A preliminary research on transcultural capacity in global public health: from the view of public health professionals.

BACKGROUND: Transcultural capacity is a key component of consolidated global public health assistance cooperation (GPHAC). The aim of this study is to investigate the transcultural capacity perceptions of public health professionals from China's disease control and prevention system after relative training in order to provide a reference for enhancing transcultural capacity during the practice of GPHAC. METHODS: A cross sectional qualitative survey in which self-administrated questionnaire with 5 open ended questions was used. The questionnaire was disseminated on the completion of an online training for China's senior public health professions on transcultural capacity in GPHAC. Descriptive statistics, word frequency analysis and content analysis were used to analyze the questionnaire data. RESULTS: Totally, 45 participants took part in this training, 25 of them voluntarily participated in this survey. The participants demonstrated the need for transcultural competence in public health services and suggested improvement in the course content arising from their wealth of knowledge and practical experience in the field. 96% of the participants considered that the training course was "very necessary" and "meaningful". The most interested topics were "Overview of transcultural adaptation and GPHAC", "Transcultural adaptation and response" and "African culture and health". The contents about "Country-specific analysis on cultural factors in public health", "rapid transcultural adaptation" and "more specific practical experiences in diverse cultural backgrounds" were suggested to be added in future training. The participants considered that transcultural capacity ensured the smooth progress of GPHAC and they both could complement each other, transcultural adaptation was the premise of gaining trust and reaching cooperation, it can be conducive to the health assistance professionals to integrate into local cultural life, facilitating their foreign assistance work to be effective and efficient, and impart experiences well. The participants hoped to put the concept into action. CONCLUSION: The importance of transcultural competence in GPHAC is becoming a consensus of public health professionals. Enhanced transcultural competence reflected in the attitude of public health as well as other health workers would promote GPHAC and would foster efficient emergency health response management among many countries.

Robotic gastrectomy versus laparoscopic gastrectomy for gastric cancer: meta-analysis and trial sequential analysis of prospective observational studies.

BACKGROUND: To evaluate short- and long-term outcomes of robotic gastrectomy (RG) in patients with gastric cancer to determine whether RG is an acceptable alternative to laparoscopic gastrectomy (LG). METHODS: PubMed, Embase, the Cochrane Library, and Chinese Biomedical Database were searched for prospective observational studies (POSs) comparing RG with LG for gastric cancer until October 2017. We compared short-term and long-term outcomes using systematic review with meta-analysis and trial sequential analysis (TSA). RESULTS: Sixteen POSs including 4576 patients were included in the meta-analyses. Compared with LG, RG had longer operative time (MD 57.98 min, P < 0.00001), lesser blood loss (MD - 23.71 ml, P = 0.005), and shorter time to first post-operative flatulence (MD - 0.14 days, P = 0.03). No significant difference was found in terms of the number of harvested lymph nodes, complications, reoperation, mortality, open conversion, proximal resection margin, and distal resection margin. The meta-analyses of complications, overall survival, and disease-free survival did not yield any sign of statistically significant difference between the two treatments, and the cumulative Z-curve crossed neither the traditional boundary nor the trial sequential monitoring boundary, suggesting the lack of firm evidence. TSA demonstrated that the cumulative Z-curve crossed either the traditional boundary or the trial sequential monitoring boundary on blood loss and operative time. CONCLUSIONS: The present study demonstrates that RG is as acceptable as LG in terms of short- and long-term outcomes. The TSA demonstrated that further studies are not needed to evaluate the operative time and blood loss differences between these techniques.

Discovery of new chromen-4-one derivatives as telomerase inhibitors through regulating expression of dyskerin.

A series of new trimethoxyphenyl-4H-chromen derivatives as telomerase inhibitors through regulation dyskerin were designed and synthesised. The anticancer activity assay in vitro showed that compound 5i 3-(4-(4-isonicotinoylpiperazin-1-yl)butoxy)-5,7-dimethoxy-2-(3,4,5-trimethoxyphenyl)-4H-chromen-4-one exhibited high activity against Hela, SMMC-7721, SGC-7901, U87 and HepG2 cell lines. Compound 5i also showed potent inhibitory activity against telomerase. The further results confirmed this title compound could significantly improve pathological changes induced rat hepatic tumor in vivo. Preliminary mechanisms showed that compound 5i inhibited telomerase activity through decrease expression of dyskerin.

[Effect of two Pi deficiency syndrome models on the configuration and function of the skeletal muscle in mice].

OBJECTIVE: To observe the relation between Pi deficiency syndrome (PDS) and the configuration and functions of extensor digitorum longus (EDL)and soleus (SOL). METHODS: Totally 36 ICR mice were randomly divided into 3 groups according to weight matching principle, the control group, the exhausted group, and the rhubarb group, 12 in each group. Two PDS models were established by either purgation with rhubarb diarrhea (as Group A) or exhausted swimming plus sleep deprivation (as Group B).The cross sectional area (CSA) of type I and II fibers of extensor digitorum longus (EDL) and soleus (SOL), relative proportions of type I and II fibers were measured by m-ATPase histochemical method. The isotonic contraction and the maximum tetanus contraction of EDL and SOL were detected by PowerLab system. RESULTS: Compared with the control group, the body weight, body temperature, and the general health condition of PDS model rats obviously decreased; the spleen index and the thymus index were also lower; the maximal isotonic contraction and the maximum tetanus contraction obviously decreased; the cross section areas of EDL and SOL were reduced with loosely arranged cells. In EDL, the proportion of type I fibers was added and the proportion of type II fibers was lowered. In SOL, there was no change in the proportion of type I and type II fibers. CONCLUSIONS: EDL and SOL were obviously atrophied in the two PDS model mice. The type I fibers of SOL was more significantly atrophied in Group B.

Electrocardiographic findings in accessory right precordial leads in adults and seniors with notched S waves in lead V1-a preliminary study.

BACKGROUND: Atypical right bundle branch block (RBBB) may present with an rS pattern and notched S wave in lead V1 . The notched S wave may represent slowed conduction or delayed activation of the right ventricular conduction system or ventricular myocardium. METHODS: We retrospectively analyzed the QRS patterns in accessory right precordial leads (from V3 R to V5 R) in 15 adults/senior individuals with notched S wave in lead V1 . RESULTS: In the right accessory precordial leads, 13 showed triphasic QRS pattern with final R' wave in their QRS complexes. This QRS pattern in association with notched S wave in lead V1 is suggestive of the presence of RBBB (incomplete or complete). CONCLUSIONS: A notched S wave in lead V1 and in the right precordial accessory leads associated with a final R' wave suggests the possibility of concealed RBBB (incomplete or complete).

Correlation between ST-segment elevation and negative T waves in the precordial leads in acute pulmonary embolism: insights into serial electrocardiogram changes.

BACKGROUND: Acute pulmonary embolism (APE) is often misdiagnosed as acute coronary syndrome because of the similarity of the presenting symptoms and of the electrocardiogram (ECG) manifestations. In APE, ST-segment elevation (STE) in leads V1 to V3 /V4 , mimicking anteroseptal myocardial infarction, is not a rare phenomenon. Negative T waves (NTW) in the precordial leads mimicking the "Wellens' syndrome" is an important ECG manifestation of APE. The evolution of these ECG changes-STE and NTW-in APE has not been thoroughly studied. METHODS: We present two patient cases with APE and their evolving serial ECGs to analyze the correlation between STE and NTW. RESULTS: NTW developed later than STE in these two patient cases. CONCLUSIONS: NTW might represent a "postischemic" ECG pattern indicating a previous stage with transmural myocardial ischemia.

Effects of Cd2+ ions on root anatomical structure of four rice genotypes.

Root anatomical structures of four rice breeding materials (maintainer lines YixiangB and E2B, restorer lines R892 and Mianhui725), grown under different Cd2+ levels, were observed and the root resistance to Cd2+ ions was evaluated. Under low Cd stress, the new roots appeared in the cortex of four rice genotypes. The diameter of the new root in YixiangB was larger than that of E2B. The restorer line R892 generated more roots than Mianhui725. Under high Cd2+ stress, broken epidermis, damaged cortex and black spots appeared in both maintainer and restorerlines. In general, anatomical damages in the restorer lines (R892 and Mianhui725) were slighter than those of the maintainer lines (YixiangB and E2B). Thus, the restorer lines had more adaptive ability to Cd2+ stress than maintainer lines.

Correlation between ECG presentation and cardiovascular magnetic resonance imaging in Takotsubo cardiomyopathy.

Takotsubo cardiomyopathy (TTC) is characterized by acute and reversible ventricular dysfunction in the absence of significant coronary artery disease, typically triggered by acute emotional or physical stress. In the acute phase of TTC, the electrocardiogram (ECG) shows ST-segment elevation, which rapidly evolves into negative T waves and QT prolongation. However, different types of ventricular dysfunction may be associated with different patterns of ECG presentation. In this paper, we discuss the correlation between ECG presentation and cardiovascular magnetic resonance imaging in TTC.

ST-segment deviation pattern of takotsubo cardiomyopathy similar to acute pericarditis: diffuse ST-segment elevation.

BACKGROUND: Possible similarities or differences in the ST- and PR-segment deviations in the electrocardiogram of takotsubo cardiomyopathy (TTC) and acute pericarditis (AP) are not well defined. METHODS: We compared different parameters of the admission electrocardiogram in eight patients with TTC and eight patients with AP with ST-segment elevation in the acute phase. RESULTS: We found significant differences in the maximal magnitude of the T wave in the precordial leads, but not in the ST- and PR-segment deviation patterns between the two patient groups. All the patients in the two groups showed consistent ST-segment depression in lead aVR and absence of ST-segment elevation in lead V1. CONCLUSIONS: The ST- and PR-segment deviation patterns in TTC are similar to that of AP, namely diffuse ST-segment elevations with reciprocal changes in aVR and V1 and PR-segment elevation in aVR accompanied by PR-segment depression in the inferior leads, possibly indicating that TTC has ECG characteristics of circumferential subepicardial ischemia in the acute phase.

Correlation of soil microbes and soil micro-environment under long-term safflower (Carthamus tinctorius L.) plantation in China.

Microbial community structure and ecological functions are influenced by interactions between above and belowground biota. There is an urgent need for intensive monitoring of microbes feedback of soil micro-ecosystem for setting up a good agricultural practice. Recent researches have revealed that many soils characteristic can effect microbial community structure. In the present study factors affecting microbial community structure and soil in Carthamus tinctorius plantations in arid agricultural ecosystem of northern Xinjiang, China were identified. The result of the study revealed that soil type was the key factor in safflower yield; Unscientific field management resulted high fertility level (bacteria dominant) of soil to turn to low fertility level (fungi dominant), and Detruded Canonical Correspondence Analysis (DCCA) showed that soil water content, organic matter, available N, P and K were the dominant factors affecting distribution of microbial community. Soil water content showed a significant positive correlation with soil microbes quantity (P < 0.01), while others showed a significant quantity correlation with soil microbe quantity (P < 0.05).

Ambulatory ECG-based T-wave alternans and heart rate turbulence can predict cardiac mortality in patients with myocardial infarction with or without diabetes mellitus.

BACKGROUND: Many patients who survive a myocardial infarction (MI) remain at risk of sudden cardiac death despite revascularization and optimal medical treatment. We used the modified moving average (MMA) method to assess the utility of T-wave alternans (TWA) and heart rate turbulence (HRT) as risk markers in MI patients with or without diabetes mellitus (DM). METHODS: We prospectively enrolled 248 consecutive patients: 96 with MI (post-MI patients); 77 MI with DM (post-MI + DM patients); 75 controls without cardiovascular disease (group control). Both TWA and HRT were measured on ambulatory electrocardiograms (AECGs). HRT was assessed by two parameters ─ turbulence onset (TO) and turbulence slope (TS). HRT was considered positive when both TO ≥0% and TS ≤2.5 ms/R-R interval were met. The endpoint was cardiac mortality. RESULTS: TWA values differed significantly between MI and controls. Post-MI + DM patients had higher TWA values than post-MI patients (58 ± 21 µV VS 52 ± 18 µV, P = 0.029). Impaired HRT--increased TO and decreased TS were observed in MI patients with or without DM. During follow-up of 578 ± 146 days, cardiac death occurred in ten patients and three of them suffered sudden cardiac death (SCD). Multivariate analysis determined that a HRT-positive outcome [HR (95% CI): 5.01, 1.33-18.85; P = 0.017], as well as the combination of abnormal TWA (≥47 µV) and positive HRT had significant association with the endpoint [HR (95% CI): 9.08, 2.21-37.2; P = 0.002)]. CONCLUSION: This study indicates that AECGs-based TWA and HRT can predict cardiac mortality in MI patients with or without DM. Combined analysis TWA and HRT may be a convenient and useful method of identifying patients at high risk for cardiovascular death.

Cinobufacini Inhibits the Development of Pancreatic Cancer Cells through the TGFß/Smads Pathway of Pancreatic Stellate Cells.

This study aimed to test cinobufacini therapeutic potential for pancreatic cancer, verify its potential molecular mechanism, and evaluate the cinobufacini impact on pancreatic cancer microenvironment. First, the effect of cinobufacini-treated pancreatic stellate cells (PSCs) supernatant on the value-added ability of pancreatic cancer (PCCs) was tested. The results show that cinobufacini can effectively reduce the ability of PSCs supernatant to promote the value-added PCCs. Further results show that cinobufacini can effectively reduce the concentration of TGFß in the supernatant of PSCs. Subsequently, the impact of cinobufacini on the transcription and translation levels of key genes in the TGFß/Smads pathway was examined. The results showed that the impact of cinobufacini on the transcription levels of Smad2, Smad3, and Smad7 was in a concentration-dependent manner, while the transcriptional activity of collagen I mRNA was decreased with the increase of cinobufacini concentration. The results of protein expression showed that cinobufacini could upregulate the expression of inhibitory protein Smad7, inhibit the phosphorylation level of p-Smad2/3, and then suppress the expression of type I collagen (collagen I). On the one hand, this study shows that cinobufacini can inhibit the promotion of PSCs on the proliferation of PCCs. On the other hand, cinobufacini can upregulate the expression of the inhibitory molecule, Smad7, through the TGFß/Smads pathway and reduce the phosphorylation level of p-Smad2/3, thereby inhibiting the expression of collagen I and pancreatic fibrosis. cinobufacin can inhibit the proliferation of SW1900 cells by blocking the TGFß/Smads pathway of pancreatic stellate cells. These results provide a clinical basis for the treatment of pancreatic cancer.

A quantitative anatomic study of plate-screw fixation of the acetabular anterior column through an anterior approach.

BACKGROUND: Screw penetration of the hip joint is a serious complication during plate-screw internal fixation of acetabular anterior column or anterior wall fractures through an anterior approach. The purpose of the cadaveric study is to determine safe paths for screw placement on the anterior column of the acetabulum. METHODS: A total of 46 hemipelvises (24 male, 22 female) were utilized in this study. These hemipelvises were sectioned, and formed cross-sections anterior endpoint (AEP), anterior quarter point (AQP), midpoint (MP), posterior quarter point (PQP) and posterior endpoint (PEP), respectively. Positions at distances of 0.5-, 1.0-, and 1.5-cm lateral to the pelvic brim on cross-section AQP, MP and PQP were marked, respectively. The nearest distance from entry points of the anterior column to the hip joint, the average medial angulation of cortical screws at 0.5-, 1.0-, and 1.5-cm entry points on cross-section AQP, MP and PQP were measured. RESULTS: The nearest distance from 0.5-, 1.0-, and 1.5-cm entry points to the hip joint is 15.6 +/- 1.5, 13.1 +/- 1.2, and 11.2 +/- 1.4 mm, respectively. The maximum medial angulation to provide safe cortical screw placement at 0.5-, 1.0-, and 1.5-cm entry points is 8.2 +/- 2.2 degrees, 14.9 +/- 3.4 degrees, and 26.1 +/- 4.5 degrees, respectively. CONCLUSIONS: During the operation of plate-screw fixation of the anterior column on the acetabulum, there are three ways to avoid screw penetration of the hip joint. The first one is to use the long screw. Its entry point is placed as close to pelvic brim as possible, and the entry direction is parallel to the quadrilateral surface. The second one is to use the short screws whose lengths are 14, 12 and 10 mm and locate them in the region between the pelvis brim and 0.5-cm entry point, between 0.5- and 1.0-cm entry point, between 1.0- and 1.5-cm entry point, respectively, regardless of the direction of the screw placement. The third one is to take quadrilateral surface as a reference plane, and adjust the medial angulation of the screw placement according to different target locations, i.e., in the coronal plane ranges from 0 degrees to 10 degrees in the region between pelvis brim and 0.5-cm entry point, 10 degrees-20 degrees in the region between 0.5- and 1.0-cm entry point, and 20 degrees-30 degrees in the region between 1.0- and 1.5-cm entry point.

Application of the indirect fluorescent antibody assay in the study of malaria infection in the Yangtze River Three Gorges Reservoir, China.

BACKGROUND: China Yangtze Three Gorges Project (TGP) is one of the biggest construction projects in the world. The areas around the Three Gorge Dam has a history of tertian malaria and subtertian malaria epidemic, but there are no overall data about malaria epidemics before the completion of the project. The objective of this study was to get a reliable baseline on malaria infection in the Yangtze River Three Gorges reservoir area and to provide reference data for future studies about the impact of the project on malaria epidemics. METHODS: Two surveys of malaria infection were carried out in area, at six-month intervals in May and October 2008. About 3,600 dual specimens blood film samples for parasite diagnosis and filter paper blood spots for serology (using the immunofluorescence antibody test) were collected from the general population, including school populations, whenever possible. RESULTS: The overall percentage of positive response of the same population during post-transmission periods was about twice (1.40/0.72) of that in pre-transmission. Positive individuals under 15 years of age were detected in all the localities. CONCLUSION: A certain extent of malaria infection existed in this area. Additional studies are needed to determine the length of malaria experience, and chemotherapeutic intervention as well as the distribution of main vectors for transmission in this area.

[Advances in etiology, epidemiology and genetic diversity of Thelazia callipaeda].

Thelazia callipaeda, T. californiensis and T. gulosa are three causative agents of human thelaziasis. Most of the reported cases were caused by T. callipaeda, occurring in the old world, particularly in Asian and European countries. T. californiensis and T. gulosa have rarely been reported infecting humans in North America. T. callipaeda has long been called the oriental eye worm, referring to its traditional distribution across eastern and southeastern Asia (i.e., China, Korea, Japan, Indonesia, Thailand, and India) where infection is endemic in animals and humans, usually in poorer rural areas and mainly among children and the elderly. The identification of the parasite was mainly based on the characteristics of oral and genital organs. In Asia and Europe, vectors for this nematode are male Phortica okadai and P. variegata drosophilids respectively, which feed on ocular secretions of hosts and transmit infective stage larvae to domestic and wild carnivores, lagomorphs, and humans. China probably has the largest number of cases with thelaziasis in the world, and lots of cases have been existed in other Asian countries such as Japan and Korea. Although a few of human cases have been reported, there were high infection rates of wild animals and domesticated dogs and cats in most of European countries. Based on the cox1 gene, a total of 21 haplotypes were identified in the samples from worldwide, in which, one circulated only in European countries (h1), while the other 20 haplotypes were distributed in Korea, Japan and China. In general, the Chinese clinical isolates of T. callipaeda expressed high genetic diversity. The population differences between Europe and Asian countries were greater than those among China, Korea and Japan. The T. callipaeda populations from Europe and Asia should be divided into two separate sub-populations. These two groups started to diverge during the middle Pleistocene.

Acute anterior wall myocardial infarction entailing ST-segment elevation in lead V3R, V1 or aVR: electrocardiographic and angiographic correlations.

BACKGROUND: The correlation between ST-segment elevation (ST upward arrow) in lead V(3)R (ST upward arrow(V3R)), lead V(1) (ST upward arrow(V1)), and lead aVR (ST upward arrow(aVR)) during anterior wall acute myocardial infarction (AMI) and the culprit lesion site in the left anterior descending (LAD) coronary artery and the nature of the conal branch of the right coronary artery has not been thoroughly described. METHODS: One hundred forty-two patients with first anterior wall AMI were included. The 15-lead electrocardiogram with the standard 12 leads plus leads V(3)R through V(5)R showing the most pronounced ST-segment deviation before initiation of reperfusion therapy was evaluated and correlated with the exact LAD occlusion site in relation to the first septal perforator (S1) and the nature of the conal branch of the right coronary artery as determined by coronary angiography. RESULTS: ST-segment elevation in lead aVR, ST upward arrow(V1) of at least 2 mm, and ST upward arrow(V3R) of at least 1 mm were more prevalent among patients with occlusions proximal to S1 than patients with occlusions distal to S1 (41.7% vs 4.9%, P < .01; 30.0% vs 7.3%, P < .01; and 91.7% vs 4.9%, P < .01, respectively). Of the 60 patients with occlusions proximal to S1, 20 patients had a small conal branch (18 patients with ST upward arrow(aVR) and 15 patients with ST upward arrow(V1) >or=2 mm), and 24 patients had a large conal branch (all patients with non-ST upward arrow(aVR) and ST upward arrow(V1) <2 mm; P < .01). The sensitivity of ST upward arrow(V1) of more than 1 mm, of at least 2 mm, ST upward arrow(V3R) of at least 1.5 mm, and ST upward arrow(aVR) for detecting a small conal branch was 65.1%, 81.8%, 84.0%, and 90%, respectively; the specificity was 68.5%, 64%, 66.7%, and 64.9%, respectively. CONCLUSIONS: In patients with anterior wall AMI, ST upward arrow(V3R) of at least 1 mm combined with ST upward arrow in leads V(2) through V(4) were strongly predictive of LAD occlusion proximal to S1; furthermore, ST upward arrow(aVR) and ST upward arrow(V1) of at least 2 mm were found to be useful in identifying LAD occlusion proximal to S1. ST upward arrow(aVR), ST upward arrow(V3R) of at least 1.5 mm, and ST upward arrow(V1) of at least 2.0 mm were also associated with the presence of a small conal branch not reaching the intraventricular septum during anterior wall AMI.

Clinical observation on the combined treatment of 57 cases of non-small cell lung cancer using argon-helium cryosurgery and Chinese herbal medicine.

OBJECTIVE: To observe the clinical effect of the combined therapy using argon-helium cryosurgery (Ar-He knife) and Chinese herbal medicine in treating non-small cell lung cancer (NSCLC). METHODS: Fifty-seven patients of NSCLC were treated with the combined therapy and observed. RESULTS: The treatment was successfully completed in all patients with mild adverse reactions. The effective rate was 83.8% 3 months after the operation, 79.6% 6 months after the operation, and 77.3% 12 months after the operation, with median survival of 9 months. The survival rate after 12 months was 46.67% (21/45), 34.62% (9/26) after 18 months, and 36.36% (4/11) after 24 months. CONCLUSION: Argon-helium cryosurgery therapy is superior in its assured orientation, quick tumor load deprivation and less postoperational reaction. Combined with Chinese herbal medication, Argon-helium cryosurgery therapy can prolong survival time, relieve clinical symptoms, and elevate the quality of life in NSCLC patients, and is thus worthy of promotion.

Laparoscopic Radical Gastrectomy for Resectable Advanced Gastric Cancer Within Enhanced Recovery Programs: A Prospective Randomized Controlled Trial.

BACKGROUND: Enhanced recovery programs have become an important focus of perioperative management. A few studies have demonstrated the efficacy of an enhanced recovery after surgery (ERAS, which includes optimized pain control, restricted I.V. fluids, early initiation of postoperative oral feeding, and enforced mobilization) protocol in patients undergoing radical gastrectomy. We investigated the feasibility and safety of laparoscopic radical gastrectomy within ERAS programs. METHODS: In this single-center prospective randomized controlled trial conducted between September 2013 and August 2014, 149 consecutive locally advanced gastric cancer patients (T2-4, any N, M0) diagnosed by the CT scanning were allocated to either ERAS group (N = 73) or conventional pathway group (N = 76). The same surgical technique was used in both groups, that is, laparoscopic gastrectomy with D2 lymphadenectomy and R0 resection. Intergroup differences were evaluated for clinical parameters and C-reactive protein for testing tissue injury. RESULTS: ERAS combined with laparoscopic gastrectomy was observed in our study. Recovery parameters such as time to return to normal diet (days) 1.90 ± 0.71 versus 3.52 ± 0.81, P = .003 and time to the first defecation (days) 2.97 ± 1.23 versus 5.20 ± 1.81, P = .015 were measured. The post hospital stay (days) in ERAS and the conventional care group were 6.38 ± 2.04 and 8.62 ± 2.87, P < .001, respectively. No statistically significant intergroup differences were observed in terms of postoperative complications and C-reactive protein levels. One patient in the ERAS group was readmitted because of anastomotic leakage. No instances of deaths were reported during the 30-day follow-up period. CONCLUSION: This study demonstrates the feasibility and safety of ERAS protocol in advanced gastric cancer patients undergoing laparoscopic radical gastrectomy and was associated with shorter duration of hospital stay. ( Clinicaltrials.gov Identifier No NCT02348229).

Tetramethylpyrazine ameliorated disuse-induced gastrocnemius muscle atrophy in hindlimb unloading rats through suppression of Ca2+/ROS-mediated apoptosis.

The purpose of this study was to examine the possible mechanism underlying the protective effect of tetramethylpyrazine (TMP) against disuse-induced muscle atrophy. Sprague-Dawley rats were randomly assigned to receive 14 days of hindlimb unloading (HLU, a model of disuse atrophy) or cage controls. The rats were given TMP (60 mg/kg body mass) or vehicle (water) by gavage. Compared with vehicle treatment, TMP significantly attenuated the loss of gastrocnemius muscle mass (-33.56%, P < 0.01), the decrease of cross-sectional area of slow fiber (-10.99%, P < 0.05) and fast fiber (-15.78%, P < 0.01) during HLU. Although TMP failed to further improve recovery of muscle function or fatigability compared with vehicle treatment, it can suppress the higher level of lactate (-22.71%, P < 0.01) induced by HLU. Besides, TMP could effectually reduce the increased protein expression of muscle RING-finger protein 1 induced by HLU (-14.52%, P < 0.01). Furthermore, TMP can ameliorate the calcium overload (-54.39%, P < 0.05), the increase of malondialdehyde content (-19.82%, P < 0.05), the decrease of superoxide dismutase activity (21.34%, P < 0.05), and myonuclear apoptosis (-78.22%, P < 0.01) induced by HLU. Moreover, TMP significantly reduced HLU-induced increase of Bax to B-cell lymphoma 2 (-36.36%, P < 0.01) and cytochrome c release (-36.16%, P < 0.05). In conclusion, TMP attenuated HLU-induced gastrocnemius muscle atrophy through suppression of Ca2+/reactive oxygen species increase and consequent proteolysis and apoptosis. Therefore, TMP might exhibit therapeutic effect against oxidative stress, cytosolic calcium overload, and mitochondrial damage in disuse-induced muscle atrophy.