Current status and future perspectives on the methods of prognosis evaluation for intrahepatic cholangiocarcinoma / 中华外科杂志

Intrahepatic cholangiocarcinoma (ICC) is the second most common primary malignant tumor in the liver after hepatocellular carcinoma. Its incidence and mortality rates have increased worldwide in recent years. Surgical resection is the best treatment modality for ICC;however,the overall prognosis remains poor. Accurate evaluation of post operative prognosis allows personalized treatment and improved long-term outcomes of ICC. The American Joint Commission on Cancer TNM staging manual is the basis for the standardized diagnosis and treatment of ICC;however,the contents of stage T and stage N need to be improved. The nomogram model or scoring system established in the analysis of commonly used clinicopathological parameters can provide individualized prognostic evaluation and improve prediction accuracy;however,more studies are needed to validate the results before clinical use. Meanwhile,imaging features exhibit great potential to establish the post operative prognosis evaluation system for ICC. Molecular-based classification provides an accurate guarantee for prognostic assessment as well as selection of populations that are sensitive to targeted therapy or immunotherapy. Therefore,the establishment of a prognosis evaluation system,based on clinical and pathological characteristics and centered on the combination of multidisciplinary and multi-omics,will be conducive to improving the long-term outcomes of ICC after surgical resection in the context of big medical data.

Status and challenges of neoadjuvant immunotherapy for hepatocellular carcinoma / 中华外科杂志

With the development of modern liver surgical techniques and the progress of perioperative management,the survival rate after resection of hepatocellular carcinoma has been greatly improved,but the high recurrence and metastasis rate still limits the long-term survival after surgery. Preoperative neoadjuvant therapy has been confirmed to significantly reduce the postoperative recurrence rate and prolong survival in other types of cancer,but there has been a lack of effective systemic therapy for hepatocellular carcinoma for a long time,so the efficacy and regimen of neoadjuvant therapy for hepatocellular carcinoma are still controversial. PD-1/PD-L1 monoclonal antibody combined with anti-angiogenic targeted drugs has become a first-line regimen in systemic therapy for advanced hepatocellular carcinoma. This regimen has definite efficacy and high safety,bringing hope for neoadjuvant therapy of hepatocellular carcinoma. Recently,three clinical trials of neoadjuvant immunotherapy for hepatocellular carcinoma have been published internationally,which preliminarily suggest the efficacy and safety of neoadjuvant immunotherapy for hepatocellular carcinoma and lay a solid foundation for carrying out larger sample clinical studies in the future.

Innovation ability-driven optimization of the experimental teaching of human anatomy and animal physiology / 生物工程学报

Innovation and entrepreneurship training through higher education sector is an important way to foster innovative talents and enhance their social adaptation abilities. We reformed and optimized the experimental teaching of human anatomy and animal physiology with the aim to promote the integration of students' theory learning with practice, to promote students' ability to apply anatomical and physiological knowledge to medicine, pharmacy, and life practice. Last but not least, students' innovative consciousness of applying scientific research to serve the society could also be enhanced. These practices would enhance the practical ability of the students through integrating the innovation education and professional education.

Pharmacological interactions between intrathecal pregabalin plus tianeptine or clopidogrel in a rat model of neuropathic pain

Background@#There is still unmet need in treating neuropathic pain and increasing awareness regarding the use of drug combinations to increase the effectiveness of treatment and reduce adverse effects in patients with neuropathic pain. @*Methods@#This study was performed to determine the individual and combined effects of pregabalin, tianeptine, and clopidogrel in a rat model of neuropathic pain.The model was created by ligation of the L5-L6 spinal nerve in male Sprague–Dawley rats; mechanical allodynia was confirmed using von Frey filaments. Drugs were administered to the intrathecal space and mechanical allodynia was assessed; drug interactions were estimated by isobolographic or fixed-dose analyses. @*Results@#Intrathecal pregabalin and tianeptine increased the mechanical withdrawal threshold in a dose-dependent manner, but intrathecal clopidogrel had little effect on the mechanical withdrawal threshold. An additive effect was noted between pregabalin and tianeptine, but not between pregabalin and clopidogrel. @*Conclusions@#These findings suggest that intrathecal coadministration of pregabalin and tianeptine effectively attenuated mechanical allodynia in the rat model of neuropathic pain. Thus, pregabalin plus tianeptine may be a valid option to enhance the efficacy of neuropathic pain treatment.

Development of the curriculum of "Human Anatomy and Physiology" for special education major / 生物工程学报

Human Anatomy and Physiology is one of the basic professional courses for students majored in special education in normal colleges. It is of great importance to develop a comprehensive curriculum and improve the associated teaching approaches. In recent years, we have taken a series of approaches including optimizing the teaching content, highlighting the curriculum value, diversifying the teaching methods, and improving the evaluation methods. These approaches have received good effects and responses. Here we summarize the experiences and share our insights with colleagues.

SHANK2 is a frequently amplified oncogene with evolutionarily conserved roles in regulating Hippo signaling

Dysfunction of the Hippo pathway enables cells to evade contact inhibition and provides advantages for cancerous overgrowth. However, for a significant portion of human cancer, how Hippo signaling is perturbed remains unknown. To answer this question, we performed a genome-wide screening for genes that affect the Hippo pathway in Drosophila and cross-referenced the hit genes with human cancer genome. In our screen, Prosap was identified as a novel regulator of the Hippo pathway that potently affects tissue growth. Interestingly, a mammalian homolog of Prosap, SHANK2, is the most frequently amplified gene on 11q13, a major tumor amplicon in human cancer. Gene amplification profile in this 11q13 amplicon clearly indicates selective pressure for SHANK2 amplification. More importantly, across the human cancer genome, SHANK2 is the most frequently amplified gene that is not located within the Myc amplicon. Further studies in multiple human cell lines confirmed that SHANK2 overexpression causes deregulation of Hippo signaling through competitive binding for a LATS1 activator, and as a potential oncogene, SHANK2 promotes cellular transformation and tumor formation in vivo. In cancer cell lines with deregulated Hippo pathway, depletion of SHANK2 restores Hippo signaling and ceases cellular proliferation. Taken together, these results suggest that SHANK2 is an evolutionarily conserved Hippo pathway regulator, commonly amplified in human cancer and potently promotes cancer. Our study for the first time illustrated oncogenic function of SHANK2, one of the most frequently amplified gene in human cancer. Furthermore, given that in normal adult tissues, SHANK2's expression is largely restricted to the nervous system, SHANK2 may represent an interesting target for anticancer therapy.

Slow Breathing Training for Hypertension: A Systematic Review / 中国康复理论与实践

Objective:To evaluate the effects of slow breathing training on hypertension. Methods:Articles about slow breathing training for hypertension were retrieved from CNKI, Wangfang Data, PubMed and Web of Science, until March, 2021. The authors, publishing time, subjects, interventions and courses, and outcome indexes and conclusion were extracted. Results:There were 924 articles returned, and 35 included, which published mainly from 2009 to 2020. The subjects were patients with hypertension, and the outcome index was blood pressure. Conclusion:Slow breathing training may work for hypertension, which associates to baroreflex sensitivity, heart rate variability, sympathetic nerve activity and cardiopulmonary diastolic receptors.

A new strategy based on acid-alkali complexation for rapidly and accurately fishing phytochemicals in sennae folium / 中草药·英文版

Objective: There are some anthraquinones, anthraquinones and flavonones in Sennae Folium which exhibited significant acidity, such as sennoside A/B and sennoside C/D. The current strategies used in separating these components are mainly based on conventional column chromatography which is time consuming, laborious and costly. This study is aimed at exploring a method of precipitation extraction of acid components in Sennae Folium. Using alkaloid as a “hook”, it is reasonable to use the principle of “acid-alkali complexation” to "fish" the acidic components in Sennae Folium. Methods: Isothermal titration calorimeter (ITC) was used to measure the extraction efficiency of different alkaloids. Then, alkaloid determined by ITC was mixed with extracting solution of Sennae Folium to form complex. High performance liquid chromatography coupled with mass spectrometry (HPLC-MS2) was used to investigate the ingredients “fished” by berberine (Ber). The mechanism of “fishing” process was explained by ITC, optical activity, fluorescence spectrometry and scanning electron microscope. Results: The ITC results proved that the choice of “hook” was particularly important in the process of “fishing”. Among the hooks, the fishing efficiency of the isoquinoline alkaloids (Ber) was the highest, reaching 10.3%. Nine ingredients were detected and determined by HPLC-MS2, and the main components were sennoside A/B and sennoside C/D. Based on ITC test of Ber and sennoside A, the combination mechanism of the two ingredients was a chemical reaction with a nearly binding ratio (2:1). Fluorescence and optical properties of the active ingredients were changed after complexation. By scanning electron microscope, we found that two types of components had obviously self-assembled behavior during the formation process. Conclusion: Ber successfully “fished” the main acidic components, sennoside A/B and sennoside C/D, from Sennae Folium. Combined with different characterizations, the “fishing” process was determined as a chemical association reaction induced by electrostatic interaction or π-π stacking. Therefore, with special identification ability, the “fishing” process had the potential of practical application.

Effect of resection of adenoids and/or tonsil on the immune indexes in children with obstructive sleep apnea hypopnea syndrome / 中华耳鼻咽喉头颈外科杂志

Objective@#To study the effect on immune indexes in children with obstructive sleep apnea hypopnea syndrome (OSAHS) before and after resection of adenoid and/or tonsil.@*Methods@#A total of 100 children with OSAHS due to adenoid hypertrophy were enrolled in Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Dalian Medical University from December 2016 to December 2018. Some cases were complicated with tonsil hypertrophy or chronic tonsillitis. 6 ml of fasting peripheral venous blood were collected from all subjects at the 1st day before surgery, 4th day, 1 month, 3 months and 6 months after surgery to detect lymphoid subsets percentage (CD3+, CD4+,CD8+, CD4/CD8, CD19, NK) and level of immunoglobulin (IgG, IgA, IgM). Grouping: group A was a total of 51 cases with adenoid hypertrophy after Adenoid plasma ablation; group B was a total of 27 cases with adenoid hypertrophy and chronic tonsillitis after plasma ablation of adenoid and tonsil; and group C was a total of 22 cases hypertrophy of adenoid and tonsil after plasma ablation of adenoid and tonsil.In the baseline data, age, gender and other variables were analyzed by anova and chi-square test, repeated measurement anova was used for intra-group and inter-group comparison of observation indicators at different time points after operation, and independent sample t-test was used for comparison between the two groups at observation points 3 months after operation.@*Results@#(1) In group A, the percentage of CD19 lymphocytes before surgery was higher than that at 4th day after surgery, and the difference was statistically significant (21.85±6.20 vs.19.18±5.91, P<0.05). The other immune indexes were not statistically different before and after surgery (P>0.05). (2) In group B, the percentage of CD19 lymphocytes, CD3+T lymphocytes, CD8+T lymphocytes and the level of IgG at 4th day after surgery were significantly different between those before surgery (all P<0.05). At the 1st month after surgery, the percentage of CD3+T lymphocytes, CD8+T lymphocytes, CD19 lymphocytes and the level of IgG were significantly different between those before surgery (all P<0.05). The other immune indexes were not statistically different before and after operation (P>0.05). (3) In group C, the percentage of CD19 lymphocytes and the CD3+T lymphocytes at 4th day after surgery were significantly different between those before surgery (all P<0.05).In the 1st month after surgery, the percentage of CD8+T lymphocytes and CD19 lymphocytes were significantly different between those before surgery (all P<0.05). The other immune indexes were not statistically different before and after operation (P>0.05). (4) Among three groups, the percentage of CD4+T lymphocytes, the levels of IgG and IgA before surgery between group A and Group B were statistically significant (all P<0.05). At 4th day after surgery, the percentage of CD4+T lymphocytes in group B and C were lower than those in group A, and the differences were statistically significant (32.22±6.14, 32.36±6.87 vs. 36.36±5.19, all P<0.05); the other immune indexes were not statistically different among each group before and after surgery (P>0.05).@*Conclusions@#Resection of adenoid has no significant effect on the immune indexes in children with OSAHS. The children with OSAHS complicated with tonsil problems have immune index disorder before surgery. Surgery has a certain effect on the immune indexes of children with OSAHS in a short period of time, and tends to normal level after one month.

Role of HMGB1 in Post-traumatic Endoplasmic Reticulum Stress in Rat Lung Tissues / 法医学杂志

OBJECTIVES@#To explore the role of high mobility group B1 （HMGB1） protein in the post-traumatic endoplasmic reticulum stress （ERS） in rat lung tissues.@*METHODS@#The rat model of acute lung injury was established by crushing the hind limbs of rats with standard weight. The first experiment was to divide rats into postural control group and crush groups （6 h, 18 h and 30 h after crushing）. The second experiment was to divide rats into postural control group, 18 h crush group, HMGB1 inhibitor sodium butyrate （SB） group and 18 h crush+SB group. The protein expression changes of HMGB1 and ERS- related proteins （GRP78, caspase-12, CHOP and IRE1α） in rat lung tissues were detected with Western blotting. Meanwhile, the pathological changes of rat lungs were observed by HE stain.@*RESULTS@#Compared with the postural control group, the expression levels of ERS-related proteins （GRP78, caspase-12, CHOP and IRE1α） and HMGB1 protein in rat lung tissues by crushing the hind limbs of rats were obviously increased. The protein levels reduced at 30 h after crushing but were still higher than those of postural control group and obvious pathological changes of acute lung injury were observed simultaneously in rats. Compared with the 18 h crush group, the expression levels of the ERS-related proteins and HMGB1 protein in rat lung tissues were attenuated in 18 h crush+SB group, and the pathological changes of rat lung injury began to alleviate.@*CONCLUSIONS@#HMGB1-ERS pathway activated by traumatic stress can lead to acute lung injury in rats.

Intra-arterial chemotherapy for the treatment of retinoblastoma / 眼科新进展

Intra-arterial chemotherapy (IAC) refers to the injection of chemotherapeutics into patients' eyes through arteria ophthalmica in order to local chemotherapy for retinoblastoma (RB).The common drugs in the treatment of RB include melphalan,topotecan and carboplatin.IAC can form the high-concentration drug effects on local areas.It can effectively kill tumors and significantly reduce the occurrence rate of complications after intravenous chemotherapy.Application of IAC can cure patients with RB in B,C,D and E stage in international criteria,which can effectively improve eye protection rate.Complications of IAC include eyelids edema,chemosis,blepharoptosis,ocular motility disorders,vitreous hemorrhage,ischemia of choroid or retina,transient myelosuppression,etc.It should be further conduction of long-term and large-sample cases studies on how to improve curative effects and reduce serious eye complications.

Role of endoplasmic reticulum stress in the pathogenesis of liver diseases / 基础医学与临床

Endoplasmic reticulum stress (ERS) is an important cellular self-protection mechanism. It can activate the unfolded protein response (UPR) that promotes cell survival, but sustained ERS may lead to cell apoptosis. There are a lot of endoplasmic reticulum in the liver cells, and many liver-related diseases are associaled with endoplasmic reticulum stress, such as alcoholic liver disease, non-alcoholic liver disease, toxic liver injury, viral hepatitis, hepatic malignant tumors and hepatic ischemia- perfusion injury. This article will summarize the role of ERS in the pathogenesis of liver-related diseases and the significance of intervention in liver disease.

Application of CTC and CTM in liver transplantation for hepatocellular carcinoma / 医学研究生学报

Hepatocellular carcinoma (HCC) is one of the most common malignancies in the world. For all the advances in surgical techniques,including transplantation, no substantial improvement has been made in the curative effect of HCC. The 1-year survival rate of the HCC patients with recurrence after liver transplantation is only 18%. In order to optimize the screening criteria for transplant recipients,perfect the distribution system of the donor,reduce the recurrence rate and improve the survival of the patients, it is necessary to gain a deeper insight into the tumor biological characteristics of the patients undergoing liver transplantation,precisely predict their prognostic indexes,and ascertain the relationship of post-transplant recurrence and metastasis with the patient's immune status, so as to carry out effective intervention for high-risk patients and individualized and integrated treatment for those with recur-rence or metastasis. Evidence shows that circulating tumor cells (CTC) and circulating tumor microemboli (CTM) are closely related with and contribute even more than other factors,such as the tumor size,tumor number,and vascular invasion,to the postoperative re-currence and metastasis of HCC. Therefore,a dynamic evaluation of CTC and CTM before liver transplantation can provide essential in-dicators for screening the recipient and predicting postoperative recurrence and metastasis.

New strategy on scientific connotation of Chinese materia medica compatibility enlightened by precipitation from Chinese materia medica formula decoction / 中草药

Recently, the Chinese materia medica (CMM) compatibility theory research was focused on aspect of chemical composition, which is an important strategy to explain the principle of prescriptions. There are various chemical compositions in a compound prescription of CMM, including alkaloids, glycosides, organic acids, tannins, protein, micro elements and so on. Complex interactions always inevitably occur during the water decoction process of CMM prescription after the dissolution of active ingredients, most significantly, it also generates the precipitation. Clinically, traditional Chinese medicines (TCM) treat diseases with both precipitation and decoction. Precipitation generated process might contain the scientific connotation of CMM compatibility. Thus, the scientists had been studying the precipitation from this process. Through summarizing the results of related researches in recent years, this review introduces different interactions of various active ingredients in compound prescriptions and research progress of precipitation in decoction, aiming to lay a foundation for further study on the precipitation from CMM decoction and provide a new idea to explain the theory of CMM compatibility.

Effect of the methylprednisolone on postoperative reaction after coblation tonsillectomy / 中国耳鼻咽喉头颈外科

OBJECTIVE To evaluate the effect of intravenous infusion of methylprednisolone on postoperative recovery and complications after coblation tonsillectomy.METHODS Eighty three patients who were scheduled for coblation tonsillectomy from December 2015 to December 2016 were included in this study.Firstly,they were divided into 2 groups,i.e.,the younger group (＜12 years) and the older group (≥12 years old).Secondly,these two groups were further divided into experimental group and control group by the prospective,double-blind and randomized method.The experimental group was treated with methylprednisolone and antibiotics for 3 days.Then,the postoperative reactions such as the pain,activity,pharyngeal edema,body condition,exfoliation time of the tunic albuginea,post-tonsillectomy hemorrhage were observed.RESULTS 1.From the third day to fifth day,using methylprednisolone can alleviate pain (Z=4.42,P=0.00),increase the activity(Z=2.64,P=0.00)and reduce pharyngeal edema(Z=2.84,3.10,all P=0.00) in younger group.2.After operation,in the younger group,the incidence rate of gastrointestinal discomfort in control group was higher than that in experimental group(x2=4.97,P=0.03).In the older group,the incidence rate of gastrointestinal discomfort(x2=5.24,P=0.02) and sleep disturbance(x2=5.03,P=0.03) in control group was higher than those in experimental group.3.In the older group,exfoliation average time of the tunic albuginea in experimental group was longer than that in control group(t=2.16,P=0.04).4.Secondary bleeding rate was not statistically significant in the two groups(x2=1.29,P=0.26).CONCLUSION Intravenous infusion of methylprednisolone after coblation tonsillectomy is beneficial,especially in the relief of pain,gastrointestinal discomfort and pharyngeal edema.

Clinical efficacy of unilateral percutaneous transfacet screws combined with contralateral pedicle screw versus bilateral pedicle screws fixation in the treatment of the degenerative lumbar disease / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the surgical outcome of unilateral pedicle screw(UPS) after TLIF technique combined with contralateral percutaneous transfacet screw(PTS) fixation vs bilateral pedicle screws(BPS) fixation in treatment of degenerative lumbar disease.</p><p><b>METHODS</b>From January 2009 to June 2012, 46 patients with degenerative lumbar diseases, including 30 males and 16 females with an average age of 51.5 years old, who were divided into two groups according to different fixation methods. Twenty-two cases underwent UPS after TLIF technique combined with contralateral PTS fixation (group A), while the others underwent BPS fixation(group B). The relative data were analyzed, such as blood loss volume, operative time, fusion rate, ODI score, JOA score and so on.</p><p><b>RESULTS</b>All the patients were followed up for 1 to 3 years with an average of 22 months. Except one case of each group was uncertainty fusion, the rest have obtained bony fusion, and the fusion rates in group A and B were 95.5% and 95.8%, respectively. No displacement and breakage of screw were found during follow-up. Operative time and blood loss volume in group A were better than of group B(<0.05). ODI and JOA scores had improved obviously than preoperation(<0.05), but the differences had no statistical significance between two groups(>0.05).</p><p><b>CONCLUSIONS</b>Two approaches had similar clinical outcomes for degenerative lumbar disease with no severe instability. Compared with BPS fixation, the UPS after TLIF technique and contralateral PTS fixation has the advantages of less trauma, shorter operative time and less blood loss, and it is a safe and feasible surgical technique.</p>

New qualities control strategy of Scutellaria baicalensis by isothermal titration calorimetry / 中国中药杂志

It has been focused on that there will be precipitates when decoction of Scutellariat Radix mixed with Coptidis Rhizoma. Precipitation was derived from interaction between acidic and basic compounds. This study was based on the interaction between active ingredients after compatibility, strived to explore whether it was feasible to judge the qualities of different Scutellariat Radix by isothermal titration calorimetry (ITC), build a new method established to characterize the qualities of traditional Chinese medicine by taking a series of active ingredients as index. We selected Scutellariat Radix (including three batches of different Scutellariat Radix bought from market and immature Scutellariat Radix which usually was used as adulterant) in different batches as the samples. First, we used ITC to determine the binding heat of the reactions between berberine and the decoctions of different Scutellariat Radix. The test showed that the binding heat of berberine titrated Scutellariat Radix was Scutellariat Radix A (－317.20 μJ), Scutellariat Radix B (－292.83 μJ), Scutellariat Radix C (－208.95 μJ) and immature Scutellariat Radix (－21.53 μJ), respectively. We chose deionized water titrated by berberine (2.51 μJ) as control. The heat change of berberine titrated immature Scutellariat Radix was much less than berberine titrated Scutellariat Radix. Then we determined the absorbance of different decoctions of Scutellariat Radix by UV Spectrophotometry on the maximum absorption wavelength, and the result is： Scutellariat Radix A (0.372), Scutellariat Radix B (0.333), Scutellariat Radix C (0.272), immature Scutellariat Radix (0.124). The absorbance of immature Scutellariat Radix was also less than Scutellariat Radix. The result of ITC assay was corresponded to UV spectrophotometry test. In conclusion, ITC could be used to characterize the quality of Scutellariat Radix. The new method to characterize the qualities of traditional Chinese medicine by taking a kind of active ingredients as index building by ITC was simple, scientific and feasible.

Short-term efficacy of da Vinci robotic surgical system on rectal cancer in 101 patients / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the feasibility and safety of da Vinci robotic surgical system in rectal cancer radical operation, and to summarize its short-term efficacy and clinical experience.</p><p><b>METHODS</b>Data of 101 cases undergoing da Vinci robotic surgical system for rectal cancer radical operation from March 2010 to September 2012 were retrospectively analyzed. Evaluation was focused on operative procedure, complication, recovery and pathology.</p><p><b>RESULTS</b>All the 101 cases underwent operation successfully and safely without conversion to open procedure. Rectal cancer radical operation with da Vinci robotic surgical system included 73 low anterior resections and 28 abdominoperineal resections. The average operative time was (210.3±47.2) min. The average blood lose was (60.5±28.7) ml without transfusion. Lymphadenectomy harvest was 17.3±5.4. Passage of first flatus was (2.7±0.7) d. Distal margin was (5.3±2.3) cm without residual cancer cells. The complication rate was 6.9%, including anastomotic leakage(n=2), perineum incision infection(n=2), pulmonary infection (n=2), urinary retention (n=1). There was no postoperative death. The mean follow-up time was(12.9±8.0) months. No local recurrence was found except 2 cases with distant metastasis.</p><p><b>CONCLUSION</b>Application of da Vinci robotic surgical system in rectal cancer radical operation is safe and patients recover quickly The short-term efficacy is satisfactory.</p>

Robotic-assisted radical gastrectomy using da Vinci robotic system: a report of 41 cases / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the feasibility and safety of da Vinci robotic-assisted radical gastrectomy for gastric cancer.</p><p><b>METHODS</b>Forty-one patients with gastric cancer from Southwest Hospital between March 2010 and December 2011 underwent da Vinci robotic-assisted radical gastrectomy including total gastrectomy(n=12) and distal gastrectomy (n=29).</p><p><b>RESULTS</b>Conversion was required in two patients. One was converted to open surgery, and the other to conventional laparoscopic surgery. The remaining thirty-nine patients underwent da Vinci robotic-assisted radical gastrectomy successfully. The mean operative time was (285±61) min for total gastrectomy, and (225±39) min for distal gastrectomy. The mean blood loss was (180±157) ml in total gastrectomy, and (150±127) ml in distal gastrectomy. The mean number of harvested lymph nodes was 34.2±18.5. The mean time for gastrointestinal function recovery was (3.1±1.2) days. The time to ambulation was (2.7±1.5) days. The time to oral liquid intake was (3.7±1.5) days. Two patients had complication including wound infection and pneumonia. After follow up ranging from 1 to 21 months (median 11 months), 4 patients died from peritoneal metastasis, 1 survived with tumor, and the remaining 36 patients survived without disease.</p><p><b>CONCLUSIONS</b>da Vinci robotic-assisted radical gastrectomy is a feasible and safe surgical procedure with clear operation field, precise dissection, minimal trauma and fast recovery.</p>

Influence of CO2 pneumoperitoneum pressures on the expression of adhesion molecules of gastric cancer cells / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To study the effect of different CO2 pneumoperitoneum pressures on the expression of adhesion molecules of human gastric cancer cell line MNK-45.</p><p><b>METHODS</b>MKN-45 cells in the experimental groups were exposed to simulated CO2 environment maintained at different pressures (1.2, 1.6, 2.0 kPa) for 4 hours. Control groups were exposed to room air. At the 0, 24, 48, 72, 96 hours after treatment, CD44v6, ICAM-1 and E-cadherin were detected by flow cytometry method.</p><p><b>RESULTS</b>CD44v6 and ICAM-1 expressions showed pattern of firstly elevating, then descending to normal under the pressures of 1.2 kPa and 1.6 kPa. The expressions were different from control group significantly at 24 and 48 hours (P<0.01), while the 72 hours expression showed no difference compared with the controls (P>0.05). E-cadherin expression decreased significantly right after treatment compared to the control (P<0.01), but recovered to the level of control at 48 hours (P>0.05). In the 2.0 kPa group the expression changes of CD44v6, ICAM-1 and E-cadherin were more remarkable. CD44v6 and ICAM-1 expressions were increased significantly compared to control right after treatment (P<0.05). E-cadherin expression was significantly decreased even at 48 hours compared to the controls (P<0.01).</p><p><b>CONCLUSION</b>In vitro CO2 pneumoperitoneum pressures have transient influence on the adhesion molecules expression of gastric cancer cell MKN-45, then those expressions can recover in a short-time.</p>