.Transwell assay found that the drug also inhibited the metastasis ability of tumor cells.Furthermore,anti-VEGFR-2 ScFv-As^-stealth nanoparticles significantly delayed the growth of Bel7402 xenografts after administration(92.9%),followed by As_2O_3-stealth nanoparticles,anti-VEGFR-2 ScFv,and As203(61.4%,58.8%,20.5%,P<0.05).The concentration of As_2O_3 in anti-VEGFR-2 ScFv-As_2O_3-steallh nanoparticles group was more selectively.Conclusions:Anti-VEGFR-2 ScFv-As_2O_3-stealth nanoparticles is a potent and selective anti-hepatocellular carcinoma agent which could inhibit the growth of liver cancer as a targeting agent both in vitro and in vivo and also significantly inhibit angiogenesis.
基金Supported by the National Natural Science Foundation of China,No.81773126,No.81560475,and No.82160486.
文摘BACKGROUND T1b gallbladder carcinoma(GBC)is defined as a tumor that invades the perimuscular connective tissue without extension beyond the serosa or into the liver.However,controversy still exists over whether patients with T1b GBC should undergo cholecystectomy alone or radical GBC resection.AIM To explore the optimal surgical approach in patients with T1b gallbladder cancer of different pathological grades.METHODS Patients with T1bN0M0 GBC who underwent surgical treatment between 2000 and 2017 were included in the Surveillance,Epidemiology,and End Results database.The Kaplan-Meier method and log-rank test were used to analyze the overall survival(OS)and disease-specific survival(DSS)of patients with T1b GBC of different pathological grades.Cox regression analysis was used to identify independent predictors of mortality and explore the selection of surgical methods in patients with T1b GBC of different pathological grades and their relationship with prognosis.RESULTS Of the 528 patients diagnosed with T1bN0M0 GBC,346 underwent simple cholecystectomy(SC)(65.5%),131 underwent SC with lymph node resection(SC+LN)(24.8%),and 51 underwent radical cholecystectomy(RC)(9.7%).Without considering the pathological grade,both the OS(P<0.001)and DSS(P=0.003)of T1b GBC patients who underwent SC(10-year OS:27.8%,10-year DSS:55.1%)alone were significantly lower than those of patients who underwent SC+LN(10-year OS:35.5%,10-year DSS:66.3%)or RC(10-year OS:50.3%,10-year DSS:75.9%).Analysis of T1b GBC according to pathological classification revealed no significant difference in OS and DSS between different types of procedures in patients with grade Ⅰ T1b GBC.In patients with grade Ⅱ T1b GBC,obvious survival improvement was observed in the OS(P=0.002)and DSS(P=0.039)of those who underwent SC+LN(10-year OS:34.6%,10-year DSS:61.3%)or RC(10-year OS:50.5%,10-year DSS:78.8%)compared with those who received SC(10-year OS:28.1%,10-year DSS:58.3%).Among patients with grade Ⅲ or Ⅳ T1b GBC,SC+LN(10-year OS:48.5%,10-year DSS:72.2%),and RC(10-year OS:80%,10-year DSS:80%)benefited OS(P=0.005)and DSS(P=0.009)far more than SC(10-year OS:20.1%,10-year DSS:38.1%)alone.CONCLUSION Simple cholecystectomy may be an adequate treatment for grade Ⅰ T1b GBC,whereas more extensive surgery is optimal for grades Ⅱ-Ⅳ T1b GBC.
