Study on Regulation Effects of Volatile Oil from Angelica sinensis on Autophagy of Myocardial Cell H 9C2 in Rats with Hypoxia/reoxygenation Injury / 中国药房

OBJECTIVE：To investigate the regulation effects of volatile oil from Angelica sinensis on autophagy of myocardial cell H 9C2 in rats with hypoxia and reoxygenation （H/R）injury. METHODS ：Using myocardial cell H 9C2 as subject ，CCK-8 method was used to screen the optimal concentration and administration time of volatile oil from A. sinensis. The acitivity of LDH in cell supernatant was determined after treated with volatile oil from A. sinensis by ELISA. Using autophagy inhibitors （3-methyladenine，5 mmol/L） as positive control ，MDC method and Western blotting assay were used to detect average fluorescence intensity of MDC and the expression of autophagy related proteins [Beclin- 1，microtubule associated protein light chain 3Ⅱ（LC3Ⅱ），LC3Ⅰ] in H 9C2 cells after treated with medicines. RESULTS ：After treated with 0.6 μmol/L violate oil from A. sinensis for 6 h，compared with blank group ，LDH activity in cell supernatant ，average fluorescence intensity of MDC ，the expression of Beclin- 1，LC3Ⅱ/LC3Ⅰ ratio in cells were increased significantly in H/R group ，while the expression of p 62 was decreased significantly （P＜0.05 or P＜0.01）. Compared with H/R group ，the activity of LDH in cell supernatant of H/R+drug group as well as average fluorescence intensity of MDC ，the expression of Beclin- 1，LC3Ⅱ/LC3Ⅰratio in cells in H/R+drug group and H/R+autophagy inhibitor group were decreased significantly ，while the expression of p 62 were increased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS ：The volatile oil from A. sinensis can reduce the autophagy level of H/R injury myocardial cells by regulating the expression of autophagy related proteins.

Enhanced recovery after surgery in total laparoscopic radical gastrectomy / 中华普通外科杂志

Objective To investigate the effect of enhanced recovery after surgery (ERAS) on immune function and postoperative recovery in gastric cancer patients undergoing total laparoscopic radical gastrectomy.Methods Patients were randomly divided into ERAS group and control group.Blood CD4 +,CD8+,CD4 + CD25 +,C-reactive protein,postoperative recovery and complications were compared between the two groups.Results On day1,CD4 +,CD8 +,CD4 + CD25 + in the two groups were significantly lower than those before surgery (t =9.070,7.297,5.830,12.870,3.529,10.547,all P＜0.05).The ERAS group had higher CD8 +,CD4 + CD25 + levels than the control group (t =2.163,2.203,P ＜ 0.05).On day3,CD4 + CD25 + in ERAS group was not different from that before surgery (t =1.062,P ＞ 0.05) while the other indexes in the two groups raised but still were lower than preoperative level (t =3.322,5.015,3.418,9.912,all P ＜0.05);CD4 +,CDs +,CD4 + CD25 + in ERAS group were higher than control group (t =2.804,2.040,2.210,all P＜0.05).On day5,CD4+,CD4 + CD25+ in the two groups and CDs+ in ERAS group returned to the preoperative level,while CDs + of the control group was still lower than the preoperative level (t =6.862,P ＜0.05).On day1,3 and 5,the C-reactive protein levels of the two groups were higher than those before surgery(t=-13.338,-13.715,-11.319,-12.286,-13.182,-15.076,all P ＜ 0.05),and ERAS group were lower than the control group (t =-3.246,-2.100,-2.211,all P＜0.05).There was no mortality in neither groups.The time of passage gas by anus,defecation,getting out of bed,oral feeding,and postoperative hospital stay in the ERAS group were less than thoseinthecontrolgroup[(2.8±1.0)dvs.(3.9±0.9)d,t=-5.974;(3.8± 0.9)d vs.(4.3±1.0)d,t=-2.700;(19.1 ±4.0)hvs.(35.9±6.6)h,t=-16.045;(9.9 ±1.6)d vs.(11.5±2.0) d,t =-4.479,all P ＜ 0.05].Conclusions ERAS in the perioperative period of patients with total laparoscopic radical gastrectomy mitigates the stress on the cellular immune system,reduces inflammatory response,and help fast recover the postoperative gastrointestinal function.

Serosal and muscular layers incision and use of submucosal layers exfoliation technique in laparoscopic surgery for gastric gastrointestinal stromal tumors / 中华普通外科杂志

Objective To explore the feasibility and clinical efficacy of serosal muscular layers incision and submucosal layers exfoliation technique in laparoscopic surgery for gastric gastrointestinal stromal tumors(GIST).Methods 28 patients with gastric GIST underwent serosal muscular layers incision and submucosal layers exfoliation technique under laparoscopic surgery.Patients' clinicopathologic characteristics,operative outcomes,postoperative complications,and follow up results were analyzed retrospectively.Results Surgery was successfully completed in all patients,and no one was converted to open surgery.The average operation time was (66 ± 15) min,and the intra operative blood loss was (16 ± 10) ml,the time of passage of gas by anus after operation was (20 ± 10)h,the time starting liquid diet was (2.5 ± 1.6) d,and the length of postoperative hospital stay was (7 ± 3) d.One patient had delayed gastric emptying,one had incisional infection.All the specimen had complete pseudocapsule and negative margin.pathology was all gastric GIST.After a median 22 months followed up,no recurrence or metastasis were found.Conclusion Serosal muscular layers incision and submucosal layers exfoliation under laparoscopic surgery is a safe and feasible procedure for treating gastric GIST.

Serosal and muscular layers incision and use of submucosal layers exfoliation technique in laparoscopic surgery for gastric gastrointestinal stromal tumors / 中华普通外科杂志

Objective@#To explore the feasibility and clinical efficacy of serosal muscular layers incision and submucosal layers exfoliation technique in laparoscopic surgery for gastric gastrointestinal stromal tumors(GIST).@*Methods@#28 patients with gastric GIST underwent serosal muscular layers incision and submucosal layers exfoliation technique under laparoscopic surgery. Patients′clinicopathologic characteristics, operative outcomes, postoperative complications, and follow up results were analyzed retrospectively.@*Results@#Surgery was successfully completed in all patients, and no one was converted to open surgery.The average operation time was (66±15) min, and the intra operative blood loss was (16±10) ml, the time of passage of gas by anus after operation was (20±10)h, the time starting liquid diet was(2.5±1.6)d, and the length of postoperative hospital stay was (7±3)d. One patient had delayed gastric emptying, one had incisional infection. All the specimen had complete pseudocapsule and negative margin. pathology was all gastric GIST. After a median 22 months followed up, no recurrence or metastasis were found.@*Conclusion@#Serosal muscular layers incision and submucosal layers exfoliation under laparoscopic surgery is a safe and feasible procedure for treating gastric GIST.

Accurate low ligation of inferior mesenteric artery and root lymph node dissection according to different vascular typing in laparoscopic radical resection of rectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the feasibility and clinical significance of precision low inferior mesenteric artery (IMA) ligation with the left colonic artery (LCA) preservation and root lymph node dissection in laparoscopic radical resection for rectal cancer, according to the inferior mesenteric artery (IMA) types.</p><p><b>METHODS</b>One Hundred and fore cases of rectal cancer patients who underwent laparoscopic resection in The Sixth Affiliated Hospital of Sun Yat-sen University from October 2015 to June 2016 were selected and divided into study group and control group according to different surgical methods. The study group (52 cases) accepted precision low IMA ligation with the LCA preservation and root lymph node (No.253) dissection, according to the IMA types and length examined by preoperative computed tomography angiography (CTA) reconstruction. The control group (52 cases) accepted the traditional high IMA ligation. The perioperative efficacy indexes and postoperative recovery situation of the two groups were compared.</p><p><b>RESULTS</b>The IMA types, IMA length and preoperative clinical stages were not significantly different between the two groups (all P>0.05). The surgery was completed smoothly for patients in both groups, with no conversion to open surgery. But two patients in the study group underwent left colonic artery ligation for intra-operative need. There were no significant differences in the operative time, intra-operative blood lose, the rate of protective ileostomy and post-operative pathological stages between the two groups (all P>0.05). More total lymph nodes [(24.9±5.7) vs. (16.9±4.2), P=0.001] and No.253 lymph nodes [(2.4±1.1) vs. (1.5±0.8), P=0.001] were harvested in study group as compared to control group. However, the positive rate of total harvested lymph nodes and No.253 lymph nodes between the two groups were not significantly different (P>0.05). There were no significant differences between the two groups in postoperative first anal exhaust time, postoperative hospital stay, total volume of postoperative intraperitoneal drainage, postoperative abdominal drainage tube retention time, postoperative anal drainage tube retention time and postoperative catheter retention time (All P>0.05). There were 2 cases of postoperative dysuria and 1 case of anastomotic bleeding in study group. There were 3 cases of postoperative dysuria and 2 cases of anastomotic leak in control group. Less postoperative complications (5.8% vs. 9.6%, P<0.05) in study group as compared to control group. There was no rehospitalization or death case in two groups within 30 days after operation.</p><p><b>CONCLUSIONS</b>In the laparoscopic radical resection of rectal cancer, preserving LCA and cleaning the root lymph nodes according to IMA types, which could increase the number of harvested lymph nodes and reduce the postoperative complications was safe and effective.</p>

Clinical value of circulating tumor cell detection in evaluating the prognosis of patients with gastric cancer / 中华普通外科杂志

Objective To evaluate circulating tumor cells (CTC) in prognosis prediction of gastric cancer.Method Peripheral blood samples were obtained from 65 patients with gastric cancer and 20 normal volunteers.CTC were detected by using CellSearch(R) CTC Detecting System.Postoperative progress-free survival (PFIS) and overall survival (OS) were evaluated against CTC status and clinicopathological factors.Result CTC were positive in 35 out of 65 (53％) patients compared to 1 out of 20 (5％) healthy controls,P ＜ 0.05.CTC were not statistically corelated with patients' age,sex and lymph node status or distal metastasis,vascular invasion and tumor markers (all P ＞ 0.05).CTC positive patients had poorer OS (P ＜ 0.05) and PFS (P ＜ 0.05) compared with those with negative CTC.Conclusion Positive CTC in gastric cancer patients predict poor prognosis after radical gastrectomy.

Studying the Effect of Downregulating Autophagy-Related Gene LC3 on TLR3 Apoptotic Pathway Mediated by dsRNA in Hepatocellular Carcinoma Cells / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The purpose of this study is to examine the role of the double-stranded RNA (dsRNA) activated Toll–interleukin-1 receptor domain-containing adaptor inducing interferon β (TRIF) signal pathway in triggering apoptosis in hepatocellular carcinoma (HCC) cells. MATERIALS AND METHODS: First, siRNA targeted autophagy–related gene LC3 (pU6H1-LC3 siRNA and siLC3) and a dsRNA used as a Toll-like receptor 3 (TLR3) ligand was constructed and synthesized, respectively. Then, a human HCC cell line was transfected with dsRNA, siLC3, and cotransfected with siLC3 and dsRNA (siLC3+dsRNA), respectively. Finally, quantification real-time polymerase chain reaction, western blotting, and immunofluorescence staining were used in the HCC line (SMMC7721), and MTT assay, flow cytometry, terminal deoxynucleotidyl transferase-mediated dUTP nick-end-labeling, and transmission electron microscopy were used in an HCC xenograft model of nude mice. Human umbilical vein endothelial cell tube forming assay, color Doppler ultrasonographic flow image examination, and CD34-positive microvessel density were used in vitro and in vivo. RESULTS: Compared with untreated cells, the protein and mRNA expression of TLR3 and TRIF was up-regulated, in order, siLC3+dsRNA, dsRNA, and siLC3. Expression of LC3 was obviously down-regulated and the autophagosomes were significantly decreased in siLC3+dsRNA and siLC3, whereas in dsRNA (p < 0.05). LC3 and TRIF colocation was observed in HepG2 cells. Decreased cell viability, increased apoptosis, decrease in xenograft tumor volume, and angiogenesis potential were also observed in order (p < 0.05). CONCLUSION: Suppression of intracellular autophagy resulted in decreased degradation of TRIF protein, which can promote triggering of apoptosis by the TLR3-TRIF pathway. dsRNA and siLC3 could play anticancer roles in coordination.

Influences of inferior mesenteric artery types and Riolan artery arcade absence on the incidence of anastomotic leakage after laparoscopic resection of rectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the influences of inferior mesenteric artery (IMA) types and Riolan artery arcade absence on the incidence of anastomotic leakage(AL) after laparoscopic resection of rectal cancer.</p><p><b>METHODS</b>Clinical data of 116 local advanced rectal cancer patients who underwent laparoscopic resection in The Sixth Affiliated Hospital of Sun Yat-sen University from January 2012 to December 2014 were analyzed retrospectively. IMA and Riolan artery arcade were examined by preoperative computed tomography angiography (CTA) reconstruction. The influences of IMA type, Riolan artery arcade absence and ligation site (high or low) on AL were analyzed by Logistic regression.</p><p><b>RESULTS</b>The proportion of IMA types(I(-IIII() was 57.8%(67/116), 10.3%(12/116), 31.0%(36/116) and 0.9%(1/116), respectively. Riolan artery arcade absence was found in 60.3%(70/116). Eight (6.9%) patients suffered from AL. IMA type III( had significantly higher AL incidence as compared to other IMA types [19.4%(7/36) vs. 1.2%(1/80), P=0.001]. Meanwhile, patients with Riolan artery arcade absence also had significantly higher AL incidence[11.4%(8/70) vs. 0.0%(0/46), P=0.030]. However, the difference in AL incidence between high and Low IMA ligation was not statistically significant [8.0%(7/87) vs. 3.4%(1/29), P=0.531]. Seven of these 8 AL patients were found in IMA type III( with Riolan artery arcade absence and high ligation. Multivariate analysis showed that IMA type III( (P=0.001) and Riolan artery arcade absence (P=0.002) were independent risk factors of AL.</p><p><b>CONCLUSIONS</b>IMA type III( with Riolan artery arcade absence increases AL incidence significantly in laparoscopic resection of rectal cancer. IMA type and Riolan aretry arcade absence or not contribute to the selection of IMA ligation site in the operation. For the colorectal cancer patients with IMA type III( and Riolan artery arcade absence, selective low IMA ligation with root lymph node dissection should be recommended.</p>

Study on quantitative criteria of intraoperative nerve action potentials for early diagnosis in peripheral nerve injury / 中华显微外科杂志

Objective To investigate the feasibility of amplitude of intraoperative nerve action potentials (NAP) for early quantitative diagnosis of peripheral nerve injury. Methods The sciatic nerve injury model were established in 16 rabbits. Intraoperative NAP were recorded after 4 weeks. According to amplitude of NAP, the injuried nerve were divided into 3 groups: NAP ＜ 100 μV in A group, 100 μV ≤NAP ＜ 500 μV in B group, NAP ≥ 500 μV in C group. Nerve specimen 1cm distal to injuried point were resected that received glycine silver stain and image analysis including number, diameter and cross section area of regenerative axons. Footprint parameter and ulcer area were measured and contrasted between each two groups. Results The number, diameter and cross section area of A group regenerative axons have significant difference with B and C group, no significant difference between B and C group; Footprint parameter and ulcer area have significant difference in each two groups. Conclusion Amplitude of intraoperative NAP can be a quantitative criteria to diagnose the degree of peripheral nerve injury that provides experiment evidence for guide intraoperative decision-making in clinical practice.

Quality standard for Xuesaitong Granules / 中成药

AIM:To establish the quality standard for Xuesaitong Granule(total saponins of Radix et Rhizoma Notoginseng). METHODS:The contents of notoginsenoside R1,ginsenoside Rg1 and Rb1 were determined on the Shim-Pack C 18 (250 mm?4.6 mm,5 ?m) column,with CH3CN—H2O gradual elution and monitored at 203 nm. RESULTS:The average recovery of notoginsenoside R1 was 100.0% (RSD=1.00%,n=6),the minimum detection quantity cannot be lower than 5% labelled weight. The average recovery of ginsenoside Rg1 was 99.8 % (RSD=0.47%,n=6),the minimum detection quantity cannot be lower than 20% labelled weight. The average recovery of ginsenoside Rb1 was 99.8% (RSD=0.79%,n=6),the minimum detection quantity cannot be lower than 30% labelled weight. CONCLUSION:The method is simple,reliable,accurate and can be applied to the quality control of Xuesaitong Granules.

Toxicology of Sanqi Shuishu Capsule / 中成药

AIM: To study toxicology of Sanqi Shuishu Capsule (SQSS) (Panax Notoginseng, Semen Ziziphi Spinosae; Fructus Schisandrae, etc). in order to establish a theoretical basic for clinical use. METHODS: With the aid of the acute toxicity tests, the inheritance toxicity tests, feeding the rat on trial research for 30 d, we observed the toxicology of SQ SS Capsule. RESULTS: SQ SS Capsule had not action of mutation, micronucleolus proliferation of rat's marrow polychrouiatic erythrocytes increase, and rat's sperm malformation. CONCLUSION: Poisonous effect has not been observed in SQ SS Capsule.

Study on preparation process for Xuesaitong Dropping Pills / 中成药

Objective: To establish the optimum preparation process for Xuesaitong Dropping Pills(total saponin of Radix Notoginseng). Methods: On the basis of orthogonal design, preparation conditions were selected among sort of polyglycol (as substance), consumption of polyglycol and processing temperature of usoline (as cooling agent). Results: Under the condition of using polyglycol 6000, and processing temperature at 10～15 ?C , the quality of Xuesaitong Dropping Pills is good.