Objective:To comprehensively analyze the survival status and prognostic factors of colorectal cancer patients with liver metastasis.Methods:The clinical and follow-up data of 84 patients with liver metastasis from colorectal cancer in the Central Hospital Affiliated to Chongqing University from January to June 2019 were analyzed retrospectively.The basic information of patients was collected, Kaplan-Meier method was used to calculate the median survival time, Log-rank test was used for univariate analysis, and Cox regression model was used to analyze the related factors affecting the prognosis of colorectal cancer patients with liver metastasis.Results:All 84 patients with liver metastasis from colorectal cancer were followed up, the median follow-up time was 25.5 months, the follow-up rate was 100.0%, and there was no loss of follow-up.The 1-year, 2-year and 3-year survival rates were 84.52%(71/84), 66.67%(56/84)and 51.19%(43/84), respectively.The median survival time was(25.16±5.48)months.The results of univariate analysis showed that whether the body weight decreased more than 20% in recent 6 months was related to the prognosis(P<0.05). There were statistically significant differences between groups in mrEMVI, pathological type, pathological grade, mrT stage, mrN stage, circumferential resection margin(CRM), invasion length, invasion depth, the distance from the lower end of the tumor to the anal margin, and the number of liver metastatic lesions, which were related to the prognosis(P<0.05). There were statistically significant differences in neoadjuvant chemotherapy, operation time and complications between groups, which were related to the prognosis(P<0.05). The influence of each factor on the prognosis of patients from high to low were: weight loss of more than 20% in recent 6 months(OR=2.264), number of liver metastases(OR=2.035), pathological type(OR=1.751), neoadjuvant chemotherapy(OR=1.382), pathological classification(OR=1.186).Conclusion:Over 20% weight loss, mrEMVI, pathological type, pathological grade, mrT stage, mrN stage, CRM, length of invasion, depth of invasion, distance from the lower end of the tumor to the anal margin, number of liver metastatic lesions, neoadjuvant chemotherapy, operation time and complications are the main factors affecting the prognosis of patients with colorectal cancer with liver transfer.Clinically, timely and effective preventive measures can be taken before and after the operation to benefit the survival of patients and improve the prognosis of patients.

Casein kinase 1α (CK1α) mediates the phosphorylation and degradation of interferon-α/β receptor 1 (IFNAR1) in response to viral infection. However, how CK1α regulates hepatitis B virus (HBV) replication and the anti-HBV effects of IFN-α are less reported. Here we show that CK1α can interact with IFNAR1 in hepatoma carcinoma cells and increased the abundance of IFNAR1 by reducing the ubiquitination levels in the presence of HBV. Furthermore, CK1α promotes the IFN-α triggered JAK-STAT signaling pathway and consequently enhances the antiviral effects of IFN-α against HBV replication. Our results collectively provide evidence that CK1α positively regulates the anti-HBV activity of IFN-α in hepatoma carcinoma cells, which would be a promising therapeutic target to improve the effectiveness of IFN-α therapy to cure CHB.

目的 探讨案例式教学联合PBL教学模式在消化内科规培医生中的应用以及对教学效果的影响.方法 选择重庆市急救医疗中心2020年6月-2021年6月间培训的40名医生作为研究对象,选择随机分组的方式将其分为观察组和对照组,各20例,其中对照组采用常规教学模式,观察组使用案例式教学联合PBL教学模式,对比两组规培医生的教学效果以及对教学方式的满意程度.结果 在经过教学后,观察组的出科考试成绩、出科笔试成绩以及出科临床操作成绩评分均高于对照组(P＜0.05);观察组的提高学习主动性、加强资料分析能力、提高解决问题能力、加强交流能力、培养团队协作能力、总结学习方法等方面的评分均高于对照组(P＜0.05);观察组的教学满意度高于对照组,差异具有统计学意义(P＜0.05).结论 在消化内科规培医生的教学活动当中,案例式教学联合PBL教学模式能够提高学生的学习成绩,并培养临床思维的形成,以综合的角度促进规培医生的综合素质,值得研究和借鉴.

Objective: To understand the protective effect of NF-kappa B signaling pathway inhibitor pyrrolidinedithio-carbamate (PDTC) on mice with chronic atrophic gastritis (CAG). Methods: Helicobacter pylon (H. pylori) infection combined with high-salt diet was used to construct the CAG mouse model, and 100 or 200 mg/kg/day PDTC was intragastrically treated for 8 weeks. Then, hematoxylin and eosin (HE) and Alcian blue-periodic acid-Schiff (AB-PAS) staining were used to observe the pathology of gastric mucosa, while immunohistochemistry, quantitative real-time polymerase chain reaction (qRT-PCR), enzyme-linked immuno sorbent assay (ELISA) and western blotting were determined to detect the expression of related molecules. Results: The nuclear content of NF-kappa B p65 in the gastric mucosa of the CAG mice was increased accompanying by the structural disorder of the gastric mucosal epithelium, inflammatory cell infiltration, intestinal metaplasia, and increased MUC2 expression, but the symptoms were alleviated after PDTC treatment. In addition, the expressions of TNF-alpha, IL-1 beta, IL-6 and COX2 in the gastric mucosa and serum of CAG mice were higher than those control mice, which were reduced in CAG mice treated with either 100 or 200 mg/kg PDTC. Furthermore, 100 mg/kg and 200 mg/kg PDTC treatments reduced the serum PGE 2 in CAG mice with the decreased PCNA and Ki-67 expression in gastric mucosa. The therapeutic effect of 200 mg/kg PDTC was significantly better than that of 100 mg/kg PDTC. Conclusion: PDTC inhibited inflammation and the excessive proliferation of gastric mucosal epithelial cells, thereby exerting a potential therapeutic effect on CAG.

目的 明确炎症性肠病患者外周血单个核细胞(peripheral blood mononuclear cell,PBMC)中长链非编码RNA(long non-coding RNA,LncRNA)的表达谱特征,并明确关键LncRNA与病情指标相关性.方法 分离炎症性肠病患者PBMC,以正常志愿者PBMC为对照,提取RNA并进行LncRNA表达谱芯片检测,筛选关键LncRNA并分析其与炎症性肠病病情活动度的相关性.结果 溃疡性结肠炎(ulcerative colitis,UC)组差异表达LncRNA 1 672个、克罗恩病(Crohn's disease,CD)组差异表达LncRNA 1048个,2组共有差异表达177个;差异表达中ENSG00000251186.1改变最为明显,在UC组中上调9.4倍、CD组中上调8.9倍;ENSG00000251186.1与UC组患者CRP、ESR及改良Mayo评分均呈正相关关系,与CD组患者的CRP、ESR及CD活动指数也为正相关关系;ROC曲线显示ENSG00000251186.1曲线下面积UC组为0.9024、CD组为0.903 1.结论 炎症性肠病患者外周血单个核细胞LncRNA表达谱出现显著异常,其中ENSG00000251186.1明显上调且与炎症指标、病情活动度密切相关,可能有助于IBD的早期诊断.

BACKGROUND:Diabetic nephropathy (DN) is one of the leading causes of end-stage kidney disease. Recently, there is no specific drug available to block the kidney damage. Astragaloside IV (AS-IV) is a major active component of Astragalus membranaceus (Fisch) Bge and has been demonstrated to benefit the kidney functions. This study explores the potential pharmacological action of AS-IV in DN of rats.METHODS:Male Sprague-Dawley rats were fed with high-fat diet and injected with streptozotocin to induce diabetes. The diabetic rats were randomized and treated with vehicle or AS-IV (80 mg/kg) daily by gavage for 12 weeks as the DN or AS-IV group, respectively. The normal control rats were fed with normal chow and injected with vehicles (n = 8 per group). These rats were monitored for diabetes- and kidney function-related measures. The expression profiles of gene mRNA transcripts in the kidney tissues were analyzed by RNA-seq and quantitative RT-PCR. The levels of advanced glycation end products (AGEs), IL-1β, and IL-18 in the serum samples and kidney tissues were quantified by ELISA. The levels of collagen IV (COL-4) and fibronectin (FN) expression in kidney tissues were examined by immunohistochemistry and Western blot.RESULTS:In comparison with the DN group, AS-IV treatment significantly reduced blood glucose levels, food and water consumption, 24 h urine, renal index values, 24 h urine total proteins, blood urea nitrogen (BUN) levels, and creatinine clearance rates (CCR), accompanied by minimizing the DN-induced early kidney damages, fibrosis, and microstructural changes. Furthermore, AS-IV treatment significantly modulated the DN-altered gene transcription profiles in the kidney of rats, particularly for inflammation-related genes, including the nucleotide-binding oligomerization domain-like receptor signaling, which was validated by quantitative RT-PCR. AS-IV treatment significantly decreased the levels of serum and kidney AGEs, IL-1β, and IL-18 expression and fibrosis indexes in the kidney of rats.CONCLUSION:AS-IV treatment ameliorated the severity of DN by inhibiting inflammation-related gene expression in the kidney of rats.

Objective: This study aims to determine the changes in the serum leptin, C-reactive protein (CRP), IL-10, and IL-6 levels in pancreatitis patients after Rheum officinale treatment. Methods: 88 patients with severe pancreatitis were recruited. 44 patients receiving the conventional therapy were enrolled in the control group, while the remaining 44 patients taking Rheum officinale orally in additional to the conventional therapy were enrolled in the treatment group. The mortality rate, symptoms and signs after admission, and the changes in the time to the first defecation, the time to the disappearance of abdominal pain and tenderness, and the serum leptin, TNF-alpha, VEGF, CRP, IL-10, and IL-6 levels, were measured and recorded. Results: No significant differences were found regarding the time from onset to admission, the Acute Physiology and Chronic Health Evaluation II scores, the cause of the disease, or the incidence rate of acute respiratory distress syndrome between the treatment and control groups (P>0.05). The overall effective rate was 97.93% in the treatment group, which was significantly higher than it was in the control group (84.09%) (P<0.05). Meanwhile, the mortality rate and total hospitalization expense in the treatment group were significantly reduced, and the hospitalization duration, the time to the first defecation, and the time to the disappearance of abdominal pain and tenderness as well as the negative-conversion time of serum amylase were significantly shortened (P<0.05). Additionally, the leptin, TNF-alpha, VEGF, CRP, IL-10, and IL-6 levels were significantly reduced after the treatment (P<0.05). Conclusion: Rheum officinale can downregulate the serum leptin, CRP, IL-10, and IL-6 levels and promote the recovery of patients with severe pancreatitis.

目的 观察复合乳酸菌胶囊辅助四联疗法治疗幽门螺杆菌(H.pylori)阳性消化性溃疡的疗效.方法 选取2015年2月至2017年10月重庆市第四人民医院收治的H.pylori阳性消化性溃疡患者88例,按随机数字表法分为观察组(45例)与对照组(43例).对照组患者给予四联疗法治疗,观察组患者在对照组基础上给予复合乳酸菌胶囊治疗.两组患者均连续治疗4周后,观察比较两组患者临床治疗效果.结果 观察组治疗后上腹疼痛、喛气、反酸、烧心程度显著轻于对照组(P<0.05).观察组H.pylori根除率为93.33％,显著高于对照组的72.09％(P<0.05).观察组治疗总有效率为95.56％,明显高于对照组的74.42％(P<0.05).观察组不良反应发生率为4.44％,显著低于对照组的30.23％(P<0.05).结论 针对消化性溃疡患者采用复合乳酸菌胶囊辅助四联疗法治疗,可有效缓解患者临床症状,提高H.pylori根除率,促进溃疡愈合,且药物不良反应少,值得临床推广应用.

目的 探讨内镜下套扎、硬化剂单用及联用治疗食管静脉曲张的临床效果.方法 回顾性研究该院174例静脉曲张患者,根据治疗方法不同分为3组,每组58例,分别进行套扎治疗、硬化治疗和联合治疗的处理,比较各组患者治疗后门静脉内径、血流速度和血流量的统计学差异.结果 治疗后,3组患者血流速度、血流量和肝功能[总胆红素(Tbil)、血清白蛋白(ALB)、谷丙转氨酶(ALT)含量]指标与术前比较,差异均有统计学意义(P<0.05),治疗后联合组血流速度、血流量和Tbil含量明显高于套扎组和硬化组,ALB和ALT含量明显低于套扎组和硬化组.不同时点比较,3组患者随着时间迁移,血流速度、血流量和Tbil含量明显上升,ALB和ALT含量明显下降(P<0.05).联合组临床疗效明显优于套扎组和硬化组,且有效率高于套扎组和硬化组患者(P<0.05),联合组患者发热、恶心/呕吐、进食异物感症状发生率明显低于套扎组和硬化组(P<0.05).结论 套扎治疗和硬化治疗对于静脉曲张患者有一定疗效,联合治疗食管静脉曲张的效果更佳,值得临床推广.

目的 探讨核糖核酸治疗乙型肝炎导致的慢加急性肝衰竭(ACLF)患者的临床疗效.方法 对收治的166例的ACLF患者(慢性乙型肝炎导致)进行研究,根据患者入院单双日均分为异甘草酸镁组与核糖核酸组,每组83例.异甘草酸镁组给予异甘酸镁治疗,核糖核酸组在异甘草酸镁组的基础上予以核糖核酸治疗,比较2组患者治疗前后外周血细胞计数(WBC、NEU、PLT、HGB)、肝功能相关生化指标(TBIL、ALT、ALB、INR)、HBV DNA转阴率及两组患者不良反应发生情况.结果 2组患者治疗前后WBC、NEU、PLT、HGB计数、TBIL、ALT、ALB、INR含量差异有统计学意义(P<0.05),随着时间迁移,WBC、NEU计数、TBIL、ALT、ALB、INR含量呈现显著下降趋势,PLT、HGB计数呈现显著上升趋势.治疗后核糖核酸组WBC、NEU、PLT、HGB计数显著高于异甘草酸镁组,核糖核酸组TBIL、ALT含量显著低于异甘草酸镁组.核糖核酸组患者治疗6周、治疗12周后HBV DNA转阴率显著高于异甘草酸镁组患者(P<0.05).核糖核酸组患者肌肉酸痛、不良反应总构成显著低于异甘草酸镁组患者(P<0.05).结论 乙型肝炎加急性肝衰竭病症在核糖核酸治疗下疗效尤为显著,转阴率高,肝功能指标改善明显,而且降低了不良反应的发生率,值得应用.

Objective To investigate the differences of the contents of pepsinogen Ⅰ(PGⅠ),PGⅡ and PGⅠ/PGⅡ in patients with atrophic gastritis and patients with early gastric cancer patients in order to provide a theoretical basis for the differential diagnosis of disease and disease classification.Methods Fifty-seven patients with mild gastritis were enrolled as control group, 29 patients with chronic atrophic gastritis were enrolled as atrophic gastritis group and 7 patients with gastric cancer were enrolled as gastric cancer group,who were treated in our hospital from January 2016 to August 2016.The serum levels of PGⅠ,PGⅡ and PGⅠ/PGⅡ ratio were detected and compared among the three groups.Results The patient's sex and educational history had no effects on the prevalence of atrophic gastritis and gastric cancer (P>0.05),however, the monthly income in different age groups had effects on the prevalence (P<0.05).The levels of PGⅠ/PGⅡin atrophic gastritis group were significantly lower than those in contol group,however,the levels of PGⅡwere obviously higher than those in control group (P<0.05).The levels of PGⅠ,PGⅠ/PGⅡin gastric cancer group were significantly lower than those in contol group and those in atrophic gastritis group, but the levels of PGⅡwere significantly higher than those in contol group and those in atrophic gastritis group (P<0.05).The levels of PGⅠ,PGⅠ/PGⅡin moderate and severe atrophic gastritis groups were significantly lower than those in mild atrophic gastritis group,however,the levels of PGⅡwere significantly higher than those in mild atrophic gastritis group (P<0.05).The levels of PGⅠ,PGⅠ/PGⅡin severe atrophic gastritis groups were significantly lower than those in moderate atrophic gastritis group,but the levels of PGⅡwere significantly higher than those in moderate atrophic gastritis group (P<0.05).There were no significant differences in the levels of PGⅡin different developmental stages of gastric cancer (P>0.05).The levels of PGⅠ,PGⅠ/PGⅡ in aggressive-phase and advanced gastric cancer were significantly lower than those in early gastric cancer,moreover, the levels of PGⅠ,PGⅠ/PGⅡin advanced gastric cancer were significantly lower than those in aggressive-phase gastric cancer (P<0.05).Conclusion The detection of pepsinogen has a certain value in differential diagnosis between chronic atrophic gastritis and early gastric cancer,which has the advantages of simplicity and high-performance, therefor,which is worth using widely in clinical practice.

Objective To study the experiment method for largely expanding mice dendritic cells(DCs) in vitro.Methods The lymphokines combined with tumor necrosis factor-α(TNF-α),interleukin-4(IL-4) and granulocyte-macrophage colonystimulating factor(GM-CSF) were adopted for inducing and cultivating DCs in vitro;the immunostimulatory activity of DCs was detected by the mixed lymphocyte reaction.Results The cell surface exhibited a large number of burr-lke process on 6-8 d of culture,i.e.,DCs;the cultured DCs had the ability to strongly immunostimulate the proliferation of T lymphocytes,which with the T cells/DCs ratio of 10:1 was strongest.Conclusion The combination of TNF-α,IL-4 and GM-CSF is a better method for largely expanding mice DCs in vitro.