Amelanotic metastatic gastric malignant melanoma: a case report.

Melanoma is a malignant form of cutaneous cancer with an increasing incidence since 1970s, accounting for nearly 75% of the death related to skin cancer especially in western countries. Highest recurrence and mortality were observed for the subtype with distal metastasis, demonstrating poor outcomes. However, high incidence of gastrointestinal metastasis of malignant melanoma is frequently misdiagnosed due to lack of specific clinical manifestations, especially for the rare observed cases presented amelanotic appearance, accounting for about 2% of all metastatic cases. In the present study, we reported a 36-year-old male patient, who was firstly diagnosed as gastric cancer, and then was confirmed as amelanotic melanoma metastasis by pathological examination, demonstrating positive for melanoma markers including Melan A, S-100, Hmb45 and CD79a. In conclusion, for the amelanotic neoplasm observed during gastroscopy in patients with melanoma history, pathological examination should be carried out to confirm the possibility of melanoma metastasis, providing evidences for the following treatment.

Neuropilin-1 is up-regulated by cancer-associated fibroblast-secreted IL-8 and associated with cell proliferation of gallbladder cancer.

We previously demonstrated that cancer-associated fibroblasts (CAFs) promoted the proliferation of gallbladder cancer (GBC) cells, but the mechanism is not clear. Neuropilin-1 (NRP-1) plays an important role in various malignancies as transmembrane glycoprotein. Our goal was to reveal the relationship between CAFs and NRP-1 and their potential functions in GBC. In this study, we found NRP-1 was overexpressed in GBC tissue, associated with poor survival and was up-regulated by CAFs. The cytokine array cluster analysis revealed IL-8 secreted by CAFs facilitated the up-regulation of NRP-1 in tumour cells. NRP-1 knockdown suppressed tumour growth in vivo. Gene expression microarray analysis showed 581 differentially regulated genes under NRP-1 knockdown conditions. Ingenuity pathway analysis demonstrated that NRP-1 knockdown may inhibit tumour progression by affecting cell proliferation. We then confirmed that NRP-1 knockdown in NOZ and GBC-SD cells significantly inhibited cell proliferation. Additionally, the IL-8 mediated MDM2 and CCNA2 expression were affected by NRP-1 knockdown. Our findings suggested that NRP-1 was up-regulated by CAF-secreted IL-8, which subsequently promoted GBC cell proliferation, and these molecules may serve as useful prognostic biomarkers and therapeutic targets for GBC.

Enhancing flashover performance of alumina/epoxy spacers by adaptive surface charge regulation using graded conductivity coating.

Surface flashover properties of alumina/epoxy spacers, involving a surface charge accumulation process, are critical for the safe and reliable operation of a high-voltage direct-current (HVDC) gas-insulated transmission line (GIL). This study reports surface charging behavior and flashover performance of alumina/epoxy spacers with different surface conductivity graded coating (SCGC) schemes in SF6/N2 mixtures under DC stress. Four kinds of SCGC schemes, i.e. localized coating near high voltage (HV-coating), near grounded electrode (GND-coating), at the middle of spacer surface (SPM-coating) and near both high voltage and grounded electrode (HV-GND-coating), are designed by partially spraying SiC/epoxy composites on the spacer surface. Surface charge distribution patterns exhibit varied features with different SCGC schemes. The HV-coating and GND-coating schemes lead to aggravated homo-charge and hetero-charge accumulation respectively, whereas in the SPM-coating scheme surface charge shows a multi-tier distribution pattern with alternating polarity. A transition of the dominant surface charge mechanism from bulk conductivity to surface conductivity with increasing conductivity on the coated area is found. Flashover performance differs a lot with different SCGC schemes: the HV-coating and HV-GND-coating schemes increase the flashover voltage while the SPM-coating and GND-coating schemes degrade it. The optimal surface insulation strength is achieved in the HV-coating scheme with a coating width of about 10 mm. The impact of different SCGC schemes on flashover performance is revealed based on the electric field analysis by considering the effect of surface charges.

Quantifying the Effects of Formalin Fixation on the Mechanical Properties of Cortical Bone Using Beam Theory and Optimization Methodology With Specimen-Specific Finite Element Models.

The effects of formalin fixation on bone material properties remain debatable. In this study, we collected 36 fresh-frozen cuboid-shaped cortical specimens from five male bovine femurs and immersed half of the specimens into 4% formalin fixation liquid for 30 days. We then conducted three-point bending tests and used both beam theory method and an optimization method combined with specimen-specific finite element (FE) models to identify material parameters. Through the optimization FE method, the formalin-fixed bones showed a significantly lower Young's modulus (-12%) compared to the fresh-frozen specimens, while no difference was observed using the beam theory method. Meanwhile, both the optimization FE and beam theory methods revealed higher effective failure strains for formalin-fixed bones compared to fresh-frozen ones (52% higher through the optimization FE method and 84% higher through the beam theory method). Hence, we conclude that the formalin fixation has a significant effect on bovine cortical bones at small, elastic, as well as large, plastic deformations.

Dual effects of atmospheric pressure plasma jet on skin wound healing of mice.

Cold plasma has become an attractive tool for promoting wound healing and treating skin diseases. This article presents an atmospheric pressure plasma jet (APPJ) generated in argon gas through dielectric barrier discharge, which was applied to superficial skin wounds in BALB/c mice. The mice (n = 50) were assigned randomly into five groups (named A, B, C, D, E) with 10 animals in each group. Natural wound healing was compared with stimulated wound healing treated daily with APPJ for different time spans (10, 20, 30, 40, and 50 seconds) on 14 consecutive days. APPJ emission spectra, morphological changes in animal wounds, and tissue histological parameters were analyzed. Statistical results revealed that wound size changed over the duration of the experimental period and there was a significant interaction between experimental day and group. Differences between group C and other groups at day 7 were statistically significant (p < 0.05). All groups had nearly achieved closure of the untreated control wounds at day 14. The wounds treated with APPJ for 10, 20, 30, and 40 seconds showed significantly enhanced daily improvement compared with the control and almost complete closure at day 12, 10, 7, and 13, respectively. The optimal results of epidermal cell regeneration, granulation tissue hyperplasia, and collagen deposition in histological aspect were observed at day 7. However, the wounds treated for 50 seconds were less well healed at day 14 than those of the control. It was concluded that appropriate doses of cold plasma could inactivate bacteria around the wound, activate fibroblast proliferation in wound tissue, and eventually promote wound healing. Whereas, over doses of plasma suppressed wound healing due to causing cell death by apoptosis or necrosis. Both positive and negative effects may be related to the existence of reactive oxygen and nitrogen species (ROS and RNS) in APPJ.

Squamous/adenosquamous carcinoma of the gallbladder: Analysis of 34 cases and comparison of clinicopathologic features and surgical outcomes with adenocarcinoma.

OBJECTIVES: To explore clinicopathological features and effects of surgical treatment of squamous/adenosquamous carcinoma of the gallbladder. METHODS: We enrolled 411 patients who were surgically treated for gallbladder cancer in our hospital, including 10 with squamous cell carcinoma (SCC), 24 with adenosquamous carcinoma (ASC), and 377 with adenocarcinoma (AC). The ASC-SCC group was compared with the AC group for clinicopathological features and surgical outcomes. RESULTS: The patients' average age was 61.4 years. Abdominal pain was the most common presenting symptom, and 67.6% of patients had gallstones. All patients had advanced-stage (T3/T4) carcinomas. The ASC-SCC group had significantly higher percentages of T4 disease (61.8%) and N1 nodal involvement (58.8%) than did the AC group (T4 disease: 34.0%, P = 0.001; N1 involvement: 39.0%, P = 0.02). Patients in the ASC-SCC group who underwent R0 resections had significantly better 1-year survival (30%) than those who underwent R1 or R2 resections (0%; P = 0.025), but lower 1-year survival rates than similar-staged patients in the AC group (69.3%; P = 0.016). CONCLUSIONS: Patients with gallbladder ASC-SCC were similar to those with AC in clinical characteristics, but tended to have more infiltration of multiple adjacent organs and lymphatic metastasis. Curative resection could give these patients better outcomes.

[Screening and identification of indoleacetic acid producing endophytic bacterium in Panax ginseng].

Endophytic bacteria which was producing indoleacetic acid was screened from Panax ginseng by using the Salkowski method. The active strain was also tested for its ability of nitrogen fixation by using the Ashby agar plates, the PKV plates and quantitative analysis of Mo-Sb-Ascrobiology acid colorimetry was used to measure its ability of phosphate solubilization, for its ability of potassium solubilization the silicate medium and flame spectrophotometry was used, for its ability of producing siderophores the method detecting CAS was used, for its ability of producing ACC deaminase the Alpha ketone butyric acid method was applied. And the effect on promoting growth of seed by active strain was tested. The results showed that the indoleacetic acid producing strain of JJ5-2 was obtained from 118 endophytes, which the content of indoleacetic acid was 10.2 mg x L(-1). The JJ5-2 strain also had characteristics of phosphate and potassium solubilization, nitrogen fixation, producing siderophores traits, and the promoting germination of ginseng seeds. The JJ5-2 strain was identified as Bacillus thuringiensis by analyzing morphology, physiological and biochemical properties and 16S rRNA gene sequences.

[Expression and clinical significance of vascular endothelial growth factor-C and nm23-H1 in stage II and III colorectal carcinomas].

OBJECTIVE: To discuss the expression and clinical significance of VEGF-C and nm23-H1 in stage II and III colorectal carcinomas. METHODS: SP immunohistochemical staining was employed to determine the expression of vascular endothelial growth factor-C (VEGF-C) and nm23-H1 in the tumor tissues of 110 cases of stage II and III colorectal carcinomas and in the adjacent mucosal tissues of 53 cases as control, and analyze their correlation with cliniopathological features and prognosis. RESULTS: The positive expression of VEGF-C in the carcinoma tissues was 71.8%, significantly higher than that in the adjacent mucosal tissues (22.6%, P < 0.001). The positive expression of nm23-H1 in the carcinoma tissues was 57.3%, significantly lower than that in the adjacent mucosal tissues (90.6%, P < 0.001). The expression of VEGF-C was significantly correlated with lymph node metastasis (P < 0.05), and the nm23-H1 expression was significantly correlated with lymph node metastasis and pathological type (P < 0.05). The expression of VEGF-C and nm23-H1 did not show a significant correlation with age, gender, primary tumor site, tumor size and depth of invasion (P > 0.05). The VEGF-C expression was negatively related with nm23-H1 expression in colorectal carcinoma (r = -0.361, P < 0.001). The median overall survival (MOS) and median disease free survival (MDFS) of 110 patients with colorectal carcinoma were 55 and 48 months, respectively. The colorectal patients with different VEGF-C and nm23-H1 expression showed significant differences in the 5-year OS rate and 5-year DFS rate (P < 0.001). The patients with negative VEGF-C expression and positive nm23-H1 expression had a better prognosis. CONCLUSIONS: The joint detection of VEGF-C and nm23-H1 expression is very promising in prediction of the prognosis of patients with stage II and III colorectal carcinoma. However, whether it can be used as a marker in prognosis judgment needs further investigation.

Safety and efficacy of therapeutic endoscopic retrograde cholangiopancreatography for patients over 90 years of age.

AIMS: This study aimed to explore the safety and efficacy of endoscopic retrograde cholangiopancreatography (ERCP) in patients over 90 years of age. METHODS: The study included 176 patients aged over 85 years who received their ERCP from February 2002 to January 2021. In the case group (super-elderly group), 44 patients were 90 years old or above. In the control group (younger group), there were 132 patients aged 85-89 years. The control group was matched according to patient gender and the same indications of ERCP at a 1:3 ratio. Logistic regression models were employed to evaluate all complications. RESULTS: The case group had higher acute physiology and chronic health evaluation scoring system (APACHE-II) scores and rate of hypoalbuminemia. APACHE-II scores (≥6 or 7) were significantly more common in the case group. The rates of technical success and complete success in the case group were 100% and 100% respectively, which were similar to the rates in the control group, namely a technical success rate of 98.5% and a complete success rate of 98.5%. The rate of complication in the case group was 9.1%, which was slightly lower than that of the control group (15.2%, P > 0.05). ERCP-related death occurred in one patient in the control group, who had malignant biliary obstruction and died from cholangitis. There was no significant difference in the incidence of complications such as pancreatitis, hemorrhage, and infection between the two groups. In the multivariate analysis, the independent risk factor was Charlson Comorbidity Index (CCI) for overall complication. CONCLUSIONS: ERCP can be performed safely and successfully in patients aged ≥90 years. Geriatr Gerontol Int 2022; 22: 50-55.

Risk factors for complications in elderly patients aged 85 years and over undergoing endoscopic biliary stone removal.

Background and aim: The number of elderly patients with biliary stones is increasing. Endoscopic retrograde cholangiography (ERCP) is considered to be an effective treatment for biliary stones. Having a sound knowledge of the risk factors can help reduce the incidence and severity of complications for ERCP. Furthermore, limited research has been published on patients aged over 85 years undergoing endoscopic biliary stone removal. This study aims to determine the risk factors that lead to complications of ERCP in patients over 85 years of age. Methods: This was a single-center retrospective study. We analyzed 156 patients aged ≥ 85 years with biliary stones who underwent their first ERCP at Chinese PLA General Hospital from February 2002 to March 2021. Logistic regression models were employed to identify the independent risk factors for complications. Results: A total of 13 patients (8.3%) had complications. Thereinto, pancreatitis, cholangitis, bleeding, and other complications occurred in 4 cases (2.6%), 1 cases (0.6%), 4 cases (2.6%), and 4 cases (2.6%), respectively. There was no perforation or death related to ERCP. Independent risk factors for complications were acute biliary pancreatitis (ABP) (P = 0.017) and Charlson Comorbidity Index (CCI) (P = 0.019). Significantly, reasons for incomplete stone removal at once were large stone (>10 mm) (P < 0.001) and higher acute physiology and chronic health evaluation scoring system (APACHE-II) (P = 0.005). Conclusions: ERCP was recommended with caution in patients ≥ 85 years of age with ABP or higher CCI undergoing endoscopic biliary stone removal. In patients with ABP without cholangitis or biliary obstruction we recommend against urgent (within 48 h) ERCP. Patients with higher CCI who can tolerate ERCP can undergo rapid ERCP biliary stenting or nasobiliary implantation with later treatment of stones, and patients who cannot tolerate ERCP are treated promptly with PTCD and aggressive conservative treatment.

Intense boundary emission destroys normal radio-frequency plasma sheath.

The plasma sheath is the non-neutral space charge region that isolates bulk plasma from a boundary. Radio-frequency (RF) sheaths are formed when applying RF voltage to electrodes. Generally, applied bias is mainly consumed by a RF sheath, which shields an external field. Here we report evidence that an intense boundary emission destroys a normal RF sheath and establishes a type of RF plasma where external bias is consumed by bulk plasma instead of a sheath. Ions are naturally confined while plasma electrons are unobstructed, generating a strong RF current in the entire plasma, combined with a unique particle and energy balance. The proposed model offers the possibility for ion erosion mitigation of a plasma-facing component. It also inspires techniques for reaction rate control in plasma processing and wave mode conversion.

UV-cured nanocomposite coating for surface charging mitigation and breakdown strength enhancement: exploring the combination of surface topographical structure and perfluorooctyl chain.

A facile method using a nanocomposite coating is proposed to suppress surface charge accumulation and enhance the surface breakdown strength of polymeric insulating materials like epoxy resin, by covering a thin 1,1,2,2-tetrahydroperfluorodecyltrimethoxysilane modified alumina (Al2O3) flake/UV curable resin nanocomposite coating. Due to the peculiar characteristics of perfluorooctyl chains at the microscale and the intricate topographical structure of morphology at the mesoscale, the coating exhibits enhanced water/oil repellence, surface charge accumulation resistance, and flashover withstanding capability. It is found that increasing the content of modified Al2O3 is conducive to decreasing the surface free energy of the specimens, rendering them superhydrophobic. Experimental tests in air show that the presence of nanoparticles generates numerous carrier traps at the surface layer, contributing to a much faster charge decay rate. Furthermore, impulse flashover voltage tests under vacuum show a >100% improvement of surface electrical strength. Further experimental results reveal that lower secondary electron emission yield remarkably alleviates the surface charging phenomenon, thus relieving electric field distortion caused by hetero-charges. We envision that such a multifunctional strategy for surface discharge mitigation is efficient, adaptable and easy to scale up, and thereby exhibits great prospects for applications in electronics and electrical power systems.

Recycling experimental investigation on end of life photovoltaic panels by application of high voltage fragmentation.

With the rapid development of photovoltaic industry, the recycling of waste solar photovoltaic (PV) panels is becoming a critical and global challenge. Considering PV panels recycling is significantly effective and worthwhile to save natural resources and reduce the cost of production, how to selectively recycle valuable components of PV panels is the hot and dominant topic. Different from current mechanical crushing, heat treatment and chemical operation processes, novel and environment-friendly recycling approaches by using high voltage pulse discharge in water, called high voltage fragmentation (HVF), was discussed under different discharge conditions. The results showed that discharging across surface and interior of PV panels produced ablation round holes, sputter metal particles and dendritic channels. The average particle size decreased with the ascent of pulse number and voltage amplitude. Considering the energy consumption, the optimal condition of HVF in this paper was 160 kV for 300 pulses with the energy consumption of 192.99 J/g, crushing the PV panels into particles of 4.1 mm in average (13.7% of the initial size). More particle was distributed among the 0.1-2 mm size fractions as the energy increased. Selective fragmented products, such as Cu, Al, Pb, Ag and Sn, are concentrated on the fractions under 1 mm. Finally, hybrid crushing energy consumption model combined with fractal theory was discussed, which presented close relationship between energy and average particle size. Walker's model (n = 2.047 determined by fractal theory) had the best fitting effect.

[Clinicopathological analysis and differential diagnosis of primary peritoneal adenocarcinoma].

OBJECTIVE: To investigate the clinicopathological characteristics and differential diagnosis of primary peritoneal adenocarcinoma. METHODS: The clinico-pathological data of 8 patients with primary peritoneal adenocarcinoma, all female, aged 55.7 (45 - 69), were analyzed retrospectively. Immunohistochemistry was used to detect the expression of pan-cytokine, cytokine (CK) 7, CK20, CA125, CEA, epithelial membrane antigen (EMA), vimentin, calretinin, and P63 in the specimens of tumor obtained during tumor reduction surgery. Microscopy was conducted for pathological examination. RESULTS: The common clinical symptoms of these 8 patients included abdominal distention and ascites. Pre-operationally, 6 cases were diagnosed as with ovarian cancer, I case as with malignant mesothelioma, and I as with peritoneal carcinoma. The misdiagnosis rate was 87.5%. Post-operational pathological examination showed 7 cases of serous papillary adenocarcinoma and one case of mucinous adenocarcinoma. Immunohistochemistry showed the positive rates of the different biological markers as follows: pan-CK (8/8), CK7 (8/8), CK20 (1/8), CA125 (7/8), CEA (7/8), EMA (8/8), vimentin (1/8), calretinin (1/8), and P53 (8/8). CONCLUSION: A rare malignant tumor arising from the secondary Müllerian system, primary peritoneal adenocarcinoma shares similar histopathological characters with ovary carcinoma, so is easy to be misdiagnosed. Immunohistochemical staining is helpful to the differential diagnosis.

Who benefits from R0 resection? A single-center analysis of patients with stage â £ gallbladder cancer.

OBJECTIVES: Most patients with gallbladder cancer (GBC) present with advanced-stage disease and have a poor prognosis. Radical resection remains the only therapeutic option to improve survival in patients with GBC. This study aimed to analyze the prognostic factors in patients with stage Ⅳ GBC and to identify a subgroup of patients who might benefit from R0 resection. METHODS: A total of 285 patients with stage Ⅳ GBC were retrospectively analyzed at our institution from January 2008 to December 2012. Factors potentially influencing the prognosis of GBC after surgery were analyzed by univariate and multivariate analyses. RESULTS: The 1-, 3-, and 5-year overall survival rates were 6.6% (15/229), 0.9% (2/229), and 0 (0/229), respectively. Ascites (relative risk [RR] = 1.631, 95% confidence interval [CI]: 1.221-2.180, P = 0.001), pathological grade (RR = 1.337, 95% CI: 1.050-1.702, P = 0.018), T stage (RR = 1.421, 95% CI: 1.099-1.837, P = 0.000), M stage (RR = 1.896, 95% CI: 1.409-2.552, P = 0.000), and surgery (RR = 1.542, 95% CI: 1.022-2.327, P = 0.039) were identified as independent risk factors influencing prognosis. The median survival time (MST) was significantly higher in patients undergoing R0 resection than in those undergoing R1/R2 resection (6.0 vs. 2.7 months; P < 0.001). In subgroup analyses, stage ⅣA patients benefited from R0 resection (MST for R0 vs. R1/R2, 11.0 vs. 4.0 months; P = 0.003), while R0 resection had a significant survival benefit than R1/R2 resection in patient with stage ⅣB GBC without distant metastasis (MST for R0 vs. R1/R2, 6.0 vs. 3.0 months; P = 0.007). CONCLUSION: Ascites, pathological grade, T stage, M stage, and surgery were independent risk factors influencing prognosis in patients with stage IV GBC. N2 lymph node metastasis did not preclude curative resection, and radical resection should be considered in patients with stage Ⅳ GBC without distant metastasis once R0 margin was achieved.

Low-temperature Plasma Promotes Fibroblast Proliferation in Wound Healing by ROS-activated NF-κB Signaling Pathway.

Low-temperature plasma (LTP) has shown great promise in wound healing, although the underlying mechanism remains poorly understood. In the present study, an argon atmospheric pressure plasma jet was employed to treat L929 murine fibroblasts cultured in vitro and skin wounds in BALB/c mice. The in vitro analysis revealed that treatment of fibroblasts with LTP for 15 s resulted in a significant increase in cell proliferation, secretion of epidermal growth factor (EGF) and transforming growth factor-ßi (TGF-ßi), production of intracellular reactive oxygen species (ROS), and the percentage of cells in S phase, protein expression of phosphorylated p65 (P-p65) and cyclinD1, but a noted decrease in the protein expression of inhibitor kappa B (IκB). The in vitro experiments demonstrated that 30-s LTP treatment enhanced the number of fibroblasts and the ability of collagen synthesis, while 50-s treatment led to the opposite outcomes. These results suggested that LTP treatment promotes the fibroblast proliferation in wound healing by inducing the generation of ROS, upregulating the expression of P-p65, downregulating the expression of IκB, and activating the NF-κB signaling pathway and consequently altering cell cycle progression (increased DNA synthesis in S phage).

Low temperature plasma promoting fibroblast proliferation by activating the NF-κB pathway and increasing cyclinD1 expression.

The potential applications of low temperature plasma (LTP) in wound healing have aroused the concern of many researchers. In this study, an argon atmospheric pressure plasma jet was applied to generate LTP for treatment of murine fibroblast cell (L929) cultured in vitro to investigate the effect of NF-κB pathway on fibroblast proliferation. The results showed that, compared with the control, L929 cells treated with plasma for less than 20 s had significant increases of proliferation; the productions of intracellular ROS, O2- and NO increased with prolongation of LTP treatment time; NF-κB pathway was activated by LTP in a proper dose range, and the expression of cyclinD1 in LTP-treated cells increased with the same trend as cell proliferation. After RNA interference to block p65 expression, with the same treatment time, RNAi-treated cells proliferated more slowly and expressed less cyclinD1 than normal cells. Furthermore, pretreatment with N-acetyl-L-cysteine (NAC) markedly prevented the plasma-induced changes in cells. In conclusion, the proliferation of L929 cells induced by LTP was closely related to NF-κB signaling pathway, which might be activated by appropriate level of intracellular ROS. These novel findings can provide some theoretical reference of LTP inducing cell proliferation and promoting wound healing.

Clinical epidemiological survey of gallbladder carcinoma in northwestern China, 2009-2013: 2379 cases in 17 centers.

OBJECTIVE: To analyze the clinical epidemiological characteristics of patients with gallbladder carcinoma recruited from 17 hospitals in five northwestern provinces of China (Shaanxi Province, Gansu Province, Qinghai Province, Ningxia Hui Autonomous Region, and Xinjiang Uygur Autonomous Region) from 2009 to 2013, and to summarize the clinical diagnosis and treatment data of gallbladder carcinoma. METHODS: Clinical information of 2379 patients with gallbladder carcinoma from 17 hospitals in five northwestern provinces of China was retrospectively collected and analyzed using the "Questionnaire for Gallbladder Carcinoma Patients in Northwestern Area of China." All information was verified with EpiData software and analyzed with SPSS 13.0 software. RESULTS: (1) Gallbladder carcinoma accounted for 2.7% (2379/86,609) of all biliary tract diseases during the study period, which was significantly higher than that from 1986 to 1998 (P < 0.001). (2) Gallbladder carcinoma was more prone to occur in elderly women. The male:female incidence ratio was 1.0:2.1, the average age of onset of disease was 63.7 ± 11.3 years, and the incidence was higher in farmers than in other occupational groups. (3) A total of 57.2% (1360/2379) of patients with gallbladder carcinoma also had gallstones. (4) Abdominal pain (1796/2379, 75.5%) and jaundice (727/2379, 30.6%) were the most common clinical manifestations, 81.2% (1527/1881) were positive in those receiving B ultrasound examinations and 90.7% (1567/1727) were positive in those undergoing computed tomography, and 64.5% (1124/1742) of patients with gallbladder carcinoma were positive for carbohydrate antigen (CA) 19-9. (5) The pathological type of gallbladder carcinoma was mainly moderately and poorly differentiated adenocarcinoma with a high degree of malignancy. At admission, 55.1% (1091/1981) of patients had stage IV cancer among patients with TNM staging information; 55.9% (1331/2379) had lymphatic metastasis, 29.7% (706/2379) had bile duct metastasis, and 53.1% (1263/2379) had liver metastasis. (6) A total of 283 patients (283/2379, 11.9%) had incidentally detected gallbladder carcinoma. (7) The rate of radical surgical resection was 30.4% (723/2379). CONCLUSION: The proportion of gallbladder carcinoma in biliary tract diseases in the northwestern area of China was significantly higher from 2009 to 2013 than from 1986 to 1998. Gallbladder carcinoma was common in older women and mainly diagnosed at an advanced stage. Compared with other surveys in different regions, the rate of metastasis in this survey was high, leading to a low resection rate. Populations at high risk should undergo B-ultrasound examinations at regular follow-up intervals to increase the rate of early diagnosis of gallbladder carcinoma.

[The mechanism of irbesartan against diabetes induced myocardial fibrosis in rat model].

OBJECTIVE: To observe the protective effect of irbesartan on myocardial fibrosis in diabetic rats, and analyze the role of extracellular signal-regulated kinase (ERK) pathway in this protection. METHODS: Thirty two male SD rats were randomly divided into two groups:normal control group (CON, n=10), experimental group (n=22). Twenty diabetic rats which had modelled successfully were randomly divided into two groups:diabetic group (DM, n=10), irbesartan + DM group (Ir+DM, n=10). After 8 weeks, fasting blood glucose (FBG) level, body weight (BW), the ratio of heart weight/body weight (H/B) and left ventricular weight index (LVWI) were measured. The myocardial morphological and fibrotic changes were observed by Masson staining. Col I and col Ⅲ contents were evaluated using ELISA method, and the protein expressions of ERK1/2, p-ERK1/2 in heart tissue were tested by Western blot. RESULTS: Compared with CON group, in diabetic rats, the levels of FBG, H/B and LVWI were increased while BW was decreased. The contents of col I and col Ⅲ were increased as well as the protein expression of p-ERK1/2 and the ratio of p-ERK1/2/ERK1/2(P<0.05,P<0.01), which had the statistic differences, while ERK1/2 protein expression was not changed. Masson staining showed myocardial collagen was increased, arranged in disorder and uneven distribution. However, in Ir+ DM group, BW was increased obviously, H/B, LVWI, the contents of col I and col Ⅲ were decreased significantly (P<0.05,P<0.01), p-ERK1/2 protein expression and the ratio of p-ERK1/2/ERK1/2 were decreased (P<0.01), which had the statistic differences. Meanwhile myocardial morphology was improved significantly. CONCLUSIONS: Diabetes can induce the happening of myocardial fibrosis, and irbesartan can induce the damage of myocardial fibrosis through inhibitting the activation of ERK.

An optimized micro-assay of myosin II ATPase activity based on the molybdenum blue method and its application in screening natural product inhibitors.

Myosin II plays multiple roles in physiological and pathological functions through its ATPase activity. The present study was designed to optimize a micro-assay of myosin II ATPase activity based on molybdenum blue method, using a known myosin II ATPase inhibitor, blebbistatin. Several parameters were observed in the enzymatic reaction procedure, including the concentrations of the substrate (ATP) and calcium chloride, pH, and the reaction and incubation times. The proportion of coloration agent was also investigated. The sensitivity of this assay was compared with the malachite green method and bioluminescence method. Additionally, 20 natural compounds were studied for myosin II ATPase inhibitory activity using the optimized method. Our results showed that ATP at the concentration of 5 mmol·L(-1) and ammonium molybdate : stannous chloride at the ratio of 15 : 1 could greatly improve the sensitivity of this method. The IC50 of blebbistatin obtained by this method was consistent with literature. Compound 8 was screened with inhibitory activity on myosin II ATPase. The optimized method showed similar accuracy, lower detecting limit, and wider linear range, which could be a promising approach to screening myosin II ATPase inhibitors in vitro.