Characteristics of four-limb blood pressure and brachial-ankle pulse wave velocity in Chinese patients with Takayasu arteritis.

Purpose: Takayasu arteritis (TA) is a rare disease, which is frequently misdiagnosed or its diagnosis can be missed. This study aimed to analyse the characteristics of four-limb blood pressure (4LBP) and brachial-ankle pulse wave velocity (baPWV) in patients with TA, which could be useful in disease detection.Materials and Methods: We consecutively enrolled 182 patients with TA at Fuwai Hospital between January 2013 and January 2016. Pulse pressure (PP), pulsatile index (PI), inter-arm systolic blood pressure (SBP) difference (IASBPD), inter-leg SBP difference (ILSBPD), ankle-brachial index (ABI), baPWV, and inter-side baPWV difference (ΔbaPWV) were analysed and compared with those of age-, sex-, and SBP-matched participants without cardiovascular diseases.Results: In the TA group, the diastolic blood pressure was lower (67.4 ± 23.7 vs 84.1 ± 15.0 mmHg), PP was larger (69.7 ± 23.6 vs 53.7 ± 10.6 mmHg), PI was higher (1.3 ± 2.1 vs. 0.6 ± 0.1 mmHg), IASBPD was larger (18.2 ± 24.1 vs 4.2 ± 3.3 mmHg), and ILSBPD was larger (10.7 ± 15.0 vs 5.3 ± 4.1 mmHg) than those of the controls (all p < 0.01). Moreover, the proportions of PP >70 mmHg (36.8% vs 4.4%), PI > 1.0 (40.1% vs 2.2%), IASBPD >15 mmHg (34.6% vs. 0%), highest ABI >1.4 (17.6% vs. 0%), ILSBPD >15 mmHg (14.8% vs. 3.3%), lowest ABI < 0.9 (24.7% vs 2.2%), and ΔbaPWV > 185 cm/s (28.6% vs. 1.1%) were significantly greater in the TA group than in the control group (all p < 0.01). Approximately 80.8% of patients with TA (vs. 10.4% of controls) presented with at least one of these seven parameters (p = 0.000).Conclusion: The characteristics of 4LBP and baPWV in most patients with TA were abnormal, which helped us perform non-invasive primary screening and comprehensive evaluation of vascular lesions in such patients.

In daily life, many people measure the blood pressure of the arm but measuring the blood pressure of a single arm is inadequate because some hypertension and vascular diseases cannot be detected this way. Synchronous limb blood pressure measurements may be used to close this gap. Measuring synchronous limb blood pressure is very convenient and helps patients understand the value of limb blood pressure and examine many other useful parameters, such as the blood pressure differences between the two arms and two legs, as well as the ankle arm index. These values and derived parameters can also help detect many vascular diseases.Takayasu arteritis is a rare disease in young women. However, the aorta and branches of these patients are narrow or occluded. Patients often experience vague and ambiguous symptoms, such as hypertension or dizziness, so they are likely to be overlooked or misdiagnosed.Our study summarises the results of synchronous limb blood pressure measurements in patients with Takayasu arteritis and compares their results with those of a control population. Synchronous limb blood pressure measurements are easy and convenient and can detect vascular problems, which may improve the ability to diagnose Takayasu arteritis.

Protection against alcohol-induced neuronal and cognitive damage by the PPARγ receptor agonist pioglitazone.

Binge alcohol drinking has emerged as a typical phenomenon in young people. This pattern of drinking, repeatedly leading to extremely high blood and brain alcohol levels and intoxication is associated with severe risks of neurodegeneration and cognitive damage. Mechanisms involved in excitotoxicity and neuroinflammation are pivotal elements in alcohol-induced neurotoxicity. Evidence has demonstrated that PPARγ receptor activation shows anti-inflammatory and neuroprotective properties. Here we examine whether treatment with the PPARγ agonist pioglitazone is beneficial in counteracting neurodegeneration, neuroinflammation and cognitive damage produced by binge alcohol intoxication. Adult Wistar rats were subjected to a 4-day binge intoxication procedure, which is commonly used to model excessive alcohol consumption in humans. Across the 4-day period, pioglitazone (0, 30, 60mg/kg) was administered orally twice daily at 12-h intervals. Degenerative cells were detected by fluoro-jade B (FJ-B) immunostaining in brain regions where expression of pro-inflammatory cytokines was also determined. The effects of pioglitazone on cognitive function were assessed in an operant reversal learning task and the Morris water maze task. Binge alcohol exposure produced selective neuronal degeneration in the hippocampal dentate gyrus and the adjacent entorhinal cortex. Pioglitazone reduced FJ-B positive cells in both regions and prevented alcohol-induced expression of pro-inflammatory cytokines. Pioglitazone also rescued alcohol-impaired reversal learning in the operant task and spatial learning deficits in the Morris water maze. These findings demonstrate that activation of PPARγ protects against neuronal and cognitive degeneration elicited by binge alcohol exposure. The protective effect of PPARγ agonist appears to be linked to inhibition of pro-inflammatory cytokines.

Neoadjuvant chemotherapy for nonmetastatic esophago-gastric adenocarcinomas: a systematic review and meta-analysis.

OBJECTIVE: A systematic review and meta-analysis was performed to investigate the efficacy of neoadjuvant chemotherapy for nonmetastatic esophago-gastric adenocarcinomas. METHODS: Electronic databases were searched systematically from January 1980 to July 2012 and a total of 2,587 patients from 17 randomized controlled trials were subjected to meta-analysis. The odds ratios (ORs) for overall survival (OS) and progression-free survival (PFS) were calculated. RESULTS: Seventeen randomized controlled trials were obtained and various comparisons of treatment approaches were performed. Randomized controlled trials detected no differences in these comparisons: R0 resection for neoadjuvant chemotherapy versus none; Preoperative chemotherapy versus surgery alone: 3-year OS, 5-year OS, 5-year OS in Europe, 3-year PFS; Preoperative chemotherapy plus postoperative chemotherapy versus postoperative chemotherapy: 1-year OS, 5-year OS; Preoperative chemotherapy versus preoperative chemoradiotherapy: 3-year OS. Randomized controlled trials detected significant differences in these comparisons: Preoperative chemotherapy plus postoperative chemotherapy versus surgery alone: 3-year and 5-year PFS, 5-year OS; Subgroup analysis examining preoperative chemotherapy versus surgery alone: 5-year OS in Asia; Preoperative chemotherapy versus postoperative chemotherapy: 1-year OS. CONCLUSION: The current limited evidence suggests that preoperative chemotherapy can be applied to patients with nonmetastatic esophago-gastric adenocarcinomas (specifically, advanced esophago-gastric cancer). However, the results should be interpreted with caution because of the statistically low power and the heterogeneity among study designs; therefore, our results need validations in future studies.

Colony Stimulating Factor-1 and its Receptor in Gastrointestinal Malignant Tumors.

Gastrointestinal malignant tumor is the fourth most common cancer in the world and the second cause of cancer death. Due to the susceptibility to lymphatic metastasis and liver metastasis, the prognosis of advanced tumor patients is still poor till now. With the development of tumor molecular biology, the tumor microenvironment and the cytokines, which are closely related to the proliferation, infiltration and metastasis, have become a research hotspot in life sciences. Colony stimulating factor-1 (CSF-1), a polypeptide chain cytokine, and its receptor CSF-1R are reported to play important roles in regulating tumor-associated macrophages in tumor microenvironment and participating in the occurrence and development in diversities of cancers. Targeted inhibition of the CSF-1/CSF-1R signal axis has broad application prospects in cancer immunotherapy. Here, we reviewed the biological characters of CSF-1/CSF-1R and their relationship with gastrointestinal malignancies.

Proteomic analysis of human lens epithelial cells exposed to microwaves.

PURPOSE: To study proteomic changes in human lens epithelial cells (HLECs) exposed to 1800-MHz Global System for Mobile Communication (GSM)-like microwaves. METHODS: In three separate experiments, HLECs were exposed and sham-exposed (six dishes each) to 1800-MHz GSM-like radiation for 2 h. The specific absorption rates were 1.0, 2.0, or 3.5 W/kg. Immediately after radiation, the proteome was extracted from the HLECs. Immobilized pH gradient two-dimensional polyacrylamide gel electrophoresis(2-DE; silver staining) and PDQuest 2-DE analysis software were used to separate and analyze the proteome of exposed and sham-exposed HLECs. Four differentially expressed protein spots were selected and identified by using electrospray ionization tandem mass spectrometry (ESI-MS-MS). RESULTS: When the protein profiles of exposed cells were compared with those of sham-exposed cells, four proteins were detected as upregulated. After analysis by ESI-MS-MS and through a database search, heat-shock protein (HSP) 70 and heterogeneous nuclear ribonucleoprotein K (hnRNP K) were determined to be upregulated in the exposed cells. CONCLUSIONS: Two-dimensional polyacrylamide gel electrophoresis combined with mass spectrometry may be a powerful tool for screening potential electromagnetic-reaction protein markers. HSP70 and hnRNP K are involved in the stress reaction of HLECs exposed to microwaves. These cell responses are nonthermal effects of the electromagnetic field.

[Hydrogen peroxide (H2O2) and methyl-beta-cyclodextrin (MPCD) down regulate caveolin expression in human lens epithelial cells (HLECs)].

Oxidative stimulation induced by hydrogen peroxide (H2O2) on human epithelial cells (HLECs) was performed to observe the effects on cell viability, caveolin expression, and cholesterol depletion in HLECs caused by methyl-beta-cyclodextrin (MbetaCD) was also studied. SRA01/04 HLECs were exposed to H2O2 or MbetaCD of various concentrations and durations. We used a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay to measure the effect of H2O2 on the viability of SRA01/04 HLECs. The distributions of caveolins after oxidative stimulation were probed by fluorescence microscopy and laser scanning confocal microscopy. Immunoblotting was performed to analyze alterations of caveolins expression. We observed that the viability of SRA01/04 HLECs under 0.1 mM H2O2 for 10 min or longer was significantly reduced (*p < 0.05, F = 11.63). Laser scanning microscopy showed immunofluorescent caveolins in SRA01/04 HLECs under 0.1 mM H2O2 for 10 min or longer, caveolins were largely confined to intracellular domains. Western blots showed both membrane and total caveolin protein (22 kDa) levels in SRA01/04 HLECs treated with 0.1, 0.2, 0.5 or 1.0 mM H2O2 for 30 min were significantly reduced, compared with the untreated (*p < 0.05, F = 6.149, or *p < 0.05, F = 14.489 respectively). In addition, the membrane and total caveolin protein level after treated with 0.1 mM (*p < 0.05, F = 6.843, or *p < 0.05, F = 7.944 respectively) H2O2 for different durations also down regulated. Fluorescence microscopy also showed that phosphorylated caveolin-1 was distributed near the focal adhesions of the cells. This study concludes that the responses of HLECs to oxidative stress may include down regulation of caveolin and phosphorylation of caveolin-1 on Tyr14, and that MbetaCD also down regulates caveolin while depleting cholesterol in HLECs.

[Clinical characteristics of angina pectoris in patients of coronary artery disease complicated with renal stenosis and the diagnostic value thereof: analysis of 2820 cases].

OBJECTIVE: To analyze the characteristics of angina symptom complex of patients with coronary artery disease (CAD) complicated with renal stenosis, and to analyze their sensitivity and specificity of angina symptom complex for the diagnosis of CAD. METHODS: The medical records of 2820 in-hospital patients who underwent coronary angiography and renal angiography simultaneously during the period from Jan 1998 to May 2005 and could be diagnosed as with CAD or renal stenosis with the stenotic degree more than 50% of the coronary or renal artery in angiography, were analyzed. The diagnosis of CAD was based on the 3 groups of symptoms recommended by American College of Cardiology/American Heart Association: (1) substernal chest discomfort with a characteristic quality and duration, (2) chest pain provoked by exertion or emotional stress, and (3) chest pain that can be relieved by rest or nitroglycerin. RESULTS: 243 of the 2820 patients had renal stenosis and 2577 of the 2820 patient did not have renal stenosis. The prevalence rates of CAD and hypertension were higher in the renal stenosis group and in the patients without renal stenosis. To diagnose CAD with any one of the 3 groups of above mentioned angina symptom complex, the sensitivity rates were 94.2%, 69.7%, and 75.5% respectively, the specificity rates were 14.3%, 40.0%, and 25.7% respectively, the positive predictive values were 86.7%, 87.3%, and 85.8% respectively, and the negative predictive values were 29.4%, 18.2%, and 15.0% respectively. To diagnose CAD by the symptoms of groups (2) plus (3), (1) plus (2), and (1) plus (3) the sensitivity rates were 68.8%, 56.7%, and 72.6% respectively, specificity rate were 40.0%, 62.9%, and 45.7% respectively, positive predictive values were 87.2%, 90.1%, and 88.8% respectively, and negative predictive values were 17.7%, 19.6, and 21.9% respectively. To diagnose CAD based on all three groups of angina symptom complex, the sensitivity was 56.3%, specificity was 62.9%, positive predictive value was 90.0%, and negative predictive value was 19.5%. CONCLUSION: For detecting CAD based on one, two or three groups of angina symptom complex, there are not significant differences in the diagnostic sensitivity and specificity, however, the positive predictive value is greater and the negative predictive value is smaller in the patients with renal stenosis compared with those without renal stenosis.

[Experimental study on the effects of hydrogen peroxide on caveolin in human lens epithelial cells].

OBJECTIVE: To observe the expression and distribution of caveolin and phosphorylated caveolin-1 in human lens epithelial cells (HLECs) under H(2)O(2) treatment. METHODS: HLECs (SRA01/04) were exposed to different concentrations of H(2)O(2) for different periods of time. The distribution of caveolin and phosphorylated caveolin-1 in H(2)O(2) treated cells was observed by laser scanning confocal microscopy and fluorescence microscopy. Western blot was conducted to analyze the protein expression alterations of caveolin and caveolin-1 phosphorylation. RESULTS: HLECs contained abundant caveolin. Immunofluorescence image of caveolin in cytoplasm increased significantly in H(2)O(2) treated cells. One hour after H(2)O(2) treatment, the cells membranes began to break, whereas the immunofluorescence image of caveolin could still be observed. Caveolin-1 was phosphorylated on tyrosine 14 in HLECs after stimulation with H(2)O(2). Western blot analysis revealed that caveolin protein level was down regulated under H(2)O(2) stress. CONCLUSIONS: The caveolin is redistributed and the caveolae is destroyed in HLECs when stimulated by H(2)O(2). And the caveolin expression also down regulated by H(2)O(2) stimulation. Caveolae and caveolin are likely to play an important role in the HLECs.

Anterior transversalis fascia approach versus preperitoneal space approach for inguinal hernia repair in residents in northern China: study protocol for a prospective, multicentre, randomised, controlled trial.

INTRODUCTION: Many surgical techniques have been used to repair abdominal wall defects in the inguinal region based on the anatomic characteristics of this region and can be categorised as 'tension' repair or 'tension-free' repair. Tension-free repair is the preferred technique for inguinal hernia repair. Tension-free repair of inguinal hernia can be performed through either the anterior transversalis fascia approach or the preperitoneal space approach. There are few large sample, randomised controlled trials investigating the curative effects of the anterior transversalis fascia approach versus the preperitoneal space approach for inguinal hernia repair in patients in northern China. METHODS AND ANALYSIS: This will be a prospective, large sample, multicentre, randomised, controlled trial. Registration date is 1 December 2016. Actual study start date is 6 February 2017. Estimated study completion date is June 2020. A cohort of over 720 patients with inguinal hernias will be recruited from nine institutions in Liaoning Province, China. Patient randomisation will be stratified by centre to undergo inguinal hernia repair via the anterior transversalis fascia approach or the preperitoneal approach. Primary and secondary outcome assessments will be performed at baseline (prior to surgery), predischarge and at postoperative 1 week, 1 month, 3 months, 1 year and 2 years. The primary outcome is the incidence of postoperative chronic inguinal pain. The secondary outcome is postoperative complications (including rates of wound infection, haematoma, seroma and hernia recurrence). ETHICS AND DISSEMINATION: This trial will be conducted in accordance with the Declaration of Helsinki and supervised by the institutional review board of the Fourth Affiliated Hospital of China Medical University (approval number 2015-027). All patients will receive information about the trial in verbal and written forms and will give informed consent before enrolment. The results will be published in peer-reviewed journals or disseminated through conference presentations. TRIAL REGISTRATION NUMBER: NCT02984917; preresults.

[DNA damage and repair induced by acute exposure of microwave from mobile phone on cultured human lens epithelial cells].

OBJECTIVE: To investigate the effects of acute exposure of low-power 217 Hz modulated 1. 8 GHz microwave radiation on the DNA damage of human lens epithelial cells (hLECs) and repair. METHODS: Cultured hLECs were exposed to 217 Hz modulated 1. 8 GHz microwave radiation at SAR (specific absorption rate) of 1. 0, 2. 0, 3. O0 and 4. 0 W/kg for 2 hours in an sXc-1800 incubator and irradiate system, the DNA single strand breaks were detected with comet assay ( single-cell gel electrophoresis) in sham-irradiated cells and irradiated cells incubated for varying periods: 0, 30 and 60 minutes after irradiation. Images of comets were digitized and analyzed using an Imagine-pro plus software, and the indexes used in this study were tail length (TL) and tail moment (TM). BrdU was added into the medium with additional one hour incubation after radiation, the cell proliferation rate was determined using a BrdU-kit. RESULTS: The difference of DNA-breaks between the exposure and sham exposure groups induced by 1.0 and 2.0 W/kg irradiation were not significant in each time points (P > 0.05) ; there were significant difference in both groups at the exposure dose of 3. 0 and 4. 0 W/kg immediately and at the time of 30 minutes after irradiation (P <0. 01) ; if the radiation exposure time was beyond one hour no differences were be able to detected in 3.0 W/kg group (P > 0. 05) compared with control, but the evidence of significant DNA damage still existed in 4. 0 W/kg group at the same time point. Cell proliferation rate had no significant difference when the application of SAR was < or = 3. 0 W/kg (P >0. 05) , however the cell proliferation was decreased significantly at the dose of 4. 0 W/kg irradiation ( P < 0. 01). CONCLUSIONS: No effective DNA damage was induced using comet assay after 2 hours irradiation of 1. 8 GHz microwave on hLECs at the dose SAR < or = 3.0 W/kg. 4.0 W/kg irradiation caused significantly DNA damage and inhibition of hLECs proliferation.

[Effect of acute exposure to microwave from mobile phone on DNA damage and repair of cultured human lens epithelial cells in vitro].

OBJECTIVE: To investigate the DNA damage of human lens epithelial cells (LECs) caused by acute exposure to low-power 217 Hz modulated 1.8 GHz microwave radiation and DNA repair. METHODS: Cultured LECs were exposed to 217 Hz modulated 1.8 GHz microwave radiation at SAR (specific absorption rate) of 0, 1, 2, 3 and 4 W/kg for 2 hours in an sXc-1800 incubator and irradiate system. The DNA single strand breaks were detected with comet assay in sham-irradiated cells and irradiated cells incubated for varying periods: 0, 30, 60, 120 and 240 min after irradiation. Images of comets were digitized and analyzed using an Imagine-pro plus software, and the indexes used in this study were tail length (TL) and tail moment (TM). RESULTS: The difference in DNA-breaks between the exposure and sham exposure groups induced by 1 and 2 W/kg irradiation was not significant at every detect time (P > 0.05). As for the dosage of 3 and 4 W/kg there was difference in both group immediately after irradiation (P < 0.01). At the time of 30 min after irradiation the difference went on at both group (P < 0.01). However, the difference disappeared after one hour's incubation in 3 W/kg group (P > 0.05), and existed in 4 W/kg group. CONCLUSION: No or repairable DNA damage was observed after 2 hour irradiation of 1.8 GHz microwave on LECs when SAR < or = 3 W/kg. The DNA damages caused by 4 W/kg irradiation were irreversible.

Neuropeptide S differently modulates alcohol-related behaviors in alcohol-preferring and non-preferring rats.

RATIONALE: Neuropeptide S (NPS) displays unique pharmacological properties and induces both anxiolytic and pro-stress/arousal activities. Previous studies performed using Wistar rats demonstrated that NPS facilitated alcohol and cocaine seeking but did not affect alcohol or cocaine consumption. OBJECTIVES: Here, we investigated the effects of NPS in Marchigian Sardinian alcohol-preferring (msP) rats, a rat strain characterized by excessive alcohol consumption comorbid with heightened anxiety and depressive-like phenotypes. Specifically, we evaluated the effect of NPS on operant alcohol self-administration by msP rats compared to Wistar rats. The effect of NPS on cue-induced reinstatement of alcohol seeking in msP rats was also evaluated. Finally, using the open field test (OFT) and the elevated plus maze (EPM), we evaluated the effects of NPS on locomotor activity and anxiety. RESULTS: NPS reduced alcohol self-administration but did not affect cue-induced reinstatement in the msP rat. In addition, NPS induced reinstatement of extinguished alcohol seeking in Wistar rats without affecting alcohol intake. In the EPM task, NPS, in accordance with its anxiolytic activity, increased the time spent in the open arm of the arena by msP rats, although this effect was not observed in Wistar rats. CONCLUSIONS: These data suggest that the effect of NPS is strongly influenced by the genetic background of the animal. In Wistar rats, NPS acts as a pro-arousal agent to promote the reinstatement of alcohol seeking. However, when alcohol drinking is motivated by or associated with a state of pathological anxiety, NPS attenuates alcohol consumption and seeking due to its anxiolytic activity.

Effects of hepatocyte growth factor/scatter factor on the invasion of colorectal cancer cells in vitro.

AIM: Hepatocyte growth factor (HGF) is a multifunctional growth factor which has pleiotrophic biological effects on epithelial cells, such as proliferation, motogenesis, invasiveness and morphogenesis. There are few reports about the role of HGF played in the colorectal cancer invasion. In the present study, we tried to investigate the possible mechanism of HGF involved in the invasion of colorectal cancer cells in vitro. METHODS: Matrigel migration assay was used to analyze the migrational ability of Caco-2 and Colo320 in vitro. We detected the mRNA expressive levels of MMP-2, MMP-9 and their natural inhibitors TIMP-1, TIMP-2 in Caco-2 cells by reverse-transcription polymerase chain reaction (PCR) technique. RESULTS: After 48 h incubation, there were notable differences when we compared the migrational numbers of Caco-2 cells in the group of HGF and PD98059 (the inhibitor of p42/p44MAPK) with the control (104.40+/-4.77 vs 126.80+/-5.40, t = 7.17, P = 0.002<0.01; 104.40+/-4.77 vs 82.80+/-4.15, t = 7.96, P = 0.001<0.01). The deviation between the HGF and PD98059 was significant (P<0.01). Compared with controls, MMP-2 and MMP-9 mRNA expressions were up-regulated by HGF (0.997+/-0.011 vs 1.207+/-0.003, t = 35.002,P = 0.001<0.01; 0.387+/-0.128 vs 0.971+/-0.147, t = 106.036, P = 0.0000<0.01, respectively); compared with controls, TIMP-1, TIMP-2 mRNA expressions were increased by PD98059 (1.344+/-0.007 vs 1.905+/-0.049, t = 17.541, P = 0.003<0.01; 1.286+/-0.020 vs 1.887+/-0.022,t = 24.623, P = 0.002<0.01, respectively). CONCLUSION: HGF promoted Caco-2 migration mainly by p42/p44MAPK pathway; HGF/SF stimulated the expression of MMP-2, MMP-9 in Caco-2 and enabled tumoral cells to damage the ECM and reach the distant organ and develop metastasis; HGF played the function of promoted-invasion and promoted-metastasis, in which cellular selection was possible.

PPARγ activation attenuates opioid consumption and modulates mesolimbic dopamine transmission.

PPARγ is one of the three isoforms identified for the peroxisome proliferator-activated receptors (PPARs) and is the receptor for the thiazolidinedione class of anti-diabetic medications including pioglitazone. PPARγ has been long studied for its role in adipogenesis and glucose metabolism, but the discovery of the localization in ventral tegmental area (VTA) neurons opens new vistas for a potential role in the regulation of reward processing and motivated behavior in drug addiction. Here, we demonstrate that activation of PPARγ by pioglitazone reduces the motivation for heroin and attenuates its rewarding properties. These effects are associated with a marked reduction of heroin-induced increase in phosphorylation of DARPP-32 protein in the nucleus accumbens (NAc) and with a marked and selective reduction of acute heroin-induced elevation of extracellular dopamine (DA) levels in the NAc shell, as measured by in vivo microdialysis. Through ex vivo electrophysiology in acute midbrain slices, we also show that stimulation of PPARγ attenuates opioid-induced excitation of VTA DA neurons via reduction of presynaptic GABA release from the rostromedial tegmental nucleus (RMTg). Consistent with this finding, site-specific microinjection of pioglitazone into the RMTg but not into the VTA reduced heroin taking. Our data illustrate that activation of PPARγ may represent a new pharmacotherapeutic option for the treatment of opioid addiction.

Extended antimicrobial prophylaxis after gastric cancer surgery: a systematic review and meta-analysis.

AIM: To investigate the efficacy of extended antimicrobial prophylaxis (EAP) after gastrectomy by systematic review of literature and meta-analysis. METHODS: Electronic databases of PubMed, Embase, CINAHL, the Cochrane Database of Systematic Reviews, the Cochrane Controlled Trials Register and the China National Knowledge Infrastructure were searched systematically from January 1980 to October 2012. Strict literature retrieval and data extraction were carried out independently by two reviewers and meta-analyses were conducted using RevMan 5.0.2 with statistics tools risk ratios (RRs) and intention-to-treat analyses to evaluate the items of total complications, surgical site infection, incision infection, organ (or space) infection, remote site infection, anastomotic leakage (or dehiscence) and mortality. Fixed model or random model was selected accordingly and forest plot was conducted to display RR. Likewise, Cochrane Risk of Bias Tool was applied to evaluate the quality of randomized controlled trials (RCTs) included in this meta-analysis. RESULTS: A total of 1095 patients with gastric cancer were enrolled in four RCTs. No statistically significant differences were detected between EAP and intraoperative antimicrobial prophylaxis (IAP) in total complications (RR of 0.86, 95%CI: 0.63-1.16, P = 0.32), surgical site infection (RR of 1.97, 95%CI: 0.86-4.48, P = 0.11), incision infection (RR of 4.92, 95%CI: 0.58-41.66, P = 0.14), organ or space infection (RR of 1.55, 95%CI: 0.61-3.89, P = 0.36), anastomotic leakage or dehiscence (RR of 3.85, 95%CI: 0.64-23.17, P = 0.14) and mortality (RR of 1.14, 95%CI: 0.10-13.12; P = 0.92). Likewise, multiple-dose antimicrobial prophylaxis showed no difference compared with single-dose antimicrobial prophylaxis in surgical site infection (RR of 1.10, 95%CI: 0.62-1.93, P = 0.75). Nevertheless, EAP showed a decreased remote site infection rate compared with IAP alone (RR of 0.54, 95%CI: 0.34-0.86, P = 0.01), which is the only significant finding. Unfortunately, EAP did not decrease the incidence of surgical site infections after gastrectomy; likewise, multiple-dose antimicrobial prophylaxis failed to decrease the incidence of surgical site infection compared with single-dose antimicrobial prophylaxis. CONCLUSION: We recommend that EAP should not be used routinely after gastrectomy until more high-quality RCTs are available.

Hypothalamic neuropeptide S receptor blockade decreases discriminative cue-induced reinstatement of cocaine seeking in the rat.

RATIONALE: Previous studies have shown that activation of brain neuropeptide S receptor (NPSR) facilitates reinstatement of cocaine seeking elicited by environmental cues predictive of drug availability. This finding suggests the possibility that blockade of NPSR receptors may be of therapeutic benefit in cocaine addiction. To evaluate this hypothesis, we investigated the effect of two newly synthetized NPSR antagonists, namely the quinolinone-amide derivative NPSR-QA1 and the NPS peptidic analogue [D-Cys(tBu)5]NPS on cocaine self-administration and on discriminative cue-induced relapse to cocaine seeking in the rat. METHODS: Separate groups of rats self-administered food and cocaine 0.25 mg/kg/inf in FR1 and FR5 (fixed ratio reinforcement schedules) for 30-min and 2-h sessions per day. After food and cocaine intake reached baseline levels, the effect of NPSR-QA1 was tested on cocaine and food self-administration. The NPSR-QA1 was injected intraperitoneally and its effect on discriminative cue-induced reinstatement was evaluated, while [D-Cys(tBut)5]NPS was injected intracranially, intra-lateral hypothalamus, intra-perifornical area of the hypothalamus, and intra-central amygdala. The effect of the NPSR-QA1 on extinction of cocaine seeking was also assessed. RESULTS: Intraperitoneal administration of NPSR-QA1 (15-30 mg/kg) did not affect cocaine self-administration. Conversely, NPSR-QA1 (15-30 mg/kg) decreased discriminative cue-induced cocaine relapse. At the lowest dose, this effect was specific, while at the highest dose, NPSR-QA1 also reduced food self-administration. The efficacy of NPSR antagonism on cocaine seeking was confirmed with [D-Cys(tBu)5]NPS (10-30 nmol/rat) as it markedly inhibited relapse behavior following site-specific injection into the lateral hypothalamus and the perifornical area of the hypothalamus but not into the central amygdala. CONCLUSIONS: The identification of the NPS/NPSR system as an important new element involved in the physiopathology of cocaine addiction and the discovery of the anti-addictive properties of NPSR antagonists opens the possibility of exploring a new mechanism for cocaine addiction treatment.

[Diagnosis and treatments for recurrent malignant tumors involving the carotid artery].

OBJECTIVE: To study the diagnosis and treatment of the malignant tumor involving carotid artery. METHODS: A total of 23 cases of recurrent malignant tumors involving the carotid artery were included in this study. For the primary cancers, 8 of 23 cases were laryngeal carcinomas, 10 hypopharyngeal carcinomas, 2 thyroid carcinomas, 1 tonsil carcinoma, 1 parotid gland carcinoma, and 1 hypopharyngeal sarcoma with the invasion of cervical esophagus. Detailed evaluation on each case was performed before treatment. The relations of recurrent tumors with neck blood vessels were determined with enhanced CT/CTA. Of 23 cases with recurrent malignant tumors involving the carotid artery, 16 cases received surgery and 7 cases received the palliative treatment without operation. RESULTS: Seven patients with palliative treatments died of hemorrhage from the invaded neck blood vessels, systemic failure or pulmonary metastasis in six months. Of 16 cases with surgery, recurrent tumors were completely excised in 14 cases and there were residual tumor tissues on artery walls in 2 cases. Within 16 surgical cases, 2 cases died of neck hemorrhoea after one week because of infection, 2 cases died of lung metastasis 8 months later, 3 cases died of neck local recurrence 1 year later, 2 cases died of lung metastasis after 2 years, 1 case died of neck local recurrence 2 years later and 1 case died of a heart attack 2 years later. The rest 5 cases were alive. CONCLUSIONS: Enhancement CT/CTA can used in the evaluation for recurrent malignant tumors involving the carotid artery. Surgical treatments can be applied to some selected patients, which can improve the quality of life and survival time of the patients.

[Experience of successful remedy of hemorrhage after treatment of head and neck neoplasms].

OBJECTIVE: To discuss the effective emergency treatment to patients with different malignant tumors of head and neck after treatment. METHODS: Eighteen hemorrhage patients which have been successfully rescued with different malignant head and neck neoplasias after operation and (or) radiotherapy were analyzed retrospectively. Emergency treatment was used in 1 patient with nasopharyngeal cancer (NPC) suffering from massive epistaxis and suffocation after radiotherapy. The digital subtraction angiography (DSA) was used in 6 patients suffering from rupture of internal maxillary artery after irradiation for NPC. Two cases suffering from ulcer bleeding from deep par of pars nasalis pharyngis underwent repair of galea aponeurotic after elotomy. Hemostasis by finger pressing and per-cutsem ligation of carotid were used in 9 patients who suffered from rupture of carotid artery, then underwent normal treatment in operating room. RESULTS: Ligation of carotid artery was used in one patient with NPC after radiotherapy suffering from bleeding from arteria carotis interna of skull base. DSA was used in 6 patients with hemorrhage of nasopharynx who was confirmed rupture of internal maxillary artery by CT and DSA. Two cases suffering from ulcer bleeding from deep par of pars nasalis pharyngis underwent repair of galea aponeurotic; pectoralis major myocutaneous flap and infra-trapezius were used in 7 patients with laryngocarcinoma, carcinoma of infra-pharynx, thyroid carcinoma and lymphadenoma of cervical part, 6 cases of them were successful while 1 patient's pectoralis major myocutaneous flap partly necrosis. One patient with thyroid carcinoma who can not be repaired after many operations and radiotherapies. One patient with lymphoma of cervical part also can not be repaired because bad body condition. All cases have no hemiplegic paralysis after first aid. One cases with NPC suffering from massive epistaxis that after ligation of carotid artery suffered from partly cerebral infarction and died of pulmonary infection 6 months postoperatively; 2 cases of nasopharyngeal carcinoma died of recurrence 11 months postoperatively; other cases died of recurrence (7 cases), metastasis and/or multi organic failure of the whole body (8 cases) from 12 to 36 months. CONCLUSION: Different treatments were used in different cases, The DSA and per cutsem Ligation of artery after hemostasis by finger pressing were the modus operandi for NPC patients with intractable epistaxis after radiotherapy and patient suffered from rupture of carotid artery respectively.