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Perforated gastric ulcer causing mediastinal emphysema: A case report

World Journal of Clinical Cases 2024年第4期12卷 859-864页

作者： Zhi-Cheng Dai Xun-Wu Gui Feng-He Yang Hao-Yuan Zhang Wen-Feng Zhang Department of General surgery Mengcheng County First People's HospitalMengcheng 233500Anhui ProvinceChina Department of Medical Imaging Mengcheng County First People's HospitalMengcheng 233500Anhui ProvinceChina

BACKGROUND Mediastinal emphysema is a condition in which air enters the mediastinum between the connective tissue spaces within the pleura for a variety of reasons.It can be spontaneous or secondary to chest trauma,esophageal perforation,medi-cally induced factors,etc.Its common symptoms are chest pain,tightness in the chest,and respiratory distress.Most mediastinal emphysema patients have mild symptoms,but severe mediastinal emphysema can cause respiratory and circulatory failure,resulting in serious consequences.CAsE sUMMARY A 75-year-old man,living alone,presented with sudden onset of severe epigastric pain with chest tightness after drinking alcohol.Due to the remoteness of his residence and lack of neighbors,the patient was found by his nephew and brought to the hospital the next morning after the disease onset.Computed tomography(CT)showed free gas in the abdominal cavity,mediastinal emph-ysema,and subcutaneous pneumothorax.Upper gastrointestinal angiography showed that the esophageal mucosa was intact and the gastric antrum was perforated.Therefore,we chose to perform open gastric perforation repair on the patient under thoracic epidural anesthesia combined with intravenous anesthesia.An operative incision of the muscle layer of the patient's abdominal wall was made,and a large amount of subperitoneal gas was revealed.And a continued incision of the peritoneum revealed the presence of a perforation of approx-imately 0.5 cm in the gastric antrum,which we repaired after pathological examination.Postoperatively,the patient received high-flow oxygen and cough exercises.Chest CT was performed on the first and sixth postoperative days,and the mediastinal and subcutaneous gas was gradually reduced.CONCLUsION After gastric perforation,a large amount of free gas in the abdominal cavity can reach the mediastinum through the loose connective tissue at the esophageal hiatus of the diaphragm,and upper gastrointestinal angiography can clarify the site of perforation.In patients with mediastinal emphysema,open surgery av

关键词： Gastric ulcer Perforated Mediastinal emphysema Case report

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Tenecteplase versus alteplase in treatment of acute sT-segment elevation myocardial infarction:A randomized non-inferiority trial

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Chinese Medical Journal 2024年第3期137卷 312-319页

作者： Xingshan Zhao Yidan Zhu Zheng Zhang Guizhou Tao Haiyan Xu Guanchang Cheng Wen Gao Liping Ma Liping Qi Xiaoyan Yan Haibo Wang Qingde Xia Yuwang Yang Wanke Li Juwen Rong Limei Wang Yutian Ding Qiang Guo Wanjun Dang Chen Yao Qin Yang Runlin Gao Yangfeng Wu shubin Qiao Department of Cardiology Beijing Jishuitan HospitalCapital Medical UniversityThe Fourth Clinical Medical College of Peking UniversityBeijing 100035China Peking University Clinical Research Institute Peking University First HospitalBeijing 100191China Department of Cardiology The First Hospital of Lanzhou UniversityLanzhouGansu 730013China Department of Cardiology The First Affiliated Hospital of Liaoning Medical UniversityJinzhouLiaoning 110002China Department of Cardiology Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Science and Peking Union Medical CollegeBeijing 100037China Department of Cardiology Huaihe Hospital of Henan UniversityKaifengHenan 450001China Department of Cardiology Bayannur HospitalBayannurInner Mongolia 015208China Department of Cardiology Puyang People’s HospitalPuyangHenan 457099China Department of Cardiology Xingtai Third HospitalXingtaiHebei 054099China Department of Cardiology Lintao County People’s HospitalDingxiGansu 730599China Department of Cardiology Dancheng County People’s HospitalZhoukouHenan 477150China Department of Cardiology The First People’s Hospital of LingbaoSanmenxiaHenan 472500China Department of Cardiology Shanyin County People’s HospitalShuozhouShanxi 036999China Department of Cardiology Uxin Banner People’s HospitalOrdosInner Mongolia 017399China Department of Cardiology Lingqiu County People’s HospitalDatongShanxi 034499China Department of Cardiology Huaibin County People’s HospitalXinyangHenan 464411China Department of Cardiology Tianzhu County People’s HospitalWuweiGansu 733200China Guangzhou Recomgen Biotech Co. LtdGuangzhouGuangdong 510530China

Background:A phase II trial on recombinant human tenecteplase tissue-type plasminogen activator(rhTNK-tPA)has previously shown its preliminary efficacy in sT elevation myocardial infarction(sTEMI)patients.This study was designed as a pivotal postmarketing trial to compare its efficacy and safety with rrecombinant human tissue-type plasminogen activator alteplase(rt-PA)in Chinese patients with sTEMI.Methods:In this multicenter,randomized,open-label,non-inferiority trial,patients with acute sTEMI were randomly assigned(1:1)to receive an intravenous bolus of 16 mg rhTNK-tPA or an intravenous bolus of 8 mg rt-PA followed by an infusion of 42 mg in 90 min.The primary endpoint was recanalization defined by thrombolysis in myocardial infarction(TIMI)flow grade 2 or 3.The secondary endpoint was clinically justified recanalization.Other endpoints included 30-day major adverse cardiovascular and cerebrovascular events(MACCEs)and safety endpoints.Results:From July 2016 to september 2019,767 eligible patients were randomly assigned to receive rhTNK-tPA(n=384)or rt-PA(n=383).Among them,369 patients had coronary angiography data on TIMI flow,and 711 patients had data on clinically justified recanalization.Both used a–15%difference as the non-inferiority efficacy margin.In comparison to rt-PA,both the proportion of patients with TIMI grade 2 or 3 flow(78.3%[148/189]vs.81.7%[147/180];differences:–3.4%;95%confidence interval[CI]:–11.5%,4.8%)and clinically justified recanalization(85.4%[305/357]vs.85.9%[304/354];difference:–0.5%;95%CI:–5.6%,4.7%)in the rhTNK-tPA group were non-inferior.The occurrence of 30-day MACCEs(10.2%[39/384]vs.11.0%[42/383];hazard ratio:0.96;95%CI:0.61,1.50)did not differ significantly between groups.No safety outcomes significantly differed between groups.Conclusion:rhTNK-tPA was non-inferior to rt-PA in the effect of improving recanalization of the infarct-related artery,a validated surrogate of clinical outcomes,among Chinese patients with acute sTEMI.Trial registration:www.ClinicalTrials.gov(No.NCT028355

关键词： Thrombolytic therapy rhTNK-tPA Randomized controlled trial sT elevation myocardial infarction

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Idiopathic mesenteric phlebosclerosis missed by a radiologist at initial diagnosis: A case report

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World Journal of Clinical Cases 2024年第10期12卷 1810-1816页

作者： Min Wang Yu-Xia Wan Jin-Wen Liao Fei Xiong Department of Gastroenterology Changning County People’s HospitalYibin 644300Sichuan ProvinceChina Department of Gastroenterology Qianwei People’s HospitalLeshan 614400Sichuan ProvinceChina Department of Gastroenterology The People’s Hospital of Jianyang CityChengdu 641400Sichuan ProvinceChina Department of Gastroenterology Sichuan Provincial People’s HospitalUniversity of Electronic Science and Technology of ChinaChengdu 610000Sichuan ProvinceChina

BACKGROUND Idiopathic mesenteric phlebosclerosis(IMP)is a rare type of ischemic colitis characterized by thickening of the wall of the right hemicolon and calcification,sclerosis,and fibrosis of mesenteric veins.The diagnosis of IMP is based on typical clinical features and imaging findings.We report a case of IMP that was initially missed by the radiologist.CAsE sUMMARY A 77-year-old woman was admitted to the hospital due to chronic diarrhea for over 2 months.she had been consuming Chinese patent medicines(CPM)containing fructus gardeniae for more than 15 years.Colonoscopy revealed an edematous mucosa,bluish-purple discoloration,erosions,and ulcerations throughout the colorectal area.Abdominal computed tomography(CT)showed diffuse mural thickening of the entire colorectum,with tortuous thread-like calcifications in the right hemicolon,left hemicolon,and rectum.Most of the calcifications were located in the mesenteric vein.The diagnosis of IMP was established based on medical history,colonoscopy,CT findings,and histopathological examination.The patient was treated conservatively with papaverine and rifaximin,and CPM was stopped.Her diarrhea symptoms improved,indicating the effectiveness of the treatment.Over the next several years,she took opium alkaloids for an extended period and did not require hospitalization for the aforementioned gastrointestinal disorder.CONCLUsION IMP is a rare gastrointestinal disease affecting Asian populations,possibly related to long-term herbal medicine intake.Accurate imaging analysis is crucial for diagnosis,but insufficient understanding of the disease can lead to misdiagnosis or missed diagnosis.Treatment strategies should be personalized.

关键词： Idiopathic mesenteric phlebosclerosis Computed tomography Colonoscopy Chinese patent medicines Fructus gardeniae Case report

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Predictive value of bilirubin and serum γ-glutamyltranspeptidase levels in type-2 diabetes mellitus patients with acute coronary syndrome

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World Journal of Diabetes 2024年第1期15卷 34-42页

作者： Jie Chen Wan-Chao Zhang Xiao-Qiang Tang Ruo-Han Yin Tao Wang Xiao-Yu Wei Chang-Jie Pan Radiology Department The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical UniversityChangzhou 213164Jiangsu ProvinceChina Radiology Department The People’s Hospital of WuQia CountyWuqia 845450Xinjiang Uygur Autonomous RegionChina

BACKGROUND Cardiovascular disease is a major complication of diabetes mellitus(DM).Type-2 DM(T2DM)is associated with an increased risk of cardiovascular events and mortality,while serum biomarkers may facilitate the prediction of these outcomes.Early differential diagnosis of T2DM complicated with acute coronary syndrome(ACs)plays an important role in controlling disease progression and improving safety.AIM To investigate the correlation of serum bilirubin andγ-glutamyltranspeptidase(γ-GGT)with major adverse cardiovascular events(MACEs)in T2DM patients with ACs.METHODs The clinical data of inpatients from January 2022 to December 2022 were analyzed retrospectively.According to different conditions,they were divided into the T2DM complicated with ACs group(T2DM+ACs,n=96),simple T2DM group(T2DM,n=85),and simple ACs group(ACs,n=90).The clinical data and laboratory indices were compared among the three groups,and the correlations of serum total bilirubin(TBIL)levels and serumγ-GGT levels with other indices were discussed.T2DM+ACs patients received a 90-day follow-up after discharge and were divided into event(n=15)and nonevent(n=81)groups according to the occurrence of MACEs;Univariate and multivariate analyses were further used to screen the independent influencing factors of MACEs in patients.REsULTs The T2DM+ACs group showed higherγ-GGT,total cholesterol,low-density lipoprotein cholesterol(LDL-C)and glycosylated hemoglobin(HbA1c)and lower TBIL and high-density lipoprotein cholesterol levels than the T2DM and ACs groups(Psed on univariate analysis,the event and nonevent groups were significantly different in age(t=3.3612,P=0.0011),TBIL level(t=3.0742,P=0.0028),γ-GGT level(t=2.6887,P=0.0085),LDL-C level(t=2.0816,P=0.0401),HbA1c level(t=2.7862,P=0.0065)and left ventricular ejection fraction(LEVF)levels(t=3.2047,P=0.0018).Multivariate logistic regression analysis further identified that TBIL level and LEVF level were protective factor for MACEs,and age andγ-GGT level were risk factors(PsION serum

关键词： Acute coronary syndrome Type-2 diabetes mellitus Total bilirubin Major adverse cardiovascular events

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Analysis and monitoring of drug therapy in a patient with peptic ulcer complicated by infection:A case report

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World Journal of Clinical Cases 2024年第8期12卷 1530-1535页

作者： Yan-Ping Gou Yue huang Li Chen Wei Zheng Yun-hua Zheng The second people’s hospital of Meishan City&Renshou county people’s hospital Meishan 620500Sichuan ProvinceChina Quality Evaluation and Medical Record Management The Affiliated Hospital of Southwest Jiaotong University&The Third People's Hospital of ChengduChengdu 610000Sichuan ProvinceChina Patriotic Health Campaign Qionglai City Health BureauChengdu 610000Sichuan ProvinceChina

BACKGROUND The role of primary-level medical pharmacists in medical institutions in China is limited;therefore,it is necessary to explore the role of pharmacists in the process of drug treatment.CAsE sUMMARY A Chinese pharmacist participated in the complete treatment of a patient with a duodenal ulcer.The rationale for drug treatment was evaluated,and adjustments were made to the antacid and anti-infective regimen,as well as the dose and frequency of administration.Body temperature,routine blood examination,and adverse drug reactions were strictly monitored.During treatment,the pharmacist recommended anti-infective therapy with ampicillin-sulbactam,which effectively controlled the infection.Additionally,the pharmacist suggested changing famotidine to lansoprazole for acid suppression and gastroprotective treatment,combined with Chinese patent medicine such as Kangfuxin Liquid.This is the first case report of a pharmacist in primary-level medical institutions adjusting drug use for patients with duodenal ulcer and pulmonary infection.CONCLUsION A pharmacist participated in the treatment process,provided individualized medication adjustment,and achieved good clinical results.

关键词： Ampicillin-sulbactam Famotidine Lansoprazole Kangfuxin Liquid Chinese pharmacist Case report

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Vulnerable brain regions in adolescent major depressive disorder:A resting-state functional magnetic resonance imaging activation likelihood estimation meta-analysis

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World Journal of Psychiatry 2024年第3期14卷 456-466页

作者： Hui Ding Qin Zhang Yan-Ping shu Bin Tian Ji Peng Yong-Zhe Hou Gang Wu Li-Yun Lin Jia-Lin Li Department of Radiology The Second People’s Hospital of Guizhou ProvinceGuiyang 550000Guizhou ProvinceChina Department of Radiology Guizhou Provincial People’s HospitalGuiyang 550000Guizhou ProvinceChina Department of Psychiatry of Women and Children The Second People's Hospital of Guizhou ProvinceGuiyang 550000Guizhou ProvinceChina Department of Radiology Zhijin County People's HospitalBijie 552100Guizhou ProvinceChina Medical Humanities College Guizhou Medical UniversityGuiyang 550000Guizhou ProvinceChina

BACKGROUND Adolescent major depressive disorder(MDD)is a significant mental health concern that often leads to recurrent depression in adulthood.Resting-state functional magnetic resonance imaging(rs-fMRI)offers unique insights into the neural mechanisms underlying this condition.However,despite previous research,the specific vulnerable brain regions affected in adolescent MDD patients have not been fully elucidated.AIM To identify consistent vulnerable brain regions in adolescent MDD patients using rs-fMRI and activation likelihood estimation(ALE)meta-analysis.METHODs We performed a comprehensive literature search through July 12,2023,for studies investigating brain functional changes in adolescent MDD patients.We utilized regional homogeneity(ReHo),amplitude of low-frequency fluctuations(ALFF)and fractional ALFF(fALFF)analyses.We compared the regions of aberrant spontaneous neural activity in adolescents with MDD vs healthy controls(HCs)using ALE.REsULTs Ten studies(369 adolescent MDD patients and 313 HCs)were included.Combining the ReHo and ALFF/fALFF data,the results revealed that the activity in the right cuneus and left precuneus was lower in the adolescent MDD patients than in the HCs(voxel size:648 mm3,Psed activity.Based on the ALFF data,we found decreased activity in the right cuneus and left precuneus in adolescent MDD patients(voxel size:736 mm3,Ps exhibiting increased activity.CONCLUsION Through ALE meta-analysis,we consistently identified the right cuneus and left precuneus as vulnerable brain regions in adolescent MDD patients,increasing our understanding of the neuropathology of affected adolescents.

关键词： Major depressive disorder Resting-state functional magnetic resonance imaging Adolescent Activation likelihood estimation Meta-analysis

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Link between mutations in ACVRL1 and PLA2G4A genes and chronic intestinal ulcers:A case report and review of literature

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World Journal of Gastrointestinal surgery 2024年第3期16卷 932-943页

作者： Yong-Jing Tang Jian Zhang Jie Wang Ren-Dong Tian Wei-Wei Zhong Ben-sheng Yao Bing-Yu Hou Ying-hua Chen Wei He Yi-huai He Department of Infectious Diseases The Affiliated Hospital of Zunyi Medical UniversityZunyi 563000Guizhou ProvinceChina Department of Gastroenterology Dafang County People's HospitalBijie 551600Guizhou ProvinceChina Department of Internal Medicine Puchang BranchMedical CommunitySuiyang County People's HospitalZunyi 563300Guizhou ProvinceChina Department of Infectious Diseases Jingmen Central HospitalJingmen 448000Hubei ProvinceChina Department of Infectious Diseases Dafang County People's HospitalBijie 551600Guizhou ProvinceChina

BACKGROUND Genetic factors of chronic intestinal ulcers are increasingly garnering attention.We present a case of chronic intestinal ulcers and bleeding associated with mu-tations of the activin A receptor type II-like 1(ACVRL1)and phospholipase A2 group IVA(PLA2G4A)genes and review the available relevant literature.CAsE sUMMARY A 20-year-old man was admitted to our center with a 6-year history of recurrent abdominal pain,diarrhea,and dark stools.At the onset 6 years ago,the patient had received treatment at a local hospital for abdominal pain persisting for 7 d,under the diagnosis of diffuse peritonitis,acute gangrenous appendicitis with perforation,adhesive intestinal obstruction,and pelvic abscess.The surgical treat-ment included exploratory laparotomy,appendectomy,intestinal adhesiolysis,and pelvic abscess removal.The patient’s condition improved and he was dis-charged.However,the recurrent episodes of abdominal pain and passage of black stools started again one year after discharge.On the basis of these features and results of subsequent colonoscopy,the clinical diagnosis was established as in-flammatory bowel disease(IBD).Accordingly,aminosalicylic acid,immunotherapy,and related symptomatic treatment were administered,but the symptoms of the patient did not improve significantly.Further investigations revealed mutations in the ACVRL1 and PLA2G4A genes.ACVRL1 and PLA2G4A are involved in angiogenesis and coagulation,respectively.This suggests that the chronic intestinal ulcers and bleeding in this case may be linked to mutations in the ACVRL1 and PLA2G4A genes.Oral Kangfuxin liquid was administered to promote healing of the intestinal mucosa and effectively manage clinical symptoms.CONCLUsION Mutations in the ACVRL1 and PLA2G4A genes may be one of the causes of chronic intestinal ulcers and bleeding in IBD.Orally administered Kangfuxin liquid may have therapeutic potential.

关键词： Intestinal ulcers Crohn’s disease Ulcerative colitis Activin A receptor type II-like 1 Phospholipase A2 group 4A Case report

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Effect of different anesthetic modalities with multimodal analgesia on postoperative pain level in colorectal tumor patients

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World Journal of Gastrointestinal Oncology 2024年第2期16卷 364-371页

作者： Ji-Chun Tang Jia-Wei Ma Jin-Jin Jian Jie shen Liang-Liang Cao Department of Anesthesiology The Affiliated Hospital of Jiangnan UniversityWuxi 214122Jiangsu ProvinceChina Department of Anesthesiology People's Hospital of Aheqi CountyKizilsu Kirgiz Autonomous Prefecture 843599Xinjiang Uygur Autonomous RegionChina Department of Critical Care Medicine Jiangnan University Medical CenterWuxi 214122Jiangsu ProvinceChina Department of Critical Care Medicine People's Hospital of Aheqi CountyKizilsu Kirgiz Autonomous Prefecture843599Xinjiang Uygur Autonomous RegionChina

BACKGROUND According to clinical data,a significant percentage of patients experience pain after surgery,highlighting the importance of alleviating postoperative pain.The current approach involves intravenous self-control analgesia,often utilizing opioid analgesics such as morphine,sufentanil,and fentanyl.surgery for colo-rectal cancer typically involves general anesthesia.Therefore,optimizing anes-thetic management and postoperative analgesic programs can effectively reduce perioperative stress and enhance postoperative recovery.The study aims to analyze the impact of different anesthesia modalities with multimodal analgesia on patients'postoperative pain.AIM To explore the effects of different anesthesia methods coupled with multi-mode analgesia on postoperative pain in patients with colorectal cancer.METHODs Following the inclusion criteria and exclusion criteria,a total of 126 patients with colorectal cancer admitted to our hospital from January 2020 to December 2022 were included,of which 63 received general anesthesia coupled with multi-mode labor pain and were set as the control group,and 63 received general anesthesia associated with epidural anesthesia coupled with multi-mode labor pain and were set as the research group.After data collection,the effects of postoperative analgesia,sedation,and recovery were compared.REsULTs Compared to the control group,the research group had shorter recovery times for orientation,extubation,eye-opening,and spontaneous respiration(Psearch group also showed lower Visual analog scale scores at 24 h and 48 h,higher Ramany scores at 6 h and 12 h,and improved cognitive function at 24 h,48 h,and 72 h(Ps were significantly reduced at various time points in the research group compared to the control group(Ps of CD3+,CD4+,and CD4+/CD8+were also lower in the research group at multiple time points(PsION For patients with colorectal cancer,general anesthesia coupled with epidural anesthes

关键词： Multimodal analgesia Anesthesia Colorectal cancer Postoperative pain

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Assessing recent recurrence after hepatectomy for hepatitis Brelated hepatocellular carcinoma by a predictive model based on sarcopenia

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World Journal of Gastroenterology 2024年第12期30卷 1727-1738页

作者： Hong Peng si-Yi Lei Wei Fan Yu Dai Yi Zhang Gen Chen Ting-Ting Xiong Tian-Zhao Liu Yue huang Xiao-Feng Wang Jin-Hui Xu Xin-hua Luo Department of Infectious Diseases Guizhou Provincial People’s HospitalGuiyang 550002Guizhou ProvinceChina Department of Hepatobiliary surgery Guizhou Provincial People’s HospitalGuiyang 550002Guizhou ProvinceChina

BACKGROUND sarcopenia may be associated with hepatocellular carcinoma(HCC)following hepatectomy.But traditional single clinical variables are still insufficient to predict recurrence.We still lack effective prediction models for recent recurrence(time to recurrences)after hepatectomy for HCC.AIM To establish an interventable prediction model to estimate recurrence-free survival(RFs)after hepatectomy for HCC based on sarcopenia.METHODs We retrospectively analyzed 283 hepatitis B-related HCC patients who underwent curative hepatectomy for the first time,and the skeletal muscle index at the third lumbar spine was measured by preoperative computed tomography.94 of these patients were enrolled for external validation.Cox multivariate analysis was per-formed to identify the risk factors of postoperative recurrence in training cohort.A nomogram model was developed to predict the RFs of HCC patients,and its predictive performance was validated.The predictive efficacy of this model was evaluated using the receiver operating characteristic curve.REsULTs Multivariate analysis showed that sarcopenia[Hazard ratio(HR)=1.767,95%CI:1.166-2.678,P5 cm(HR=2.222,95%CI:1.285-3.842,Ps B virus DNA level≥2000 IU/mL(HR=2.1,95%CI:1.407-3.135,Psk factors associated with postoperative recurrence of HCC.Based on the sarcopenia to assess the RFs model of hepatectomy with hepatitis B-related liver cancer disease(sAMD)was established combined with other the above risk factors.The area under the curve of the sAMD model was 0.782(95%CI:0.705-0.858)in the training cohort(sensitivity 81%,specificity 63%)and 0.773(95%CI:0.707-0.838)in the validation cohort.Besides,a sAMD score≥110 was better to distinguish the high-risk group of postoperative recurrence of HCC.CONCLUsION sarcopenia is associated with recent recurrence after hepatectomy for hepatitis B-related HCC.A nutritional status-based prediction m

关键词： Alpha-fetoprotein Hepatitis B virus Hepatectomy Hepatocellular carcinoma Nomogram Predictive models Recurrence Recurrence-free survival Risk factors sarcopenia

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safflower Yellow Inhibits Progression of Hepatocellular Carcinoma by Modulating Immunological Tolerance via FAK Pathway

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Chinese Journal of Integrative Medicine 2024年第4期30卷 339-347页

作者： JI hua-feng YANG Zi-qiang HAN Jun-jun LI He-fang JIN Zhao-qing CHEN Wei-qing CHEN Fei-hua GONG Mou-chun Department of General surgery First People's Hospital of Hangzhou Lin'an DistrictHangzhou(311300)China

Objective To explore the anti-tumor effect of safflower yellow(sY)against hepatocellular carcinoma(HCC)and the underlying potential mechanism.Methods An in vitro model was established by mixing Luc-Hepa1-6 cells and CD3^(+)CD8^(+)T cells,followed by adding programmed cell death protein 1(PD-1)antibody(Anti-mPD-1)with or without sY.The apoptosis was detected by flow cytometry and the level of inflammatory cytokines was determined by enzyme-linked immunosorbent assay.The protein levels of programmed cell death 1 ligand 1(PD-L1),chemokine ligand(CCL5),C-X-C motif chemokine ligand 10(CXCL10)were measured by Western blot.An in situ animal model was established in mice followed by treatment with anti-mPD-1 with or without sY.Bioluminescence imaging was monitored with an AniView 100 imaging system.To establish the FAK-overexpressed Luc-Hepa1-6 cells,cells were transfected with adenovirus containing pcDNA3.1-FAK for 48 h.Results The fluorescence intensity,apoptotic rate,release of inflammatory cytokines,and CCL5/CXCL10 secretion were dramatically facilitated by anti-mPD-1(Ps,which were extremely further enhanced by sY(Psed fluorescence intensity,elevated percentage of CD3+CD8+T cells,facilitated release of inflammatory cytokines,inactivated PD-1/PD-L1 axis,and increased CCL5/CXCL10 secretion were observed in Anti-mPD-1 treated mice(PsY(Ps of sY on inhibiting tumor cell growth,facilitating apoptosis and inflammatory cytokine releasing,suppressing the PD-1/PD-L1 axis,and inducing the CCL5/CXCL10 secretion in Anti-mPD-1 treated mixture of Luc-Hepa1-6 cells and CD3+CD8+T cells were abolished by FAK overexpression(Psion sY inhibited the progression of HCC by mediating immunological tolerance through inhibiting FAK.

关键词： hepatocellular carcinoma safflower yellow Chinese medicine tumor microenvironment programmed cell death protein 1 focal adhesion kinase

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