Follistatin‑like 1 (Fstl1) is a secreted glycoprotein that belongs to the follistatin and SPARC (secreted protein, acidic and rich in cysteine) families and was identified to serve a critical role in lung fibrosis. However, the role of Fstl1 in liver fibrosis remains undefined. Therefore, the aim of the present study was to investigate the role of Fstl1 in liver fibrosis. The results indicated that Fstl1 was highly expressed in human hepatic fibrosis tissues and activated hepatic stellate cells (HSCs). Furthermore, knockdown of Fstl1effectively suppressed HSC proliferation and the protein expression levels of α‑SMA and collagen I in transforming growth factor (TGF)‑β1‑treated HSCs. Mechanistically, knockdown of Fstl1 remarkably decreased the phosphorylation level of Smad3 in TGF‑β1‑induced HSCs. Taken together, the present study demonstrated that Fstl1serves an important role in liver fibrosis and target deletion of Fstl1 attenuated HSCs activation through suppressing TGF‑β1/Smad3 signaling pathway. Therefore, Fstl1 may be a potential therapeutic target for the treatment of liver fibrosis.

ObjectiveThis study aimed to summarize and analyze the characteristics of pulmonary sequestration to improve our understanding of this disease.MethodsBetween January 2019 and April 2023, the clinical data of 13 patients with pulmonary sequestration underwent surgical treatment at the First Affiliated Hospital of Gannan Medical University.ResultsThe male‐to‐female ratio was 4:9, the age was 0.5 to 60 years, and the average age was 38 ± 19 years. There were 10 and 3 cases of intralobar and extralobar pulmonary sequestration, respectively. Chest enhanced computed tomography (CT) and three‐dimensional vascular reconstruction showed that the abnormal blood vessels were derived from the descending thoracic aorta in nine cases and from other blood vessels in four cases. Three patients underwent thoracoscopic lobectomy, two underwent thoracoscopic segmentectomy, and eight underwent thoracoscopic wedge resection. All the patients successfully completed the surgery and were discharged postoperatively.ConclusionsSome patients with pulmonary sequestration exhibit no obvious symptoms. Patients with clinical symptoms are easily confused for pneumonia, bronchial cysts, lung abscesses, and lung tumors; therefore, patients with pulmonary sequestration are prone to missed diagnosis and misdiagnosis. Currently, enhanced chest CT combined with three‐dimensional vascular reconstruction can accurately show the course, branches, and relationship with the mass of the feeding artery. Routine pathological examination is helpful to further clarify the diagnosis of pulmonary sequestration. Minimally invasive thoracoscopic surgery is the preferred treatment for patients with pulmonary sequestration. Surgical resection is safe and feasible, and satisfactory results are typically obtained.

The treatment of patients with endocrine non-responsive advanced breast cancer (ABC) who have been heavily pretreated with anthracyclines, vinorelbine and taxanes usually involves systemic cytotoxic chemotherapy with palliative intent [1][2][3] . However, until recently, there is no standard treatment for these patients [4][5][6][7][8][9][10][11][12][13] . Capecitabine has been approved as treatment for anthracycline-and/or taxane-pretreated ABC [4][5] . Vinorelbine and gemcitabine are two other options considered effective for patients pretreated with anthracyclines and taxanes [6][7] . However, capecitabine, gemcitabine and taxanes are unaffordable for patients in this setting in China due to lack of medical insurance coverage. As a result, patients who had undergone treatment with anthracyclines, vinorelbine and taxanes would have no options left if their disease progressed. Thus, there is an unmet medical need for an effective, economic, and well-tolerated regimen for these patients in China.Mitomycin C (MMC) as single agent given in intermittent schedules induces responses of 26%-38% in previously untreated patients and 15%-25% in multiple chemotherapy-exposed patients [14][15][16][17][18] . Responses of MMC-based regimen ranging from 15%-40% were reported, of which grade 3/4 toxicities including thrombocytopenia (12%), neutropenia (62.5%), and asthenia (6.4%) were noted in one series [18] . Cisplatin (DDP), being the most potent antitumor agents known with a well established therapeutic effect and toxicity profile, was reported to have a response rate of 47% in both first-and second-line chemotherapy for ABC [13,[19][20][21][22] . However, the doublet of MMC and DDP combination was never tried on patients with ABC who had been previously treated with anthracyclines, vinorelbine and taxanes. The regimen containing MMC and DDP has been tried in other kinds of cancer with a good safety profile [23][24][25] . Moreover, combination chemotherapy with MMC has proven more effective than single-agent therapy [16] .A phase II study using the combination regimen of MMC and DDP as the salvage treatment for these patients was conducted in our institute. Antitumor activity and safety of the MMC/DDP combination were evaluated. Materials and methods Patient characteristicsBetween May 2003 and January 2005, 38 females ranging from 25 to 75 years (median, 46 years) were included in the study. Patient characteristics were listed in Table 1. 76.3% patients had performance status of 80 or more. 84.2% of the patients were diagnosed of invasive ductal carcinoma with median number of organ involvement of three (range, 1 to 6). All patients had received previous treatment with anthracyclines. Thirty-four patients (89.5%) were anthracycline-resistant, 32 (84.2%) vinorelbine-resistant and 14 (36.8%) taxane-resistant. Thirty-two patients (84.2%) had had primary tumor surgery, 12 (31.6%) hormonal therapy, 26 (68.4%) radiotherapy. Median number of previous chemotherapy regimens was three (range, 1 to 6). Eligibility criteriaPatients w...