Various dressings have been developed for the prevention and treatment of wound infections, but the complex structures and manufacturing processes designed to achieve powerful functionalities have impeded their clinical application. Herein, a dynamic injectable photothermal/chemotherapeutic hydrogel has been facilely established through mixing gellan gum (GG), indocyanine green (ICG) and amikacin (AMI) aqueous solutions at 80°C and cooling to room temperature. The hydrogel displayed a precise structure with 1.5% of GG containing ICG content of 100 μg/mL and AMI content of 1 mg/mL, and exhibited favorable injectable, self-healing, and adhesive capabilities as well as superior swelling and moisturizing properties through GG's features. Furthermore, the GG also endowed the hydrogel with the capability to efficiently release drugs in response to the microenvironment (pH 5.0, 7.4 and 8.0) of both infected and uninfected wounds. These exceptional physicochemical properties and combined effects of chemotherapy and PTT facilitated the satisfactory in vitro biocompatibility and antibacterial capability as well as wound healing acceleration ability. Therefore, such a dynamic injectable photothermal/chemotherapeutic hydrogel paves the way toward easily clinical transformation for prevention and treatment of local wound infections.

This study reports the synthesis and characterization of an injectable nano-hydrogel composite (m@NPs-HG) based on selenium nanoparticles (Se NPs) and carboxymethyl chitosan (CMCS) nanoparticles for enhanced cancer therapy. Selenium nanoparticles were stabilized using CMCS to form copper selenide nanoparticles (CSe NPs), while doxorubicin (DOX)-loaded CMCS nanoparticles (CD NPs) were encapsulated within cancer cell membranes to generate biomimetic nanoparticles (m@NPs). Subsequently, CSe NPs and m@NPs were integrated into a hydrogel via crosslinking with CuCl2, resulting in the formation of m@NPs-HG. The composite exhibited remarkable photothermal conversion capability, efficient cellular uptake, and robust reactive oxygen species (ROS) generation. In vitro experiments demonstrated significant induction of apoptosis and cytotoxicity in H22 and HepG2 cancer cells. The in vivo anti-tumor efficacy was evaluated in H22 tumor-bearing mice, revealing that m@NPs-HG combined with laser irradiation effectively suppressed tumor growth while exhibiting minimal systemic toxicity. Hemolysis and biodistribution studies further confirmed the excellent biocompatibility and targeting ability of the composite system. This study concludes that the m@NPs-HG system represents a promising theranostic platform for cancer treatment.

Dynamic antibacterial polysaccharide prodrug hydrogels are in great demand for treatment of wound infection owing to their unique advantages such as excellent biocompatibility, superior antimicrobial property as well as favorable wound healing capacity. Herein, this work highlights the successful development of a dynamic carboxymethyl chitosan (CMC) prodrug hydrogel, which is facilely constructed through Schiffer base reaction between antibacterial components (amikacin and CMC) and crosslinker (dialdehyde PEG). Moderate dynamic imine linkages endow the hydrogel with excellent injectable and self-healing capability as well as targeted on-demand drug release in slightly alkaline condition at infected wound. All ingredients and their strong intermolecular interactions endow the hydrogel with favorable swelling and moisture retention capability. Moreover, the covalent and non-covalent interactions also endow the hydrogel with superior adhesion and mechanical property. These attractive characteristics enable hydrogel to effectively kill pathogens, promote wound healing and reduce side effects of amikacin. Thereby, such a dynamic CMC prodrug hydrogel may open a new avenue for a robust therapy on wound infection, greatly advancing their use in clinics.

The purpose of this paper is to develop a pH/thermal sensitive nanohydrogel composite for in situ injection and to achieve an enhanced chemo-photothermal synergistic antitumor effect. Pluronic F127 was oxidized to aldehyde-terminated (AF127) as the precursor of the thermally sensitive hydrogel. A series of hydrogels (HG) with different rheological behaviors were obtained by adjusting the ratio of AF127 to carboxymethyl chitosan (CMCS) (AF45/CM15, AF75/CM15, and AF90/CM15). By changing the ratio of AF127 micelles to CMCS, we can adjust the sol-gel transition time and temperature to facilitate in situ tumor injection. Indocyanine green (ICG) encapsulated AF127 micelles and doxorubicin (DOX)-loaded CMCS nanoparticles (NP-DOX) can form nanohydrogel composite (HG/ICG/NP-DOX) through dynamic Schiff base covalent bonds and physical entanglement. The nanohydrogel composite has good fluidity for injection at low temperatures and can quickly form hydrogel at 37 ?. Bromelain was introduced into the complex to improve the penetration of nanoparticles by hydrolyzing the dense extracellular matrix (ECM) in tumor tissue. ICG can produce a photothermal effect under 808 nm laser irradiation, further enhancing the antitumor effect of NP-DOX. HG/ICG/NP-DOX can remain in the tumor area for a long time, and it still shows an obvious photothermal effect even after 120 h. HG/ICG/NP-DOX with laser irradiation possesses an excellent chemo-photothermal synergistic antitumor effect, and the tumor growth inhibition rate reached 93.9%. These nanohydrogel composites have great potential in the field of in situ tumor injection as local drug delivery systems.

目的:探究奥沙利铂(L-OHP)与吴茱萸碱(EVO)联用后对L-OHP耐药的人胃癌BGC-823/L-OHP细胞增殖与凋亡能力的改变及可能机制.方法:于体外建立对L-OHP耐药的胃癌BGC-823细胞株,CCK-8法分别计算EVO及L-OHP单独使用与联合使用时BGC-823/L-OHP细胞的增殖抑制率、IC50及逆转指数;流式细胞仪检测EVO联合L-OHP作用于BGC-823/L-OHP细胞前后细胞周期分布及凋亡的变化;采用Real-time PCR、Western blot法检测细胞中MDR1、MRP1 mRNA和蛋白的表达水平.结果:2.00 μmol/L EV O处理BGC-823/L-OHP细胞48 h后,L-OHP对BGC-823/L-OHP耐药细胞株的IC,.由(18.83±0.83)μg/ml变为(12.78±1.78)μg/ml,差异有统计学意义(P＜0.05);EVO与L-OHP联用耐药细胞滞留在G2期比例升高,滞留在G1期及S期的细胞比例降低(P＜0.05);细胞凋亡率高于单独用药组(P＜0.05);MDR1、MRP1 mRNA和蛋白表达水平低于单独用药组(P＜0.05).结论:EVO和L-OHP联用能逆转BGC-823/L-OHP对L-OHP的耐药性并改变其周期分布,促进细胞凋亡.

To compare the effects of Ivor-Lewis esophagectomy and McKeown esophagectomy on perioperative anxiety and depression in patients with esophageal cancer. Sixty-three patients with stage I-III middle and lower esophageal carcinoma from June 2021 to December 2022 were randomly divided into observation group (n = 32) treated with laparoscopic Ivor-Lewis esophagectomy and control group (n = 31) treated with laparoscopic McKeown esophagectomy. Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) were measured on the second day of admission and the fifth day after surgery to assess the presence of depression and anxiety. The preoperative and postoperative clinical data of both groups were compared, and multivariate analysis was used to identify risk factors associated with depression and anxiety in patients with esophageal cancer. There was no significant difference in SDS and SAS standard scores between the observation group and the control group ( P > 0.05). The postoperative SDS and SAS scores in the control group were significantly higher than those before and after operation in the observation group ( P < 0.01). According to univariate analysis, patients with TNM stage III, tumor diameter greater than 3 cm, postoperative complications, radical McKeown esophagectomy, and C-reactive protein levels above 10 mg/L had a higher incidence of depression and anxiety ( P < 0.05). Multivariate logistic analysis showed that TNM stage III (depression: OR 1.683, 95 CI 1.429–1.861; Anxiety: OR 1.739, 95 CI 1.516–1.902), postoperative complications (depression: OR 2.345, 95 CI 1.435–3.891; Anxiety: OR 1.872, 95 CI 1.372–3.471), surgical approach (depression: OR 1.609, 95 CI 1.502–3.193; Anxiety: OR 1.658, 95 CI 1.469–2.059), and C-reactive protein (depression: OR 2.260, 95 CI 1.157–4.059; Anxiety: OR 0.373, 95 CI 0.253–0.976) were all independent factors for depression and anxiety in patients after esophageal cancer surgery ( P < 0.05). The Ivor-Lewis esophagectomy has the advantages of fewer complications and low inflammatory response, which can help alleviate anxiety and depression and improve patients’ quality of life and prognosis.

Background and Aims: In radical gastrectomy for proximal gastric cancer, bleeding and spleen damage are likely to occur when dealing with short gastric vessels, especially in some obese patients with short spleen-gastric ligaments at the upper pole of the spleen. The author’s team has previously used a surgical method of pre-expanding the posterior gastric space, which effectively solves this problem. This study was performed to compare the clinical efficacy of laparoscopic proximal gastrectomy with pre-expansion of the retrogastric space versus conventional laparoscopic proximal gastrectomy, and explore the value of the pre-expansion method in laparoscopic proximal gastrectomy for gastric cancer.Methods: The clinical data of 196 patients who underwent laparoscopic proximal radical gastrectomy in the Department of Oncology of the First Affiliated Hospital of Bengbu Medical College from January 2019 to December 2021 were retrospectively analyzed. Of the patients, 99 cases underwent radical proximal gastrectomy with pre-expansion of the retrogastric space（study group）, 97 cases received conventional proximal gastrectomy（control group）. The clinical variables were compared between the two groups of patients.Results: There were no significant differences in general information such as age, sex, BMI, tumor location, tumor stage, surgical method, and esophagojejunostomy method between the two groups（all P＞0.05）. All patients in both groups completed the laparoscopic surgery uneventfully, with the same range of lymph node dissection and without conversion to open surgery. Compared with the control group, the study group had a significantly shorter average operative time [（100.3±25.8） min vs.（130.7±43.2） min, P=0.000] and significantly less average intraoperative blood loss [（35.0±5.7） mL vs.（44.9±4.7） mL, P=0.000]. Splenic injury occurred in 5 cases（5.2%） in the control group during the surgery, while no intraoperative spleen injury occurred in the study group, but the difference was not statistically significant（P＞0.05）. There were no statistically significant differences between the two groups in terms of the number of lymph node dissection, postoperative drainage volume, drainage time, postoperative hospital stay, hospital costs, and incidence of surgical complications（all P＞0.05）. No serious postoperative complications occurred in both groups of patients.Conclusion: The surgical method of pre-expanding the posterior gastric space in laparoscopic proximal gastrectomy has the advantages of less intraoperative bleeding, shorter operation time, and reduced iatrogenic splenic injury. So, it is recommended for clinical use.

Abstract Purpose To analyze the clinical efficacy of total laparoscopic π-shaped esophageal jejunostomy and laparoscopic assisted Roux en-Y esophago-jejunostomy for cardiac cancer and their effects on traumatic stress. Methods We collected clinical data from 72 patients with adenocarcinoma of the esophagogastric junction who were treated in our department between June 2020 and July 2022. All patients underwent laparoscopic total gastrectomy + D2 lymphadenectomy, in whom 38 patients underwent total laparoscopic total gastrectomy with π-shaped esophageal jejunostomy and 34 patients underwent laparoscopic-assisted total gastrectomy with Roux en-Y esophago-jejunostomy. The short-term therapeutic effects, safety and effects on stress response indicators of different surgical methods were analyzed. Results There were no significant differences in baseline clinical and pathological data between the two groups (P > 0.05). The mean operation duration was 201.7 ± 80.3 minutes in the total endoscopic π-shaped esophageal jejunostomy group, which was longer than 166.9 ± 26.9 minutes in the laparoscopic-assisted Roux en-Y esophago-jejunostomy group (P < 0.05). The length of the surgical incision in the total endoscopic π-shaped esophageal jejunostomy group was significantly shorter, measuring 4.6 ± 2.1 cm, compared to the Roux-en-Y anastomosis group, which had an average length of 10.4 ± 2.1 cm (P < 0.01). In terms of intraoperative bleeding, the intraoperative bleeding volume of 130.3 ± 50.3 ml in the total endoscopic π-shaped esophageal jejunostomy group was significantly lower than that of 167.2 ± 72.8 ml in the laparoscopic-assisted Roux en-Y esophago-jejunostomy group (P < 0.05). Postoperative recovery time to exhaust was 3.8 ± 1.2 days in total endoscopic π-shaped esophageal jejunostomy group, significantly lower than 5.0 ± 2.0 days in laparoscopic-assisted Roux en-Y esophago-jejunostomy group (P = 0.003). In terms of postoperative extubation time, postoperative hospital stay, postoperative complications and the number of dissected lymph nodes, there were no significant differences between the total endoscopic π-shaped esophageal jejunostomy group and the laparoscopic-assisted Roux en-Y esophago-jejunostomy group (P > 0.05). In terms of stress indicators, there were no significant differences in stress indicators between the two groups before surgery, and the serum levels of CRP, cortisol (COR) and IL-6 in the π anastomosis group were significantly lower than those in the Roux en-Y esophago-jejunostomy group on postoperative days 3 and 5 (P < 0.05). Conclusion Total laparoscopic total gastrectomy with π-shaped esophageal jejunostomy demonstrates safety and feasibility. This surgical approach effectively reduces intraoperative bleeding, accelerates patient recovery time, minimizes postoperative pain, lowers the risk of complications, and minimally impacts the body's traumatic stress response.

Dynamic carrier-free theranostic nanodrugs are in great demand, owing to their extraordinary high drug loading, enhanced targeting therapy, and panoramic tracking of the drug behaviors. Herein, this work highlights a successful development of pH-triggered dynamic carrier-free nanodrugs for precise tumoral targeting theragnostic, which are established through self-assembly between dasatinib (DAS) and chlorambucil (CLB). The study has proved the structure, change in particle size and zeta potential, fluorescence transition, cellular uptake, cytotoxicity as well as biosafety of the carrier-free nanodrugs. The nanodrugs are characterized by Fourier transform infrared spectroscopy, 1H nuclear magnetic resonance, X-ray diffraction, Dynamic light scattering, and Microplate reader. Cellular uptake and cytotoxicity assay are conducted for free drugs and their nanodrugs using tumor cell lines including A549, HepG2, K562, and THP1. ICR mice are applied to evaluate the biosafety of nanodrugs. The introduction of CLB into DAS nanoparticles can successfully redshift the emission wavelength from 420 to 810 nm. Moreover, the nanodrugs exhibit a dynamic fluorescence intensity conversion via tumoral intracellular gradual quenching of Aggregation-induced emission (AIE). This characteristic is beneficial to the precise monitoring of tumoral intracellular drug behaviors. Furthermore, the nanodrugs show a small-to-large size transition from 175 nm to more than 500 nm in 12 h and surficial charge reversal from −2.3 mV to more than 0.2 mV by protonation at tumoral pHs. These superior properties facilitate the improved cellular uptake and synergistic cytotoxicity on various types of tumor cells. The study shows that nanodrugs made of DAS and CLB that can self-assemble without carriers under different pH levels may be ready for testing in tumor targeting, and might someday be helpful for diagnosis and treatment in the future.

目的:探究基于成果导向的教学模式在肿瘤外科学教学中的应用.方法:将2021年1月至2022年1月在蚌埠医学院第一附属医院学习的120名临床见习学生,随机分为对照组和观察组,每组60名.对照组采用常规授课方式进行教学,观察组采用基于成果导向的教学模式.对2组学生的成绩以及对教学的满意度进行分析.结果:观察组学生的理论成绩及实践成绩均高于对照组(P＜0.01);观察组学生对课程效果、知识收获和实践的满意度均高于对照组学生(P＜0.01).结论:基于成果导向的教学模式应用在肿瘤外科学临床见习学生的教学工作中,能够提高教学质量,提升学生满意度,使学生更主动地获取知识和提高成绩,值得进一步探究和推广.

BackgroundThis study aims to investigate the effects of ω-3, ω-6 polyunsaturated fatty acids (PUFAs), and their middle metabolites prostaglandin (PGE)2 and PGE3 on proliferation, invasion, and angiogenesis formation of gastric cancer cells and to explore associated mechanism.MethodsRT-PCR and ELISA were used to detect the expression of cyclooxygenase (COX)-1 and COX-2 in gastric cancer cell lines. The effect of ω-3, ω-6, PGE2, and PGE3 on the proliferation, invasion, and angiogenesis of gastric cancer cells were measured by cell proliferation, invasion, and angiogenesis assay in vitro. COX-2 small interfering RNA (siRNA) was transfected into gastric cancer cells, and the expression of COX-2 protein was detected by Western blot. COX-2 gene silencing influencing proliferation, invasion, and angiogenesis potential of gastric cancer cells was detected by WST-1, transwell chamber, and angiogenesis assay, respectively.ResultsCOX-2 was only expressed in MKN74 and MKN45 cells. In gastric cancer cell lines with positive COX-2 expression, ω-6 and PGE2 could significantly enhance the proliferation, invasion, and angiogenesis of gastric cancer cells, and after transfection with COX-2 siRNA, the effects of ω-6 and PGE2 on enhancing the proliferation, invasion, and angiogenesis of gastric cancer cells were significantly attenuated; ω-3 and PEG3 could inhibit the proliferation, invasion, and angiogenesis of gastric cancer cells. In gastric cancer cell lines with negative COX-2 expression, ω-6 and PGE2 had no significant effect on the proliferation, invasion, and angiogenesis of gastric cancer; ω-3 and PGE3 could significantly inhibit the proliferation, invasion, and angiogenesis of gastric cancer.Conclusionω-6 PUFAs reinforce the metastatic potential of gastric cancer cells via COX-2/PGE2; ω-3 PUFAs inhibit the metastatic potential of gastric cancer via COX-1/PGE3 signaling axis.

Noble metal nanoclusters (NCs) have emerged as a new class of nanomaterials which have great potential in bioapplications. Due to their ultrasmall size and versatile surface chemistry, they show excellent luminescence, high photostability, good biocompatibility, low toxicity, and a high renal clearance rate. In recent years, much work has been reported toward the bioapplications of metal NCs, especially the Au, Ag, and Cu NCs. In this Review, we first discuss the crucial factors of metal NCs for their use as biomaterials, including the size, surface chemistry, photoluminescent properties, cytotoxicity, and metabolic activity. Then, we highlight some recent advances of metal NCs in bioapplications, such as biosensing, bioimaging, biomedical diagnosis, and therapy. It is noteworthy that the metal NCs perform quite well in cancer treatment. Finally, we have briefly discussed the current challenges and our perspectives on metal NCs in bioapplication research and further transformation into clinical application.

目的 探究胃癌细胞中CLDN18-ARHGAP26融合突变基因引起的耐化疗药的作用,并探究人参皂苷在治疗因CLDN18-ARHGAP26融合突变基因表达引起的耐化疗药治疗过程中的抗肿瘤作用.方法 采用免疫磁珠抗体标记胃癌细胞系BGC-823的侧群(SP)细胞和非侧群(NSP)细胞,选出NSP细胞转染过表达CLDN18-ARHGAP26融合突变基因的慢病毒载体.用qPCR检测细胞中CLDN18-ARHGAP26融合突变基因和三磷酸腺苷结合转运蛋白G超家族成员2(ABCG2)mRNA水平的表达.用Western blot检测转染上皮-间质转化(EMT)相关蛋白E-Cadherin、Vimentin的表达.用CCK-8检测转染细胞对化疗药奥沙利铂的敏感性.用CCK-8检测人参皂苷对转染细胞耐药性的影响.人参皂苷处理转染细胞后Western blot检测转染细胞的钙黏蛋白E(E-Cadherin)、波形蛋白(Vimentin)的表达.结果 qPCR检测显示转染过表达CLDN18-ARHGAP26融合突变基因慢病毒载体的NSP细胞中CLDN18-ARHGAP26融合突变基因表达高于未转染组,ABCG2 mRNA表达高于未转染组(P<0.001).Western bolt显示过表达CLDN18-ARHGAP26融合突变基因的NSP细胞中E-Cadherin蛋白表达低于未转染组(P<0.05),Vimentin蛋白表达高于未转染组(P<0.01),转染细胞对奥沙利铂的敏感性低于未转染组(P<0.05).人参皂苷和奥沙利铂同时处理转染细胞,细胞存活率低于单纯奥沙利铂处理(P<0.05).人参皂苷处理转染细胞后E-Cadherin蛋白表达高于未处理组(P<0.01),Vimentin蛋白表达低于未处理组(P<0.05).结论 人参皂苷能逆转胃癌细胞中CLDN18-ARHGAP26融合突变基因表达诱导的细胞EMT转化和奥沙利铂的耐药性.

The clinical transformation of polysaccharide-based nano-prodrugs remains a long way off, due to the shackles on easy metabolic clearance, dilemma of dose-dependent toxicity and immunogenicity, and poor tumor selec-tivity. To address these challenges, the fluorinated dual-crosslinked carboxymethyl chitosan (CMCS)-based nano-prodrugs with precise structure were facilely developed through the reaction of CMCS with water-soluble stimuli-responsive synergistic small molecule prodrug (Pt(IV)-1), glutaraldehyde and heptafluorobutyric anhydride successively. The fluorination enabled the nano-prodrugs to display metabolic stability and improve tumoral cellular uptake. The pH/glutathione (GSH)-sensitive dual-crosslinked structure enabled the nano-prodrugs to show physicochemical stability at physiological pH, selective drug release and synergistic cytotoxicity at tumoral intracellular pH/GSH, and circumventing the dilemma of dose-dependent toxicity and immunogenicity induced by that crosslinked or grafted via a single drug. These superior performances promoted stability in long-term storage and circulation, normal blood routine and aminotransferase, fantastic hemocompatibility, selective tumor accumulation and precisely synergistic chemotherapy, therefore achieving significant tumor growth in-hibition while minimizing side effects. Thus, the precise fluorinated dual-crosslinked CMCS-based nano-prodrugs have great potential for selective clinical cancer treatment.

目的:探讨白细胞介素-1受体2型(interleukin-1 receptor 2,IL1R2)与原癌基因c-Fos的相互作用,及其影响结肠癌细胞增殖、侵袭和血管新生的机制.方法:采用Western blot法检测结肠癌组织及癌旁组织中IL1R2和c-Fos的表达.通过双重荧光素酶测定IL1R2和c-Fos之间的相互作用关系.通过RT-PCR法检测IL1R2不同转染组IL1R2和c-Fos的mRNA表达.通过CCK8和Transwell法检测人结肠癌细胞SW620的增殖和侵袭作用.使用ELISA法测定SW620培养上清液中VEGF、VEGFR2、HIF-1α和bFGF的表达水平.结果:结肠癌组织较癌旁组织IL1R2和c-Fos的表达升高(P＜0.05).双重荧光素酶测定结果证实了c-Fos是IL1R2的真正靶点.与对照组比较,IL1R2 mimic组IL1R2和c-Fos mRNA表达升高(P＜0.05),而IL1R2 inhibitor组IL1R2和c-Fos mRNA表达降低(P＜0.05);IL1R2 mimic组细胞增殖和侵袭升高(P＜0.05),而IL1R2 inhibitor组细胞增殖和侵袭降低(P＜0.05);IL1R2 mimic组VEGF、VEGFR2、HIF-1α和bFGF表达水平升高(P＜0.05),而IL1R2 inhibitor组VEGF、VEGFR2、HIF-1α和bFGF表达水平降低(P＜0.05).结论:IL1R2与c-Fos的相互作用可以进一步影响结肠癌细胞的增殖、侵袭和血管新生.

In this study, we aimed to compare clinical efficacy of laparoscopic surgery and open surgery for colorectal cancer in the Huaihe River Basin in China. A total of 92 patients with colorectal cancer were selected as subjects. Patients were divided into control group (open surgery, n = 27 cases) and test group (laparoscopic surgery, n = 28 cases). Our results showed that the duration of operation (122.54 +/- 14.85) min and length of incision (4.51 +/- 1.065) cm were shorter in the experimental group than those in the control group. The intraoperative blood loss of the experimental group was (161.12 +/- 10.694) ml, which was less than that of the control group (218.53 +/- 15.369) ml (P < 0.05). Patients in the experimental group have higher Five-year survival rate and lower incidence of postoperative complications than those in the control group (all P < 0.05). In conclusion, in the treatment of colorectal cancer, laparoscopic surgery has a better clinical effect than open surgery, which is worthy of clinical application.

Gastric cancer is one the most common human malignancies, with an increased incidence year by year. The underlying mechanisms of Claudin 18 (CLDN18) was involvement in patients with gastric cancer remain poorly understood. We therefore investigated the function of CLDN18 in patients with gastric cancer. Blood samples were collected from gastric cancer patients. CLDN18 and CLDN18 expression were measured using Microarray and qPCR. MIT assay, Transwell assay cells, LDH activity and Caspase-3/9 activity and Flow cytometry were used to measure the effects of ARHGAP26 and CLDN18 on cell growth in gastric cancer. We firstly found that CLDN18 expression were increased in patients with gastric cancer. Then, up-regulation of CLDN18 promoted cell growth in gastric cancer. Down-regulation of CLDN18 induced apoptosis in gastric cancer. Cancer-promoting genetic of CLDN18 is compromised by CLDN18-ARHGAP26 in gastric cancer cell. Down-regulation of ARHGAP26 rescues the effects of CLDN18-mediated tumor promotion effects on gastric cancer cell. CLDN18-ARHGAP26 mediated tumor suppressive effects on gastric cancer cells by ABCG2 and ABCB1 pathway. These results provide evidence that serum CLDN18-ARHGAP26 as a biomarker for tumor promoting genetic in gastric cancer via ABCG2 and ABCB1 pathway.

Gastric cancer (GC) remains a major public health problem. Ursolic acid (UA) is reported to be effective in inhibiting GC; however, its low solubility and poor biocompatibility have greatly hindered its clinical application. Herein, an innovative reactive oxygen species (ROS)-sensitive UA dimeric prodrug is developed by coupling two UA molecules via a ROS-cleavable linkage, which can self-assemble into stable nanoparticles in the presence of surfactant. This new UA-based delivery system comprises the following major components: (I) dimeric prodrug inner core that can achieve high drug-loading (55%, w/w) and undergo rapid and selective conversion into intact drug molecules in response to ROS; (II) a polyethylene glycol (PEG) shell to improve colloid stability and extend blood circulation, and (III) surface-modified internalizing RGD (iRGD) to increase tumor targeting. Enhancement of the antitumor effect of this delivery system was demonstrated against GC tumors in vitro and in vivo. This novel approach offers the potential for clinical applications of UA.

目的:观察对比经腋窝入路免充气全腔镜甲状腺癌根治术和开放甲状腺癌根治术对cN0期甲状腺微小乳头状癌的治疗效果.方法:选取60例cN0期甲状腺微小乳头状癌的临床病理资料,其中经腋窝入路免充气全腔镜甲状腺癌根治术30例(观察组),开放甲状腺癌根治术30例(对照组),对比2种术式的临床疗效.结果:2组中央区淋巴结清扫数、中央区淋巴结转移阳性数、总并发症发生率差异无统计学意义(P>0.05);观察组手术时间、引流液总量、住院时间均较对照组更多,术中出血量少于对照组,术后颈胸部疼痛评分、美容满意度优于对照组,差异均有统计学意义(P<0.01).结论:相比开放甲状腺癌根治术,经腋窝入路免充气全腔镜甲状腺癌根治术治疗cN0期甲状腺微小乳头状癌在保证手术安全性及并发症总发生率的同时,可以降低术后疼痛,极大提高美容满意度.