Neobaicalein prevents isoflurane anesthesia-induced cognitive impairment in neonatal mice via regulating CREB1

Abstract Objectives: Isoflurane (ISO) is widely used in the clinic and research. The authors aimed to explore whether Neobaicalein (Neob) could protect neonatal mice from ISO-induced cognitive damage. Method: The open field test, Morris water maze test, and tail suspension test was performed to assess the cognitive function in mice. Enzyme-linked immunosorbent assay was used to evaluate inflammatory-related protein concentrations. Immunohistochemistry was used to assess Ionized calcium-Binding Adapter molecule-1 (IBA-1) expression. Hippocampal neuron viability was detected using the Cell Counting Kit-8 assay. Double immunofluorescence staining was employed to confirm the interaction between proteins. Western blotting was used to assess protein expression levels. Results: Neob notably improved cognitive function and exhibited anti-inflammatory effects; moreover, under isotreatment, it exhibited neuroprotective effects. Furthermore, Neob suppressed interleukin-1β, tumor necrosis factor-α, and interleukin-6 levels and upregulated interleukin-10 levels in ISO-treated mice. Neob significantly mitigated iso-induced increases in IBA-1 - positive cell numbers of the hippocampus in neonatal mice. Furthermore, it inhibited ISO-induced neuronal apoptosis. Mechanistically, Neob was observed to upregulate cAMP Response Element Binding protein (CREB1) phosphorylation and protected hippocampal neurons from ISO-mediated apoptosis. Moreover, it rescued ISO-induced abnormalities of synaptic protein. Conclusions: Neob prevented ISO anesthesia-induced cognitive impairment by suppressing apoptosis and inflammation through upregulating CREB1.

Association of homocysteine with ankylosing spondylitis: a systematic review and meta-analysis

Abstract Background: Hyperhomocysteinemia is associated with autoimmune diseases such as ankylosing spondylitis (AS), systemic lupus erythematosus (SLE), and rheumatoid arthritis (RA). Current findings regarding plasma/serum homocysteine (HCY) levels in AS patients are inconsistent. This study aims to systematically evaluate the association between circulating HCY levels and AS. Methods: Online electronic databases (PubMed, Web of Science, Embase, ScienceDirect, China National Knowledge Infrastructure (CNKI), and Wanfang data) were used to retrieve all relevant articles published up to May 7, 2020. The pooled standardized mean difference (SMD) with 95% confidence interval (CI) was calculated using the random-effect model, Stata16 software. Results: Nine articles containing 778 AS patients and 522 controls were included in this meta-analysis. No significant differences in HCY levels were found between AS and control groups (pooled SMD = 0.46, 95% CI = − 0.30 to 1.23, P = 0.23). However, subgroup analysis suggested that HCY levels were significantly higher (P < 0.05) in the AS group treated with methotrexate (MTX) compared with the control group. In contrast, HCY levels were significantly (P < 0.05) lower in the AS group receiving anti-TNF-α treatment compared with the control group. No significant differences were detected between HCY levels and disease activity scores (Bath AS disease activity index, BASDAI), and methylenetetrahydrofolate reductase (MTHFR) C677T genotype. Conclusion: This meta-analysis indicates that HCY levels are similar between AS and controls, and do not correlate with disease activity. However, different medical treatments cause fluctuations of circulating HCY levels in AS patients. Further and larger-scale studies are needed to confirm these findings. Trial registration: This study was registered at international prospective register of systematic reviews (PROSPERO), registration number: CRD42020184426.(AU)

Rhabdomyolysis and acute kidney injury in the deceased donor: a case report

Rhabdomyolysis is a common complication among brain death donors, affecting the number of organ donations and the quality of donor kidneys. Case report: Male, 17 years old, admitted to the hospital due to a car accident. Subsequently, brown urine appeared, blood myoglobin increased significantly, urine output decreased, and renal function impaired. Treatments including fluid replacement, alkalization of urine, plasma exchange and bedside CRRT were given. The patient's renal function recovered, and the organs were successfully acquired. The renal function recovered well after transplantation. Conclusion: Attention should be paid to rhabdomyolysis. Early diagnosis and treatment of patients with brain death could improve donation success rate and the recovery of postoperative renal function.

Comparison of differences of Notch1 gene methylation between hyperplastic lesions tissues and breast cancer tissues in Uyghur women / 临床与实验病理学杂志

Purpose To compare the difference of Notch1 methylation in the breast cancer and hyperplastic lesions tissue from Uyghur in Xinjiang. Methods The methylation level of Notch1 gene in Uyghur breast tissues including usual ductal hyperplasia (UDH), atypical ductal hyperplasia (ADH), ductal carcinoma in situ (DCIS), and invasive ductal carcinoma(IDC) were detected by MALDI-TOF-MS technique. The association of the methylation level with clinical pathological characteristics of patients was analyzed. The expression of Notch 1 protein was detected by immunohistochemistry. The relationship between the methylation status and expression was assay. Results The methylation rate of Notch l gene in UDH, ADH, DCIS, and IDC group was gradually decreased (P＜0.05). The 9 CpG sites methylation level of 13 CpG sites are statistically lower in cancer tissues (P＜0.05). The hypomethylation are accompanied with low differentiation, lymph node metastasis and high stage of TNM (P＜0.05). The lower DNA methylation is negatively correlated with the expression of Notch l (P＜0.05). Conclusion There was a differences of the expression and methylation rate of Notch 1 between breast cancer and hyperplastic lesions tissue, and its biological significances needs to be further studied.

Efficacy of EGFR Tyrosine Kinase Inhibitors in Non-small Cell Lung Cancer Patients Harboring Different Types of EGFR Mutations: A Retrospective Analysis / 华中科技大学学报（医学）（英德文版）

With the development of molecular pathology,many types of epidermal growth factor receptor (EGFR) mutations have been identified.The efficacy of EGFR tyrosine kinase inhibitors (EGFR-TKIs) in non-small cell lung cancer (NSCLC) patients with different types of EGFR mutations,especially in patients with single rare mutations or complex mutations (co-occurrence of two or more different mutations),has not been fully understood.This study aimed to examine the efficacy of EGFR-TKIs in NSCLC patients with different types of EGFR mutations.Clinical data of 809 NSCLC patients who harbored different types of EGFR mutations and treated from January 2012 to October 2016 at Renmin Hospital and Zhongnan Hospital,Wuhan,were retrospectively reviewed.The clinical characteristics of these patients and the efficacy of EGFR-TKIs were analyzed.Among these patients,377 patients had only the EGFR del-19 mutation,362 patients the EGFR L858R mutation in exon 21,33 patients single rare mutations and 37 patients complex mutations.Among these 809 patients,239 patients were treated with EGFR-TKIs.In all the 239 patients,the disease control rate (DCR) was 93.7％ with two patients (0.2％) achieving complete response (CR),the median progression free survival (PFS) was 13.0 months (95％ confidence interval [CI],11.6-14.4 months),and the median overall survival (OS) was 55.0 months (95％ CI,26.3-83.7 months).Subgroup analysis revealed that the DCR in patients harboring single rare or complex mutations of EGFR was significantly lower than in those with del-19 or L858R mutation (P＜0.001).Patients with classic mutations (del-19 and/or L858R mutations) demonstrated longer PFS (P＜0.001) and OS (P=0.017) than those with uncommon mutations (single rare and/or complex mutations).Furthermore,the patients with single rare mutations had shorter median OS than in those with other mutations.Multivariate Cox regression analysis identified that the type of EGFR mutations was an independent risk factor for PFS (hazard ratio [HR]=0.308,95％ CI,0.191-0.494,P＜0.001) and OS (HR=0.221,95％ CI,0.101-0.480,P＜0.001).The results suggest that the single rare or complex EGFR mutations confer inferior efficacy of EGFR-TKIs treatment to the classic mutations.The prognosis of the single rare EGFR mutations is depressing.EGFR-TKIs may be not a good choice for NSCLC patients with single rare mutations of EGFR.Further studies in these patients with uncommon mutations (especially for the patients with single rare mutations) are needed to determine a better precision treatment.

Application of arthroscopic surgery for patients with calcaneal fractures / 中国内镜杂志

Objective To study the clinical efficacy of bridge baton fixation with arthroscopic surgery in treatment of calcaneal fractures. Method From May 2013 to November 2014, 18 cases suffered from calcaneal fracture with arthroscopic surgical bridge baton fixation treatment in our hospital served as the object of the study. They were retrospectively analyzed during preoperative, postoperative the joint surface, the Bohler angle and Gissane angle , mean follow-up of 12 months, Maryland Foot Score were compared by the analysis. Results All cases were followed up for 12 months averagely. Joint surface flatness of 18 cases were significantly improved, Bohler angle, Gissane angle were also significant differences (P < 0.05). The excellent rate of Maryland score was 86.8%. Conclusion The bridge baton fixation with arthroscopic surgery for treatment of calcaneal fractures is certain effective and minimally invasive. Arthroscopy can restore the articular surface. The foot function recovery of the patients is satisfied.

Application of arthroscopic surgery for patients with calcaneal fractures / 中国内镜杂志

Objective To study the clinical efficacy of bridge baton fixation with arthroscopic surgery in treatment of calcaneal fractures. Method From May 2013 to November 2014, 18 cases suffered from calcaneal fracture with arthroscopic surgical bridge baton fixation treatment in our hospital served as the object of the study. They were retrospectively analyzed during preoperative, postoperative the joint surface, the Bohler angle and Gissane angle , mean follow-up of 12 months, Maryland Foot Score were compared by the analysis. Results All cases were followed up for 12 months averagely. Joint surface flatness of 18 cases were significantly improved, Bohler angle, Gissane angle were also significant differences (P < 0.05). The excellent rate of Maryland score was 86.8%. Conclusion The bridge baton fixation with arthroscopic surgery for treatment of calcaneal fractures is certain effective and minimally invasive. Arthroscopy can restore the articular surface. The foot function recovery of the patients is satisfied.

Establishment of an animal model of primary premature ejaculation / 中华男科学杂志

<p><b>Objective</b>To investigate the feasibility and practicability of establishing an animal model of primary premature ejaculation using the ejaculation distribution theory.</p><p><b>METHODS</b>We induced behavioral estrus in 32 ovariectomized female SD rats by subcutaneous injection of 20 μg estradiol benzoate at 48 hours and 500 μg progesterone at 4 hours before mating them with 49 male rats once a week for six times. During the last three opulations, we observed the male animals for mounting latency (ML), intromission latency (IL), ejaculation latency (EL), postejaculation interval (PEI), mounting frequency (MF), intromission frequency (IF), intromission rate (IR), and ejaculation frequency (EF).</p><p><b>RESULTS</b>Finally, 22 of the male rats were included in this study. The mean EF>33 was deemed rapid ejaculation,EF<1 sluggish ejaculation, and EF 1.5－2.5 normal ejaculation. The EL was significantly shorter in the rapid ejaculation group than in the sluggish and normal ejaculation groups. The IF was the lowest in those with rapid ejaculation. No statistically significant differences were observed in the ML among the three groups of rats.</p><p><b>CONCLUSIONS</b>Based on the mean ejaculation frequency, the male rats with rapid ejaculation were easily screened, and this animal model may play an important role in exploring the mechanisms of primary premature ejaculation.</p>

Prognostic value of Sox2 expression in digestive tract cancers: A meta-analysis / 华中科技大学学报（医学）（英德文版）

The aim of the present study was to accurately evaluate the association of Sox2 expression with the survival of patients with digestive tract cancers. Relevant literatures were identified by comprehensively searching databases including the Pubmed, Embase, CBMdisc, and Wanfang (up to October 2014). A meta-analysis was performed to clarify the association between Sox2 expression and overall survival or clinicopathological parameters of patients with digestive tract cancers (esophageal, gastric, and colorectal cancers). The results showed a significant association between high Sox2 expression and poor overall survival in patients with digestive tract carcinomas (HR=1.55, 95% CI=1.04-2.31), especially for patients with esophageal cancer (HR=2.04, 95%CI=1.30-3.22), colorectal cancer (HR=1.40, 95% CI=1.04-1.89), and digestive tract adenocarcinoma (HR=1.80, 95% CI=1.12-2.89), for Europeans (HR=1.98, 95% CI=1.44-2.71) or patients who did not receive neoadjuvant treatment (HR=1.73, 95% CI=1.10-2.72). Furthermore, Sox2 over-expression was highly correlated with vascular invasion (OR=1.86, 95% CI=1.25-2.77) and poor differentiation (OR=1.88, 95% CI=1.14-3.08), especially in esophageal and colorectal cancers. In conclusion, Sox2 expression may serve as a novel prognostic factor for patients with digestive tract cancers. Over-expression of Sox2 that is correlated with vascular invasion and poor differentiation suggests poor outcomes of patients with digestive tract cancers.

Effect of Paridis Rhizoma total saponins on apoptosis of human gastric cancer cell MKN-45 and Fas/FasL signaling pathway / 中国中药杂志

<p><b>OBJECTIVE</b>The study aimed to test if Paridis Rhizoma total saponins (PRTS) could induce apoptosis of human gastric cancer cell MKN-45.</p><p><b>METHOD</b>Based on the previous researches, PRTS was set by different concentrations to treat human gastric cancer cell for 12 h (5, 10, 20 mg x L(-1)). Fluorescent staining methods were adopted to observe apoptotic morphological changes of MKN-45. The apoptosis rates were analyzed by flow cytometry with Annexin V-FITC/PI staining. The enzymatic activities of caspase-3 and caspase-8 were measured by ELISA. The protein levels of Fas and FasL were detected by Western blotting.</p><p><b>RESULT</b>Under a fluorescence microscope, MKN-45 treated by PRTS was seen typical apoptotic morphological features. PRTS significantly increased the rate of apoptosis. Compared with the control group, there exsited significant differences in apoptosis rate of PRTS concentration of 20 mg x L(-1) (P < 0.01); besides, the enzymatic activities of caspase-3 and caspase-8 were promoted obviously after the effect of PRTS on MKN-45 cells for 12 h (P < 0.01). The protein levels of Fas and FasL in the MKN-45 were upgraded significantly.</p><p><b>CONCLUSION</b>PRTS can induce apoptosis of human gastric cancer cell MKN-45 , which is concerned with caspase-3 and caspase-8 and upgraded Fas and FasL.</p>

A study on the heavy metal pollution of home -grown vegetables in a city / 预防医学

Objective To know the contents of heavy metal (Pb,Cd,Cr,Ni,Cu,Zn,Hg and As) in home -grown vegetables in a city for providing evidences in vegetable planting.Methods A total of 248 samples from 5 vegetable plantation bases in four seasons were collected and the contents of heavy metal were determined and analyzed.Pb,Cd,Cr, Ni,Cu and Zn were determined by AAS,Hg and As were determined by AFS.The results were evaluated according to the national food sanitation standard limits.Results The exceeding rate of Ni in home -grown vegetables of root leaf and fruit was 48.48%,9.29% and 5.33% respectively,the exceeding rate of Cd was 12.12%,0.71 % and 8.00%,the exceeding rate of Pb was 0.00%,16.43% and 5.33%.The exceeding rate of other heavy metal were all below 5% or in line with the standard.The degree of heavy metal pollution decreased with season's order of autumn,summer,spring and winter.The content of As in leafy -vegetables was in significant association with the contents of AS in soil.Conclusion The heavy metal pollution of Ni,Pb and Cd in vegetables in the city is serious,and more attention should be paid to the heavy metal pollution.

A study on the heavy metal pollution in soils of vegetable plantation bases / 预防医学

Objective To know the status of heavy metal (Pb,Cd,Cr,Ni,Cu,Zn,Hg and As)contents and level of pollution in soils of vegetable plantation bases in Yongkang City.Methods A total of 84 samples from 5 vegetable plantation bases was collected and determined.Pb,Cd,Cr,Ni,Cu and Zn were determined by AAS.Hg and As were determined by AFS.And results were evaluated by using cumulative degree level,a single pollution index and Nemerow pollution index according to Safety Qualification of Agricultural Product -Environmental Requirements for Origin of Non -environmental Pollution Vegetable and Soil Environmental Quality Standard.Results The content of Cd was higher than the standard,while the other 7 heavy metals were in line with national standards.The Pb,Ni,Cu,As in vegetable plantation bases located on level one (fundamental change,clean),and Cd,Cr,Zn,Hg were level two (mild change, low accumulation).The integrated pollution index of vegetable plantation soils in Yongkang City was 0.86 (level two, warning limit).Conclusion The heavy metal contents in soils of vegetable plantation bases in Yongkang City are in line with national standards except Cd.

Study on effect of Polygonatum sibiricum on Yin deficiency model rats induced by long-term overload swimming / 中国中药杂志

<p><b>OBJECTIVE</b>To observe the effect of Polygonatum sibiricum on Yin deficiency model rats induced by long-term overload swimming.</p><p><b>METHOD</b>Except for the normal group, all of the remaining rats performed the long-term overload swimming for eight weeks, with five days every week and once every day, to establish the Yin deficiency model. The daily swimming time increased from 10 min to 180 min at the end of the 7th week, with the water depth of 60 cm and the water temperature at 30 degrees C. After the success of the modeling, the rats were orally administered with different doses of aqueous extracts from P. sibiricum (2.5, 10 g x kg(-1)) for eight weeks. After the final administration, their blood were collected from orbits to measure immunoglobulin A, G and M (IgA, IgG, IgM), interleukin 2 and 6 (IL-2, IL-6) and cAMP, cGMP contents in plasma General behavioral indicators (weight, facial temperature, pain threshold and holding power) of rats were observed during the drug administration.</p><p><b>RESULT</b>Compared with the model control group, aqueous extracts from P. sibiricum was given for eight weeks to significantly increase the rat weight and holding power of Yin deficiency model rats, decrease the facial temperature and the sensitivity of pain threshold, and increase IgA, IgG, IgM and IL-6 content and IgG content in serum, but without statistical difference. Aqueous extracts from P. sibiricum (10 g x kg(-1)) could also increase IL-2 content in serum, and decrease cAMP content and cAMP/cGMP ratio.</p><p><b>CONCLUSION</b>P. sibiricum could improve the general behavioral indicators (weight, holding power, pain threshold and facial temperature), immunologic functions (IgA, IgG, IgM) and cyclic nucleotide (cAMP, cAMP/cGMP), so as to ameliorate such Yin deficiency symptoms as dysphoria in chestpalms-soles, weight loss, soreness and weakness of waist and knees, immunologic dysfunction and cyclic nucleotide system disorders.</p>

Establish proposal of diagnosis and treatment of traditional Chinese medicine in AIDS patients with recurrent oral ulcerations / 中国中药杂志

The pathogenesis of acquired immune deficiency syndrome-associated recurrent oral ulcerations (AIDS-ROU) remained obscure and these was no specific treatment for it. Syndrome differentiation in traditional Chinese medicine (TCM) focus on integral regulation and has an advantage of the disease that etiology and pathogenesis remain obscure. A draft of Chinese medicine diagnosis and treatment standard procedure for AIDS-ROU was established by literature retrieval and peer review. Two questionnaires were carried out to investigate the confirmation and advice of in-group specialist to key points of the draft including diagnosis, treatment and nursing. Then the procedures were revised accordingly. The preliminary results showed the recovery rate of complete questionnaires in the 1st survey was 96%. Specialists confirmed more on outline, case history and physical examinations, syndrome differentiation of hyperactivity of fire due to Yin deficiency syndrome (HFYDS), treatment of heat accumulated in heart and spleen syndrome (HAHSS) and HFYDS, treatment of western medicine and nursing. They held different opinions on incidence, treatment of deficiency of spleen-QI and stomach-QI syndrome (DSSS) and criterion of therapeutical evaluation. Cronbach coefficient alpha (CCA) was 0.998 and split-half reliability R was 0.91. Recovery rate of complete questionnaires in 2nd survey was 100%. Specialists confirmed more on outline, etiology and pathogenesis, case history and physical examination, auxiliary examination, diagnostic criteria, syndrome differentiation and treatment of HAHSS and HFYDS. They held different opinions on syndrome differentiation and treatment of intermingled cold and heat syndrome and DSSS, nursing and the other therapies. CCA was 0.428 and split-half reliability R was 0.96. Coefficient of variations of the 2nd survey were less than those of the 1st survey, which mean coordination was improved. Each single item in two surveys contributed less difference in overall results according to weight coefficients. A new revision of the procedure was preliminarily established according to results of two surveys. Experts'activeness, concentration and coordination were good in two surveys. They had reached consensus in key points of the draft including diagnosis, treatment and nursing on the whole.

Construction and analysis of questionnaires on AIDS cough in traditional Chinese medicine diagnosis and treatment procedures / 中国中药杂志

<p><b>OBJECTIVE</b>To norm the behavior of AIDS cough in traditional Chinese medicine diagnosis and treatment and improve the clinical level of cough treatment for HIV/AIDS, and build AIDS cough diagnosis and treatment procedures in traditional Chinese medicine.</p><p><b>METHOD</b>Combined with clinical practice,to formulate questionnaire on AIDS cough in traditional Chinese medicine diagnosis and treatment by both English and Chinese literature research to expertise consultation and verify the results of the questionnaires on the statistics using the Delphi method.</p><p><b>RESULT</b>Questionnaire contents consist of overview, pathogeny, diagnosis standard, dialectical medication (phlegm heat resistance pulmonary lung and kidney Yin deficiency lung spleen-deficiency), treating spleen-deficiency (lung), moxibustion treatment and aftercare care and diet and mental, average (2.93-3.00), full mark rate (93.10%-100%) ranks average (9.91-10.67) and (287.50-309.50) of which are the most high value, and the variation coefficient is 0.00, the Kendall coefficient (Kendalls W) is 0.049 which is statistical significance, the questionnaire reliability value of alpha was 0.788.</p><p><b>CONCLUSION</b>Preliminary standarded concept, etiology and pathogenesis, diagnosis and syndrome differentiation treatment of AIDS cough, basically recognised by the experts in this field, and laid the foundation of traditional Chinese medicine diagnosis and treatment on develop the AIDS cough specifications.</p>

A research of Chinese medicine diagnosis and treatment standard procedure for patients with HIV associated pruritus based on experts' questionnaires / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To establish Chinese medicine diagnosis and treatment standard procedure for patients with HIV associated pruritus.</p><p><b>METHODS</b>A Chinese medicine diagnosis and treatment standard procedure for patients with HIV associated pruritus was established by literature retrieval and peer review. Two questionnaires were carried out to investigate the confirmation and advice of in-group specialists to key points of the draft including diagnosis, treatment and nursing. Then the procedures were revised accordingly.</p><p><b>RESULTS</b>The recovery rate of complete questionnaires in the 1st survey was 96%. Specialists confirmed more on case history and physical examinations, syndrome differentiation of three syndrome types, treatment of blood deficiency wind dryness syndrome (BDWDS) and nursing. They held different opinions on the outlines, auxiliary examinations, treatment of blood heat induced wind evil syndrome (BHWES) and wind cold and dampness accumulation syndrome (WCDAS), of which the coefficient of variations (CVs) was within 0.1603 -0.2473. The procedures were revised and the 2nd survey was launched. The recovery rate of complete questionnaires in the 2nd survey was 100%. Specialists confirmed more on case history and physical examinations, diagnostic criteria, syndrome differentiation of BDWDS and WCDAS, and treatment of BDWDS, of which CVs was 0. All indicated high agreement and good compliance. The CVs of other items were within 0.0638-0.1439, less than those of the 1st survey. The consistency of experts' opinions were somewhat improved. The contribution by one single item showed less difference in assessing the overall results in the two surveys. A new revision of the procedure was preliminarily established according to results of two surveys.</p><p><b>CONCLUSIONS</b>Experts' activeness, concentration, and coordination were good in the two surveys. They had reached consensus in key points of the draft including diagnosis, treatment, and nursing.</p>

Laparoscopic versus open surgery for D2 gastrectomy in advanced gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the safety and feasibility of laparoscopic D2 gastrectomy for advanced gastric cancer.</p><p><b>METHODS</b>The clinical data of 210 cases of laparoscopic gastrectomy and 180 cases of open gastrectomy for radical (D2) gastrectomy from May 2007 to Dec 2010 were analyzed retrospectively.</p><p><b>RESULTS</b>A total of 206 cases underwent laparoscopic-assisted surgery with 4 conversions. Compared to the open group, the laparoscopic group was associated with less bleeding [(208±38) ml vs. (300±52) ml, P<0.05], quicker postoperative recovery of bowel function [(2.9±0.7) d vs. (3.9±1.8) d, P<0.05], shorter postoperative length of hospital stay[(12.8±6.2) d vs. (15.6±6.8) d, P<0.05], longer operative time [(258±42) min vs. (193±30) min, P<0.05]. The number of lymph node harvested was 20.5±1.9 in the laparoscopic group and 25.8±1.5 in the open group, and the postoperative complication rate was 8.1% (17/201) vs. 8.5% (15/180), and differences were not statistically significant (both P>0.05). The recurrence rate was 2.9% (6/210) and 2.8% (5/180), and the 3-year overall survival rate was 35.6% and 37.8%, the differences were not statistically significant (both P>0.05).</p><p><b>CONCLUSIONS</b>Laparoscopic radical gastrectomy for gastric cancer is safe and effective, which can reach the same range of lymph node dissection as open gastric cancer surgery and similar survival rate.</p>

Laparoscopic splenectomy for immune thrombocytopenic purpura at a teaching institution / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>High anatomic location, fragility, and generous blood supply of the spleen makes laparoscopic splenectomy (LS) difficult to master, and few patients need splenectomy for benign disorders. The aim of this research was to assess operative outcomes and hematological results of a large series of patients treated with LS for chronic immune thrombocytopenic purpura (ITP) and to determine which clinical variables predict favorable hematological outcome.</p><p><b>METHODS</b>LS was successfully performed for 154 patients with chronic ITP from September 1999 to April 2009 at the First Affiliated Hospital of Sun Yat-sen University. Operative outcomes were assessed retrospectively. Long-term follow-up data were obtained from outpatient medical records and phone interviews. Clinical and laboratory variables (including gender, age, disease duration before surgery, previous response to steroids, preoperative platelet count, and postoperative peak platelet count) were evaluated by univariate analysis to identify potential predictors of hematological outcome. Multivariate Logistic regression model was used to determine independent predictors of hematological outcome.</p><p><b>RESULTS</b>One patient died from subphrenic abscess and postoperative sepsis. The overall major morbidity rate was 8.4%. None of the patients required a second surgery for complications. Of the 127 patients available for a mean follow-up of 43.6 months (range 9 - 114 months), the overall initial response (i.e., at two months after LS) and long-term response to LS were achieved in 89.0% and 80.3%, respectively. Five patients (3.9%) developed pneumonia 3 - 35 months after LS. Univariate analysis showed a significant difference in mean age between responders (29.1 years) and nonresponders (38.8 years; P < 0.05). Patients who responded to steroid therapy had better hematological outcome than those who did not respond (P < 0.05). Compared to nonresponders, responders to LS had a significantly higher postoperative peak platelet count (404 × 10(9)/L versus 213 × 10(9)/L, P < 0.001). Multivariate Logistic regression analysis identified postoperative peak platelet count as the only independent predictor of favorable response to LS (P < 0.001).</p><p><b>CONCLUSIONS</b>LS is a safe and effective treatment for chronic ITP. Postoperative peak platelet count may serve as a major predictor of long-term response.</p>

Expression of heat shock protein 27 in the esophageal tissue of rats with reflux esophagitis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Little attention has been paid to the expression of heat shock protein 27 (HSP27) in patients with reflux esophagitis (RE), and few studies of the importance of HSP27 in esophagitis have been carried out in animal models. This study aimed to explore the expression of HSP27 in the esophageal tissue of rats with RE.</p><p><b>METHODS</b>Eighty female Wistar rats were randomly divided into experimental groups A and B and control groups C and D (n = 20 in each group). To establish RE, rats in the two experimental groups received pylorus and forestomach ligations, while rats in the control group received gastrostomy and gastric perforation repair. The rats in groups A and C were sacrificed 7 days after surgery, and the rats in groups B and D were sacrificed 14 days after surgery. In groups A and B, 10 and 8 rats were diagnosed with RE by pathological examination, respectively (they were included in groups A' and B', respectively). The histopathological diagnosis of all the lower esophageal tissues in groups C and D was normal and 20 normal specimens were randomly selected for groups C' and D' with 10 specimens in each group. Macroscopic and microscopic esophagitis scores were assessed for the specimens in groups A' and B'. Lower esophageal tissues were collected from groups A', B', C', and D', and paraffin-embedded slices were made using part of the tissues. The expression of HSP27 in the tissues was detected using the two-step streptavidin-peroxidase immunohistochemical method. Some collected tissues were frozen, and expressions of HSP27 mRNA were detected using fluorescence quantitative polymerase chain reaction (FQ-PCR).</p><p><b>RESULTS</b>Median macroscopic and microscopic esophagitis scores in groups A' (n = 10) and B' (n = 8) were 1.0 and 1.5, and 2.0 and 2.5, respectively. There were no significant differences in the macroscopic or microscopic esophagitis scores between the two groups (Z = -0.330, P = 0.741; Z = -0.142, P = 0.887, respectively). Immunohistochemical staining showed that HSP27 was expressed in all layers of the esophageal epithelia in RE and control rats. FQ-PCR showed that HSP27 mRNA levels in the lower esophageal tissue in RE group (groups A' and B') were higher than those in control group (groups C' and D') (Z = -0.249, P = 0.001). HSP27 mRNA expression in the lower esophageal tissue was significantly different in groups B' and D' (Z = -3.027, P = 0.002). And the levels of HSP27 mRNA expression in severe RE group (microscopic esophagitis score: 3) were higher than in mild RE group (microscopic esophagitis score: 1-2) and control group (Z = -3.396, P = 0.001; Z = -3.855, P < 0.001).</p><p><b>CONCLUSIONS</b>HSP27 mRNA expression in the lower esophageal tissue of rats with RE is significantly higher than in the normal controls. Although reflux is a persistent stimulating factor, increased expression of HSP27 in the lower esophageal tissue of rats with RE requires aggravated esophageal injury.</p>

Expression and clinical significance of Notch1 and NUMB in gastric Cancer / 国际外科学杂志

Objective To investigate the expression of Notchl and NUMB in gastric cancer and explore the relationship between two genes and clinicopathologic features. Methods The mRNA and protein expressions of Notchl and NUMB in the gastric cancer tissues and normal gastric tissues were determined by realtime PCR and Western blotting. Results The mRNA expression of Notchl in gastric cancer tissues was 1.67times that of Notchl in normal gastric tissues. The increase of the mRNA expression of Notchl was correlated with tumor differentiation and lymph node metastatis of the patients ( P < 0. 05 ). The mRNA expression of NUMB in gastric cancer tissues was 0.597 times that of Notchl in normal tissues. The decrease of the mRNA expression of NUMB was correlated with tumor differentiation of the patients (P < 0.05). The expression of Notchl was negatively correlated to that of NUMB ( r = - 0.459, P < 0.05 ). The protein expression of Notchl in gastric cancer tissues was (0. 348 ±0. 133) , which was significantly higher than (0. 208 ±0. 140) in normal gastric tissues (P < 0.05 ). The protein expression of NUMB in gastric cancer tissues was (0.490 ±0.440), which was significantly lower than 0.746 ±0.390 in normal gastric tissues (P<0.05).Conclusion Up-regulation of Notchl and down-regulation of NUMB may play an important role in the occurrence and development of gastric cancer.