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World Journal of Clinical Cases 2024年第5期12卷 973-979页

作者： Yao-Bang Bai Feng Zhao Zhen-Hua Wu Guo-Ning Shi Nan Jiang Intensive Care Unit Department of Cardiac SurgeryTianjin Chest HospitalTianjin 300222China department of Cardiac surgery Tianjin Chest HospitalTianjin 300222China

BACKGROUND Venoarterial(VA)extracorporeal membrane oxygenation(ECMO),an effective short-term circulatory support method for refractory cardiogenic shock,is widely applied.However,retrospective analyses have shown that VA-ECMO-assisted cases were associated with a relatively high mortality rate of approximately 60%.Embolization in important organs caused by complications of left ventricular thrombosis(LVT)during VA-ECMO is also an important reason.Although the incidence of LVT during VA-ECMO is not high,the consequences of embolization are disastrous.CASE SUMMARY A 37-year-old female patient was admitted to hospital because of fever for 4 d and palpitations for 3 d.After excluding the diagnosis of coronary heart disease,we established a diagnosis of“clinically explosive myocarditis”.The patient still had unstable hemodynamics after drug treatment supported by VA-ECMO,with heparin for anticoagulation.On day 4 of ECMO support,a left ventricular thro-mbus attached to the papillary muscle root of the mitral valve was found by transthoracic echocardiography.Left ventricular decompression was performed and ECMO was successfully removed,but the patient eventually died of multiple cerebral embolism.CONCLUSION LVT with high mobility during VA-ECMO may cause embolism in important organs.Therefore,a"wait and see"strategy should be avoided.

关键词： Venoarterial extracorporeal membrane oxygenation Left ventricular thrombosis Cerebral embolism Magnetic Resonance Imaging Therapy Case report

MicroRNA (let-7b-5p)-targeted DARS2 regulates lung adenocarcinoma growth by PI3K/AKT signaling pathway

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Oncology Research 2024年第3期32卷 517-528页

作者： YUANYUAN XU XIAOKE CHEN department of Oncology surgery Shanghai Lung Cancer CenterShanghai Chest HospitalShanghai Jiao Tong UniversityShanghaiChina

Background:The aberrant intraellular expression of a mitochondrial aspartyl tRNA synthetase 2(DARS2)has been reported in human cancers.Nevertheless its critical role and detailed mechanism in lung adenocarcinoma(LUAD)remain unexplored.Methods:Initially,The Cancer Genome Atlas(TCGA)based Gene Expression Profiling Interactive Analysis(GEPIA)database (http:/***/)was used to analyze the prognostic relevance of DARS2 expression in LUAD.Further,cell counting kit(CCK)8,immunostaining,and transwell invasion assays in LUAD cell lines in vitro,as well as DARS2 silence on LUAD by tumorigenicity experiments in wivo in nude mice,were performed.Besides,we analyzed the expression levels of p-PI3K(phosphorylated Phosphotylinosital3 kinase),PI3K,AKT(Protein Kinase B),p-AKT(phosphorylated Protein Kinase B),PCNA(proliferating cell nudear antigen),cleaved-caspase 3,E cadherin,and N-cadherin proteins using the Westem blot analysis.Results:LUAD tissues showed higher DARS2 expression compared to normal tissues.Upregulation of DARS2 could be related to Tumor-Node-Metastasis(TNM)stage,high lymph node metastasis,and inferior prognosis.DARS2 silence decreased the proliferation,migration,and invasion abilities of LUAD cells.In addition,the DARS2 downregulation decreased the PCNA and N-cadherin expression and increased cleaved:caspase 3 and E cadherin expressions in LUAD cells,coupled with the inactivation of the PI3K/AKT signaling pathway.Moreover,DARS2 silence impaired the tumonigenicity of LUAD in vivo.Interestingly,let:7b-5p could recognize DARS2 through a complementary sequence.Mechanistically,the increased let 7b 5p expression attenuated the promo oncogenic action of DARS2 during LUAD progression,which were inversely correlated to each other in the LUAD tssues Conclusion:In summary,let 7b-5p,downregulated DARS2 expression,regulating the progression of LUAD cells by the PI3K/AKT signaling pathway.

关键词： Lung adenocarcinoma Prognosis PI3K/AKT pathway Mitochondrial asparty-tRNA synthetase MicroRNAs

Prognostic role of C-reactive protein to albumin ratio in lung cancer:An updated systematic review and meta-analysis

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Chronic Diseases and Translational Medicine 2024年第1期10卷 31-39页

作者： Zhendong Lu Siyun Fu Wei Li Xiang Gao Jinghui Wang department of Medical Oncology Beijing Tuberculosis and Thoracic Tumor Research InstituteBeijing Chest HospitalCapital Medical UniversityBeijingChina Cancer Research Center Beijing Chest HospitalBeijing Tuberculosis and Thoracic Tumor Research InstituteCapital Medical UniversityBeijingChina

Background: C-reactive protein to albumin ratio(CRP/Alb ratio,CAR)has been suggested as a potential prognostic biomarker in lung cancer.This updated systematic review and meta-analysis aimed to assess the association between CAR and lung cancer prognosis in current literature.Methods: A systematic search of databases was conducted to identify relevant studies published up to April 2023.Pooled hazard ratios(HRs)and 95%confidence intervals(CIs)were calculated to assess the association between CAR and overall survival(OS)and progression-free survival(PFS)and recurrence-free survival(RF)in lung cancer patients.Results: This meta-analysis includes 16 studies with a total of 5337 patients,indicating a significant association between higher CAR and poorer OS,PFS,and RFS in lung cancer patients,with a pooled HR of 1.78(95%CI=1.60-1.99),1.57(95%CI=1.36-1.80),and 1.97(95%CI=1.40-2.77),respectively.Conclusions: This updated meta-analysis provides evidence for the potential prognostic role of CAR in lung cancer,suggesting its utility as an effective and noninvasive biomarker for identifying high-risk patients and informing treatment decisions in a cost-effective manner.However,further large-scale studies will be necessary to establish the optimal cut-off value for CAR in lung cancer and confirm the present findings.

关键词： C-reactive protein to albumin ratio inflammation:biomarker lung cancer prognosis

miR-557 suppresses hepatocellular carcinoma cell proliferation and migration via downregulating CBX4

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BIOCELL 2024年第7期48卷 1071-1079页

作者： XULONG SUN WENTAO DING CHAO JIANG ZHIAN FANG department of Orthopedics Shanghai General HospitalShanghai Jiao Tong University School of MedicineShanghai200080China department of General surgery Shanghai General HospitalShanghai Jiao Tong University School of MedicineShanghai200080China department of Thoracic surgery Shanghai Chest HospitalShanghai Jiao Tong University School of MedicineShanghai200030China department of Radiology Zhongda HospitalSoutheast University School of MedicineNanjing210009China

Introduction:Hepatocellular carcinoma(HCC),a prevalent malignancy,poses signiﬁcant challenges with high tumor heterogeneity and poor prognosis.MicroRNAs(miRNAs)play a pivotal role in hepatocarcinogenesis.Although abnormalities in microRNA-557(miR-557)expression have been implicated in various cancer types,its role in HCC remains unclear.Therefore,there is a need to explore the function of microRNA-557 in HCC.Methods:Candidate miRNAs were identiﬁed through screening in GSE108724 and GSE20077.Real-time PCR was employed to analyze the expression level of miR-557 in hepatoma cell lines and tissues.Cell viability and migration assays were applied to assess the impact of miR-557 on HCC cell lines.Furthermore,the miR-557 target was predicted through three algorithms(Targetscan,miRWalk,and miRanda),and this was conﬁrmed through luciferase assay and Western blotting.Results:In this study,miR-557 was identiﬁed in two datasets and expressed at a low level in both hepatoma cell lines and tissues.Notably,high expression of miR-557 in HCC cells inhibited oncogenesis.Conversely,low expression of miR-557 enhanced tumor proliferation and migration.Polycomb chromobox 4(CBX4)was identiﬁed as a direct target of miR-557.Silencing CBX4 inﬂuenced the functional impact of miR-557 on HCC cell migration.Conclusion:Taken together,our study contributed to elucidating the hepatoma molecular heterogeneity and provided novel insights into miR-557 role and its target CBX4 in HCC,suggesting its potential as a future effectively druggable target for HCC intervention.

关键词： Hepatocellular carcinoma miR-557 Chromobox 4 Hepatocarcinogenesis

Ki-67 Change in Anthracyline-containing Neoadjuvant Chemotherapy Response in Breast Cancer

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Current Medical Science 2024年第1期44卷 156-167页

作者： Zi-guo YANG Le-hao REN Feng WANG Pi-lin WANG Wen-yan WANG Shu-ye LIN department of General surgery Beijing Tiantan HospitalCapital Medical UniversityBeijing 100070China department of Critical Care Medicine Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China Cancer Research Center Beijing Chest HospitalCapital Medical University/Beijing Tuberculosis and Thoracic Tumor Research InstituteBeijing 101149China

Objective Anthracycline-containing regimens are irreplaceable in neoadjuvant chemotherapy(NAC)for breast cancer(BC)at present.However,30% of early breast cancer(EBC)patients are resistant to anthracycline-containing chemotherapy,leading to poor prognosis and higher mortality.Ki-67 is associated with the prognosis and response to therapy,and it changes after NAC.Methods A total of 105 BC patients who received anthracycline-containing NAC were enrolled.Then,the optimal model of Ki-67 was selected,and its predictive efficacy was analyzed.Immunohistochemistry(IHC)was used to determine the estrogen receptor(ER),progesterone receptor(PR),and human epidermal growth factor receptor 2(HER-2)status and Ki-67 level.Fluorescent in situ hybridization(FISH)was used to verify the HER-2 when the IHC score was 2+.Results The post-NAC Ki67 level after treatment with anthracycline drugs was lower than pre-NAC Ki-67(19.6%±23.3%vs.45.6%±23.1%,P<0.001).Furthermore,patients with the Ki-67 decrease had a border line higher pathological complete response(pCR)rate(17.2%vs.0.0%,P=0.068),and a higher overall response rate(ORR)(73.6%vs.27.8%,P<0.001),when compared to patients without the Ki-67 decrease.The ΔKi-67 and ΔKi-67%were valuable markers for the prediction of both the pCR rate and ORR.The area under the curve(AUC)for ΔKi-67 on pCR and ORR was 0.809(0.698-0.921)and 0.755(0.655-0.855),respectively,while the AUC for ΔKi-67% on pCR and ORR was 0.857(0.742-0.972)and 0.720(0.618-0.822),respectively.Multivariate logistic regression model 1 revealed thatΔKi-67 was an independent predictor for both pCR[odds ratio(OR)=61.030,95% confidence interval(CI)=4.709-790.965;P=0.002]and ORR(OR=10.001,95%CI:3.044-32.858;P<0.001).Multivariate logistic regression model 2 revealed thatΔKi-67%was also an independent predictor for both pCR(OR=408.922,95%CI=8.908-18771.224;P=0.002)and ORR(OR=5.419,95%CI=1.842-15.943;P=0.002).Conclusions The present study results suggest thatΔKi67 andΔKi67%are candidate predictors for anthracycline-containing NAC response,and

关键词： breast cancer change in Ki-67 neoadjuvant chemotherapy anthracycline,response

International standard of Traditional Chinese Medicine techniques: the operating specifications for Chinese medicated bath(2022)

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Journal of Traditional Chinese Medicine 2024年第4期 851-854页

作者： ZHANG Jing WANG Chunhui JIN Xinyan YU Miao FAN Yingyi HAN Xiaoli PEI Xiaohua department of dermatology Beijing University of Chinese Medicine Third Affiliated Hospital department of chest and Breast surgery Beijing University of Chinese Medicine Xiamen Hospital Center for Evidence-Based Medicine Beijing University of Chinese Medicine department of General surgery Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University department of Breast surgery Beijing University of Chinese Medicine Third Affiliated Hospital

Chinese medicated bath is one of the external therapies in Traditional Chinese Medicine(TCM), which has been widely used clinically. The “International Standard of Traditional Chinese Medicine Techniques: The Operating Specifications for Chinese Medicated Bath” is drawn up by the Beijing University of Chinese Medicine Third Affiliated Hospital and Beijing University of Chinese Medicine Xiamen Hospital in collaboration with domestic TCM universities and hospitals. The specification includes definition, operating process, points for attention and contraindications. It is targeted to provide reference for TCM providers at home and abroad with TCM background in clinical decision-making.

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Deep learning automation of radiographic patterns for hallux valgus diagnosis

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World Journal of Orthopedics 2024年第2期15卷 105-109页

作者： Angela Hussain Cadence Lee Eric Hu Farid Amirouche department of Orthopaedic surgery University of Illinois College of MedicineChicagoIL 60612United States department of Orthopaedics surgery University of Illinois at ChicagoChicagoIL 60612United States department of Orthopaedic surgery Northshore University Health SystemSkokieIL 6007United States

Artificial intelligence(AI)and deep learning are becoming increasingly powerful tools in diagnostic and radiographic medicine.Deep learning has already been utilized for automated detection of pneumonia from chest radiographs,diabetic retinopathy,breast cancer,skin carcinoma classification,and metastatic lymphadenopathy detection,with diagnostic reliability akin to medical experts.In the World Journal of Orthopedics article,the authors apply an automated and AIassisted technique to determine the hallux valgus angle(HVA)for assessing HV foot deformity.With the U-net neural network,the authors constructed an algorithm for pattern recognition of HV foot deformity from anteroposterior highresolution radiographs.The performance of the deep learning algorithm was compared to expert clinician manual performance and assessed alongside clinician-clinician variability.The authors found that the AI tool was sufficient in assessing HVA and proposed the system as an instrument to augment clinical efficiency.Though further sophistication is needed to establish automated algorithms for more complicated foot pathologies,this work adds to the growing evidence supporting AI as a powerful diagnostic tool.

关键词： Artificial intelligence Hallux valgus Deep learning Automated radiography

LncRNA-CCAT5-mediated crosstalk between Wnt/β-Catenin and STAT3 signaling suggests novel therapeutic approaches for metastatic gastric cancer with high Wnt activity

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Cancer Communications 2024年第1期44卷 76-100页

作者： Chenchen Liu Aiwen Shen Junquan Song Lei Cheng Meng Zhang Yanong Wang Xiaowen Liu department of Gastric surgery Fudan University Shanghai Cancer CenterShanghaiP.R.China department of Oncology Shanghai Medical CollegeFudan UniversityShanghaiP.R.China department of Nephrology Shanghai Ninth People’s HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghaiP.R.China department of Pulmonary Shanghai Chest HospitalShanghai Jiao Tong UniversityShanghaiP.R.China department of Pathology Fudan University Shanghai Cancer CenterShanghaiP.R.China

Background:Although the constitutively activated Wnt/β-catenin signaling pathway plays vital roles in gastric cancer(GC)progression,few Wnt inhibitors are approved for clinical use.Additionally,the clinical significance of long non-coding RNAs(lncRNAs)in GC intraperitoneal dissemination(IPD)remains elusive.Here,we investigated the function and therapeutic potential of Wnt-transactivated lncRNA,colon cancer-associated transcript 5(CCAT5),in GC metastasis.Methods:LncRNA-sequencing assay was performed to document abun-dance changes of lncRNAs induced by Wnt family member 3A(Wnt3a)and degradation-resistantβ-catenin(S33Y mutated)in ascites-derived GC cells with low Wnt activity.Luciferase reporter,Chromatin immunoprecipitation(ChIP)-re-ChIP assays were performed to determine how CCAT5 was tran-scribed.The clinical significance of CCAT5 was examined in 2 cohorts of GC patients.The biological function of CCAT5 was investigated through gain-and loss-of-function studies.The molecular mechanism was explored through RNA-sequencing,mass spectrometry,and CRISPR/Cas9-knocknout system.The therapeutic potential of CCAT5 was examined through RNAi-based cell xenograft model and patient-derived xenograft(PDX)model of IPD.Results:WeidentifiedanovelWnt-regulatedlncRNA,CCAT5,whichwastrans-activated by theβ-catenin/transcription factor 3(TCF3)complex.CCAT5 was significantly upregulated in GC and predicted poor prognosis.Functional studies confirmed the promotive role of CCAT5 in GC growth and metastasis.Mechanis-tically,CCAT5 bound to the C-end domain of signal transducer and activator of transcription 3(STAT3)and blocks Src homology 2 domain-containing protein tyrosine phosphatase 1(SHP-1)-mediated STAT3 Y705 dephosphorylation,leading to STAT3 nuclear entry and transactivation,thus accelerating GC progression.Furthermore,we demonstrated that both Wnt3a andβ-catenin acted as activa-tor of STAT3 signaling pathway,and the interplay between CCAT5 and STAT3 was functionally essential for Wnt-drived STAT3 signaling and tumor evolu-tion.Fina

关键词： CCAT5 gastric cancer intraperitoneal dissemination STAT3 Wnt/β-catenin

The diagnostic value of tenascin-C in acute aortic syndrome

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Journal of Geriatric Cardiology 2024年第3期21卷 359-368页

作者： Ming MA Wei CHEN Hai-Long CAO Jun PAN Qing ZHOU Xin-Long TANG Dong-Jin WANG department of Thoracic and Cardiovascular surgery Nanjing Drum Tower Hospital Clinical College of Nanjing Medical UniversityNanjingChina department of Thoracic and Cardiovascular surgery Nanjing Drum Tower HospitalAffiliated Hospital of Medical SchoolNanjing UniversityNanjingChina department of Thoracic surgery Kunshan Hospital of Traditional Chinese MedicineJiangsuChina

OBJECTIVES Misdiagnosis of acute aortic syndrome(AAS)significantly increases mortality.Tenascin-C(TN-C)is an extracellular matrix glycoprotein related to cardiovascular injury.The elevation of TN-C in AAS and whether it can discriminate suddenonset of acute chest pain in Chinese remains unclear.METHODS We measured the plasma concentration of TN-C by ELISA in a cohort of 376 patients with chest or back pain.Measures to discriminate AAS from acute coronary syndrome(ACS)were compared and calculated.RESULTS From October 2016 to September 2021,376 undiagnosed patients with chest or back pain were enrolled.166 of them were finally diagnosed as AAS,100 were ACS and 110 without cardiovascular diseases(NCV).TN-C was significantly elevated in AAS at 18.18 ng/mL(IQR:13.10–27.68)compared with 7.51 ng/mL(IQR:5.67–11.38)in ACS(P<0.001)and 3.68 ng/mL(IQR:2.50–5.29)in NCV(P<0.001).There was no significant difference in TN-C level among the subtypes of AAS.Of the 166 AAS patients,the peaked level of TN-C was at acute stage(P=0.012),then a slight of decrease was observed at subacute stage.The area under receiver operating characteristic curve for AAS patients versus NCV was 0.979(95%CI:0.964-0.994)for TN-C.At a cutoff level of 11.474 ng/mL,TN-C has a sensitivity of 76.0%,specificity of 85.5%,accuracy of 82.0%,positive predictive value(PPV)of 76.0%,negative predictive value(NPV)of 85.5%.Diagnostic performance of TN-C was superior to D-dimer and hs-cTnT.CONCLUSIONS The concentration of serum TN-C in AAS patients was significantly higher than that in ACS patients and NCV.TN-C could be a new biomarker to distinguish AAS patients in the early stage after symptoms onset from other pain diseases.

关键词： acute cardiovascular elevated

Analysis of lymph node metastasis and survival prognosis in early gastric cancer patients: A retrospective study

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World Journal of Gastrointestinal surgery 2024年第6期16卷 1637-1646页

作者： Dong-Yuan Liu Jin-Jin Hu Yong-Quan Zhou Ai-Rong Tan department of General surgery The 971st Hospital of Chinese People's Liberation ArmyQingdao 266071Shandong ProvinceChina department of chest surgery Feicheng People's HospitalFeicheng 271600Shandong ProvinceChina department of Gastrointestinal surgery Zhongshan Hospital of Fudan UniversityShanghai 200032China department of Oncology Qingdao Municipal HospitalQingdao 266000Shandong ProvinceChina

BACKGROUND Early gastric cancer(EGC)is a common malignant tumor of the digestive system,and its lymph node metastasis and survival prognosis have been concerning.By retrospectively analyzing the clinical data of EGC patients,we can better under-stand the status of lymph node metastasis and its impact on survival and prog-nosis.AIM To evaluate the prognosis of EGC patients and the factors that affect lymph node METHODS The clinicopathological data of 1011 patients with EGC admitted to our hospital between January 2015 and December 2023 were collected in a retrospective cohort study.There were 561 males and 450 females.The mean age was 58±11 years.The patient underwent radical gastrectomy.The status of lymph node metastasis in each group was determined according to the pathological examination results of surgical specimens.The outcomes were as follows:(1)Lymph node metastasis in EGC patients;(2)Analysis of influencing factors of lymph node metastasis in EGC;and(3)Analysis of prognostic factors in patients with EGC.Normally distributed measurement data are expressed as mean±SD,and a t test was used for comparisons between groups.The data are expressed as absolute numbers or percentages,and the chi-square test was used for comparisons between groups.Rank data were compared using a nonparametric rank sum test.A log-rank test and a logistic regression model were used for univariate analysis.A logistic stepwise regression model and a Cox stepwise regression model were used for multivariate analysis.The Kaplan-Meier method was used to calculate the survival rate and construct survival curves.A log-rank test was used for survival analysis.RESULTS Analysis of influencing factors of lymph node metastasis in EGC.The results of the multifactor analysis showed that tumor length and diameter,tumor site,tumor invasion depth,vascular thrombus,and tumor differentiation degree were independent influencing factors for lymph node metastasis in patients with EGC(odds ratios=1.80,1.49,2.65,5.76,and 0.60;95%CI:1.29–2.50,1.11–2.00,1.81–3

关键词： Gastric neoplasms Lymph node metastasis Prognosis Influencing factor Retrospective study