Curative effect of phacoemulsification through clear corneal tunnel incision on cataract and the influences on dry eye symptom scores and break-up time / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To analyze curative effect of phacoemulsification through clear corneal tunnel incision on cataract and the influences on subjective sylptols of dry eye questionnaire scores(SDES)and break-up time(BUT).<p>METHODS: During the period from June 2015 to January 2019, 117 cataract patients(139 eyes)who underwent cataract surgery in the hospital were divided into group A(<i>n</i>=65, 72 eyes)and group B(<i>n</i>=52, 67 eyes)by random number table method. Groups A and B underwent phacoemulsification through 2.2mm and 3.0mm micro-incision, respectively. The general surgical status, SDES, BUT and curative effect indexes \〖best corrected visual acuity(BCVA), spherical equivalent(SE), endothelial cell density(ECD)\〗 were compared between the two groups.<p>RESULTS: There was no significant difference in ultrasound time, cumulative released energy, operation time or postoperative complications between two groups(<i>P</i>>0.05). After surgery, SDES scores in both groups were significantly increased, BUT was decreased compared with that at 1d before surgery. At 3mo after surgery, SDES and BUT recovered to preoperative levels. At 1d and 1wk after surgery, SDES score in group A was significantly lower than that in group B, while BUT was significantly higher than that in group B(<i>P</i><0.05). After surgery, BCVA LogMAR and ECD in both groups were significantly decreased, while SE and corneal diopter were significantly increased, without significant difference between the two groups(<i>P</i>>0.05). <p>CONCLUSION:The curative effect of phacoemulsification through clear corneal tunnel incision is reliable on cataract. The tear film function is better through 2.2mm micro-incision.

Investigation of Single-stranded Deoxyribonucleic Acid Translocation Through α-Hemolysin Nanopore with Ionic Liquid Supporting Electrolytes / 分析化学

Due to the difference in spatial configuration and charge of the bases in a DNA molecule, characteristic translocation current pulses through a single nanopore could be obtained. This could become the basis of DNA sequencing method. However, due to the fast translocation speed (sub-micro seconds) and the small current change (about pA), it is still a challenge to obtain the accurate molecular substructure with present electronic techniques. In this work, in order to control the translocation behavior of ssDNA, two kinds of ionic liquids with high viscosity and conductivity were introduced to establish a viscosity gradient with the α-hemolysin single nanopore interface and the acidity of the solution was optimized. The trans chamber contained pure BmimPF6 and the cis chamber contained 1 mol/ L BmimCl and 10 mmol/ L Tris-HCl ( pH 5. 5 ). Preliminary experiment results under this electrolyte configuration showed that poly ( dC) 15 , poly ( dC) 15 , poly(dC) 30 and poly(dC) 50 exhibited obvious long duration pulses with high current suppression ratio. The blocking depth reached more than 95％ of long blocking events. The duration time of long blocking events prolonged to tens or hundreds of milliseconds. Meanwhile, the peak-peak of baseline noise was reduced by about 30％ .

Study on Interaction of Protamine and Single-stranded DNA by Current Pulses Through Single Nanopore / 分析化学

Single nanopore current pulse method is a new, rapid and simple detection method, which is promising for single-molecule DNA sequencing and bio-sensing. Due to the short duration and the low current amplitude of the pulses caused by molecular translocation under normal conditions, pulse detection system with fast response and high sensitivity is required. In this work, based on a lab-established pulse detection system, the effect of protamine in the regulation of single-stranded (ssDNA) current pulses with α-hemolysin (α-HL) single nanopore interface was investigated. Experimental results showed that the pulses positive charged protamine and negative ssDNA probes were both well observed with the established system, and both the pulse amplitude and duration of ssDNA were increased as a result of interaction with protamine. This study provides a way to improve the resolving power of current pulses based on molecular interactions.

Efficacy of FFR-guided PCI in Coronary Artery Disease Patients With SYNTAX score≥33 Unsuitable for CABG: A Single-center Clinical Observation / 中国循环杂志

Objective: To observe the short- and long-term clinical outcomes of fraction flow reserve (FFR)-guided percutaneous coronary intervention (PCI) in coronary artery disease (CAD) patients with SYNTAX score≥33 unsuitable for coronary artery bypass grafting (CABG). Methods: A total of 117 CAD patients admitted in our hospital from 2012-01 to 2015-06 were enrolled. Since SYNTAX score≥33, EuroSCORE>6, the patients were unsuitable for CABG and treated in 2 groups: Medication group, n=20 and PCI group, during FFR-guided PCI procedure, patients received ROTA or IVUS according to physician's experience, n=97. All patients were followed-up for at least 12 months. Meanwhile, taking "coronary stent and bypass", "CABG and PCI" as key words, we searched relevant documents in VIP Chinese science and technology journal full-text database, WanFang medical database, ChinaNet and Chinese biomedical literature database from 2012-01-01 to 2015-12-31, patients' outcomes were compared with the above references to explore the clinical benefit. Results: ① PCI group and Medication group had similar SYNTAX score and EuroSCORE, P>0.05. The common pathogenesis was LAD involvement, chronic occlusion was 31.3% (5/16) in patients with partial revascularization.②PCI group had 18.6% (18/97) incidence of major adverse cardiac and cerebral events (MACCE), 2 patients died during follow-up period and 9 received revascularization; Medication group had 60% (12/20) incidence of MACCE, 3 patients died during follow-up period; the difference between 2 groups showed statistical meaning, P<0.05.③There were 22 relevant documents retrieved as comparison; in our research, PCI group had similar incidence of MACCE to the documents, P>0.05; Medication group had increased incidence of MACCE than the documents, P<0.05. Conclusion: FFR-guided PCI could bring clinical benefit in CAD patients with SYNTAX score≥33 unsuitable for CABG.

Clinical features and prognosis analysis of 36 cases with post-infarction ventricular septal rupture / 心血管康复医学杂志

Objective :To explore clinical features ,therapeutic program and prognosis of patients with post-infarction ventricular septal rupture (PI-VSR).Methods :Clinical data of 36 PI-VSR patients ,who were treated in our hospital from Dec 2009 to Dec 2016 ,were retrospectively analyzed .According to in-hospital death condition ,patients were divided into in-hospital survival group (n＝14) and in-hospital death group (n＝22).General data were compared between two groups .Multi-factor Logistic regression analysis was used to analyze influencing factors for in-hospital death in PI-VSR patients .Results :All PI-VSR patients received routine medication ,10 cases received intra-aortic balloon pump (IABP) simultaneously , eight cases received transcatheter intervention to occlude VSR and stent im- plantation ,and two cases received ventricular septal repair surgery .In-hospital mortality of PI-VSR patients was 61.1%(22/36).Compared with in-hospital survival group ,there were significant rise in age [55 (46 ,64) years vs . 67 (52 ,82) years] ,percentages of diabetes mellitus (21.4% vs.59.1%) and renal insufficiency (42.9% vs. 90. 9%) ,and significant reductions in LVEF [41 (20 , 48 )% vs.31 (20 , 38 )%] and percentage of surgery (57.1% vs.9.1%) in in-hospital death group ,P＜0.05 or ＜0.01. Multi-factor Logistic regression analysis indica-ted that LVEF and surgery were independent protective factors for in-hospital death in PI-VSR patients (OR＝0.519 ,0.001 ,P＝0.032 ,0.023).Conclusion : PI-VSR is a rare fatal complication of myocardial infarction ,and therapeutic effect of conservative treatment is poor .Transcatheter interventional occlusion is an alternative transi-tional program that might replace surgery in PI-VSR treatment .

Clinical observation on the effect of joint mobilization in treating elderly patients after distal radius fractures operation / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the effect of joint mobilization on postoperative wrist joint function, pain and grip strength for elderly patients with distal radius fracture.</p><p><b>METHODS</b>From January 2015 to June 2016, a total of 67 elderly patients with distal radius fracture were randomly divided into routine exercise group and joint mobilization group. Among them, 37 patients in the routine exercise group underwent conventional distal radius fracture postoperative joint function exercise regimen, including 16 males and 21 females with a mean age of (67.8±3.2) years old ranging from 60 to 72 years old;the injured side was dominant in 23 cases and non-dominant in 14 cases;injury mechanism was fall in 26 cases, traffic accident in 11 cases; for AO type, 6 cases were type B3, 18 cases were type C1, 7 cases were type C2, 6 cases was type C3. Other 30 patients in the joint mobilization group underwent joint mobilization on the basis of the routine exercise group including 14 males and 16 females with a mean age of (67.1±4.0) years old ranging from 61 to 74 years old; the injured side was dominant in 21 cases and non-dominant in 9 cases;injury mechanism was fall in 25 cases, traffic accident in 5 cases;for AO type, 8 cases were type B3, 13 cases were type C1, 6 cases were type C2, 9 cases were type C3. The wrist joint activity, Gartland-Werley wrist joint function score, VAS pain score and grip strength were observed at 3 months afrer treatment.</p><p><b>RESULTS</b>After 3 months' treatment, the VAS in the routine exercise group was higher than that of the joint mobilization group (<0.05). The grip strength of affected side in both groups were lower than that of contralateral side, but the average grip strength of affected side in joint mobilization group was higher than that in routine exercise group(<0.05). In routine exercise group, the average angle of flexion, extension, radial deviation were significantly higher than those of joint mobilization group(<0.05). But ulnar deviation angle in routine exercise group compared with joint mobilization group had no significant difference (>0.05). In the comparison of each item of Gartland-Werley, there was no significant difference between two groups in residual deformity and complication(>0.05); the average score of subjective score, objective score and total score in routine exercise group were significantly higher than those of the joint mobilization group (<0.05). The wrist function Gartland-Werley score in routine exercise group after treatment was excellent in 21 cases, good in 10, 6 in fair, while in joint mobilization group, excellent in 23, good in 6, fair in 1(<0.05).</p><p><b>CONCLUSIONS</b>The application of joint mobilization in the treatment of elderly patients with distal radius fracture can improve the joint activity and obtain better wrist function after surgery.</p>

Analysis of phacovitrectomy with internal limiting membrane peeling to treat foveoschisis without macular hole in ultra-high myopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the results of phacovitrectomy with internal limiting membrane(ILM) peeling to treat foveoschisis in ultra-high myopia.METHODS: Totally 32 eyes of 32 ultra-high myopia patients with foveoschisis were selected retrospectively.The preoperative refractive errors ranged from-12.00D to-20.00D with the mean of-15.78±2.16D.The best corrected visiual acuity(BCVA) were converted to LogMAR acuity, and the average BCVA was 4.1±0.4.Conventional phacovitrectomy with ILM peeling by ICG dying were performed.Gas tamponade were performed to end the operation.The BCVA and the foveoschisis cavity were observed by 1-9mo after the surgery, with the mean of 4.5mo.RESULTS: The foveoschisis cavity of 30 eyes were healed with BCVA increased and visual distortion alleviated distinctly (94%)(t=-7.91, P<0.05).CONCLUSION: Phacovitrectomy with ILM peeling is useful in treating foveoschisis in ultra-high myopia with visual function preserving.

Clinical value of different surgeries in the treatment of angle closure glaucoma with cataract / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the effects of different surgeries in the treatment of angle closure glaucoma with cataract and the improvement of quality of life.METHODS: The clinical data of 60 cases (60 eyes) with angle closure glaucoma and cataract who were admitted to the hospital between January 2014 and October 2016 were collected.According to the surgical method, they were divided into the control group (simple trabeculectomy, n=28) and the observation group (trabeculectomy combined with phacoemulsification and intraocular lens implantation, n=32).The changes of visual acuity and intraocular pressure before and after surgery were compared between the two groups.The incidence of postoperative complications was statistically analyzed, and the quality of life was compared between the two groups.RESULTS: Before surgery, there was no significant difference in visual acuity, intraocular pressure and anterior chamber depth between the two groups (P>0.05).At 4wk after surgery, the visual acuity of two groups increased and intraocular pressure decreased.The anterior chamber depth of observation group increased while that of the control group decreased (P0.05).The incidence of postoperative complications in the observation group was lower than that in the control group (P0.05).At 4wk and 3mo after surgery, the scores of the two groups increased (P<0.05), and the quality of life scores of observation group were higher than those of the control group at different time (P< 0.05).CONCLUSION: The success rate of trabeculectomy combined with phacoemulsification and intraocular lens implantation is high in the treatment of angle closure glaucoma with cataract.The regimen can improve the visual function, reduce the incidence of postoperative complications, and improve the quality of life of patients.

Analysis of clinical features of 56 cases with Terrien's marginal degeneration / 国际眼科杂志(Guoji Yanke Zazhi)

?AIM:To analyze the clinical features of Terrien marginal degeneration ( TMD) .?METHODS:Fifty-six patients(90 eyes) admitted in our hospital from January 2013 to January 2015 were selected as observation group.At the same period, 56 healthy (88 eyes) for corneal examination were as control group to analyze the clinical features of TMD. With immunohistochemistry and enzyme linked immunoassay method ( ELISA), the levels of HLA-DR, HLA-DQ and tumor necrosis factor-α( TNF-α) in blood samples of TMD patients were tested.?RESULTS:The transparent degree of the eye, lipid deposition in TMD patients with early, advanced, swelling and hole-wearing period were significantly different (χ2=10.85,χ2=65.32, P<0.05).Astigmatism in TMD patients with early and advanced, swelling and hole -wearing period were significantly different (P<0.05).The levels of HLA-DR, HLA-DQ and TNF-αin blood samples between the two groups were significantly different ( t=45.326, t=23.564, t=19.86, P<0.05).?CONCLUSION: Terrien's marginal degenerative is an inflammatory disease characterized by increased levels of TNF-α, HLA-DQ, and HLA-DR in peripheral blood, decreased corneal transparency, astigmatism and lipid deposition.This research provides experiment evidence for the mechanism of TMD.

Detection of T lymphocyte subsets in the peripheral blood of patients with advanced lung adenocarcinoma / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate the CD4+CD25+ regulatory T cells (Treg) and other lymphocyte subsets in the peripheral blood of patients with advanced lung adenocarcinoma.</p><p><b>METHODS</b>Peripheral blood samples were obtained from 64 patients with advanced lung adenocarcinoma (case group) and analyzed by flow cytometry. The ratios of CD4+CD25+Treg T cells and other T lymphocyte subsets in peripheral blood were compared with those from 33 healthy controls (control group).</p><p><b>RESULTS</b>The percentages of CD3+ and CD3+CD4+ were (66.5±11.0)% and (37.7±10.6)% respectively in the peripheral blood of the case group, which were significantly lower than those [(72.0±6.0)% and (42.0±6.4)%] in the control group (t=-3.2,-2.4; P=0.020, 0.015, respectively). The ratio of CD4+ CD25+ Treg cells in case group (10.5±4.0)% was significantly higher than that [(8.4±3.5)%] in the control group (t=-2.2, P=0.013). CD4+/CD8+ value of case group (1.4±0.8) was significantly lower than that (1.8±0.7) in control group(t=-2.2, P=0.029). CD3+CD8+, CD8+CD28-, and CD8+CD28+ showed no significant differences (all P>0.05). Smoking, differentiation grade, and size of the tumor showed no association with the function damage of T lymphocyte subsets, while the carcino-embryonic antigen level did.</p><p><b>CONCLUSIONS</b>In patients with advanced lung adenocarcinoma, Treg increases and CD4+/CD8+ decreases, suggesting remarkably suppressed immune functions. However, more research is warranted to validate the association of T cells subset dysfunction with smoking, differentiation grade, and size of tumor.</p>

The clinical study of modified total aortic arch replacement and stent elephant trunk technique treatment for patients with DeBakey I thoracic aortic dissection / 中华外科杂志

<p><b>OBJECTIVE</b>To summarize the clinical study of modified total aortic arch replacement and stent elephant trunk technique treatment to patients with DeBakey I thoracic aortic dissection.</p><p><b>METHODS</b>From January 2006 to October 2010, 101 cases of DeBakey I aortic dissection were treated by modified total arch replacement and stent elephant trunk technique, in which emergency surgery for 73 cases. There were 76 male and 25 female patients, aged from 21 to 77 years with a mean of (49 ± 8) years. Intraoperative ascending aortic replacement in 31 cases, Bentall procedure in 29 cases, Wheat procedure in 7 cases, David procedure in 34 cases. At the same time stent elephant trunk in the left subclavian artery corresponding position was windowed to rebuild the blood supply. Deep hypothermic circulatory arrest cerebral protection was completed by bilateral antegrade cerebral perfusion.</p><p><b>RESULTS</b>The mean cardiopulmonary bypass time was (212 ± 40) min, mean myocardial occlusion time was (95 ± 16) min, mean circulatory arrest time was (42 ± 8) min. Operative mortality was 1 case and hospital mortality was 5 case, which died of septicemia, acute renal failure and hemiplegia complicated with multiple organ failure. Compared with selective cerebral perfusion, the incidence of postoperative cerebral vascular accident and transient neurological dysfunction decreased. Seventy-six cases received aorta CTA before discharged, the closure rate of descending thoracic aortic dissection false lumen was 78.9%. Seventy-one patients were followed up for 5 to 49 months, 50 cases was reviewed by CTA, of which closure rate of descending thoracic aortic dissection false lumen was 88.0%, no late death and re-surgery.</p><p><b>CONCLUSIONS</b>The modified total aortic arch replacement and stent elephant trunk technique treatment for patients with DeBakey I thoracic aortic dissection was safe and effective, with less postoperative complications.</p>

Effects of rosuvastatin on monocrotaline-induced pulmonary artery hypertension in rats / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the effects of rosuvastatin on monocrotaline (MCT)-induced pulmonary artery hypertension in rats.</p><p><b>METHODS</b>Pulmonary arterial hypertension was induced by a single subcutaneous injection of monocrotaline (50 mg/kg) in rats. In the prevention protocol, 32 male Sprague-Dawley rats were randomly divided into four groups (n = 8 each): low-dose rosuvastatin prevention group (2 mg×kg(-1)×d(-1)), high-dose rosuvastatin prevention group (10 mg×kg(-1)×d(-1)), pulmonary arterial hypertension group, normal control group. Beginning on the MCT injection day, rats were treated with rosuvastatin by daily gavage for 4 weeks. Normal control group and pulmonary arterial hypertension group received vehicle by gavage. In the treatment protocol, 52 male Sprague-Dawley rats were randomly divided into four groups (n = 13 each): low-dose rosuvastatin treatment group (2 mg×kg(-1)×d(-1)), high-dose rosuvastatin treatment group (10 mg×kg(-1)×d(-1)), pulmonary arterial hypertension group, normal control group. Four weeks after MCT injection, rats were treated with rosuvastatin by daily gavage for 4 weeks. Normal control group and pulmonary arterial hypertension group received vehicle by gavage. At the end of study, survival rates, mean pulmonary arterial pressure (mPAP), wall thickness of small pulmonary artery and right ventricular hypertrophy among groups were compared. The expression levels of proliferating cell nuclear antigen (PCNA) and endothelial nitricoxide synthase (eNOS) protein in small pulmonary artery, the expression levels of Rho kinase 1(ROCK-1) and eNOS mRNA in lung tissue were also detected.</p><p><b>RESULTS</b>All rats in the prevention protocol survived. Rosuvastatin treatment improved survival in the treatment protocol (58%, 75% vs.30%, P < 0.05). Rosuvastatin therapy in both preventive or treatment protocols significantly lowered mPAP [prevention protocol: (27.53 ± 3.43), (25.72 ± 1.76) vs. (36.05 ± 2.45) mm Hg (1 mm Hg = 0.133 kPa), P < 0.01; treatment protocol: (30.39 ± 3.17), (27.59 ± 1.99) vs. (40.68 ± 1.39) mm Hg, P < 0.01], reduced thickening of small pulmonary artery wall (P < 0.01) and right ventricular hypertrophy (P < 0.01). Rosuvastatin also inhibited PCNA expression of SMC (P < 0.01), restored eNOS expression of EC (P < 0.05) and inhibited ROCK-1 mRNA expressions in lung tissue (P < 0.05).</p><p><b>CONCLUSIONS</b>Rosuvastatin therapy reduced mPAP in monocrotaline-induced pulmonary arterial hypertension rat model and this effect is linked with inhibition of ROCK-1 expression, inhibition of smooth muscle cell proliferation and restoration of endothelial cell functions.</p>

Prognostic analysis of patients with gastrointestinal stromal tumors: a single unit experience with surgical treatment of primary disease / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Gastrointestinal stromal tumor (GIST), the most common type of mesenchymal tumors of the gastrointestinal tract, is a recently recognized tumor. The biological behavior of GIST is highly variable. Surgical resection remains the major treatment for GIST. In this study we retrospectively analyzed our surgical experience with 181 GIST patients to determine the effects of the treatment and the pathological features and prognosis factors of these GIST patients.</p><p><b>METHODS</b>The clinicopathological features and follow-up data of the 181 patients with GIST who had received surgical resection between January 1999 and December 2007 at Ren Ji Hospital were retrospectively reviewed. Immunohistochemical stains including CD117 (KIT), CD34, and other markers were used. Tumor size, mitotic index and other pathological parameters were recorded. According to the consensus of NIH risk-group stratification system based on maximum tumor size and mitotic index (per 50 high power field), tumors were classified into very-low-risk group (15 tumors, 8.3%), low-risk group (48, 26.5%), intermediate-risk group (52, 28.7%) and high-risk group (66, 36.5%). Prognostic factors were analyzed by Cox analysis including age, sex, tumor size, tumor site, mitotic index, NIH categories and surgical procedures.</p><p><b>RESULTS</b>One hundred and seven (59.1%) of the 181 tumors were located in the stomach, 51 (28.2%) in the small intestine, 9 (5.0%) in the colon and rectum, and 14 (7.7%) in other sites including the omentum and mesentery. The median age of the patients was 58 (range, 24-84) years, and 102 patients (56.4%) were male. Tumor size ranged from 0.5 to 30 cm, while the mean size was 7.02 cm. Metastasis was found in 7 patients. One hundred and seventy-six (97.2%) of the 181 patients underwent radical resection, and among them 26 patients received extensive resection with the adjacent organ adherent to the tumors. The positive rate for the KIT protein (CD117) in immunostaining was 94.5% (171/181), while that for CD34 was 86.2% (156/181). The 1-, 3-, and 5-year survival rates of the 181 patients were estimated to be 95.2%, 87.9% and 78.5%, respectively. There was a significant difference in age, tumor size, tumor site, mitotic index, NIH categories, and presence or absence of multivisceral resection (P<0.05). But there was no significant difference in sex between the groups. Cox hazard proportional model revealed that advanced clinical stage and large tumor size contributed to worse prognosis. The patients who were treated with imatinib because of recurrence and metastasis or high recurrence risk showed stable disease.</p><p><b>CONCLUSIONS</b>Surgical resection is the gold standard of treatment for primary GIST. NIH categorization is simple and effective to evaluate GIST behavior and prognosis. Targeted therapy such as imatinib, a KIT tyrosine kinase inhibitor, may play an important role in the treatment of GIST.</p>

Study of loss of heterozygosity at 9p21 and P16 expression in gastrointestinal stromal tumors / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the impact of loss of heterozygosity (LOH) at chromosome 9p21 and P16(INK4A)(CDKN2A) expression on the prognosis of gastrointestinal stromal tumor (GIST).</p><p><b>METHODS</b>A total of 51 cases with GISTs were characterized by immunohistochemistry and evaluated for LOH at 9p21 by microsatellite analysis in 4 markers(D9S1751, D9S1846, D9S942 and D9S1748). Associations of LOH at 9p21 and P16(INK4A) expression encoded by CDKN2A with clinicopathological parameters and prognosis in GISTs were analyzed.</p><p><b>RESULTS</b>The frequency of 9p21 LOH was 37.0% (10/27) at D9S1751, 37.5%(12/32) at D9S1846, 42.1%(16/38) at D9S942 and 24.2%(8/33) at D9S1748. The overall frequency of LOH at 9p21 was 63.3%(31/49). In 21 samples of 51 GISTs(41.2%), P16 expression was not detected. Loss of P16 expression was 60%(12/20) in high risk group and 23.5%(4/17) in very low and low risk groups(P<0.05). The 5-year overall survival rate of p16-negative patients was 70.8%, while in P16-positive patients it was 92.0%(P<0.05).</p><p><b>CONCLUSIONS</b>LOH at 9p21 is a frequent event in GIST. Loss of CDKN2A gene at 9p21 may contribute to the progression and malignant transformation of GIST. P16 expression in GIST is associated with prognosis.</p>

Effect of c-kit mutation on the prognosis of gastrointestinal stromal tumors: a meta-analysis / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of c-kit mutation on the prognosis of gastrointestinal stromal tumors.</p><p><b>METHODS</b>A search of studies in PubMed and MedLine (from 1999 to 2008) was performed to assess the effect of c-kit mutation on the prognosis of gastrointestinal stromal tumors. The articles were retrieved with the entries of "gastrointestinal stromal tumors", "imatinib", "c-kit" and "mutation". A meta-analysis was performed to assess the data included.</p><p><b>RESULTS</b>A total of 15 articles were collected in this analysis. No significant differences was found in incidence of mitoses (> 5/50 HPF) between the patients with wild type c-kit (wild type group) and the ones with mutated c-kit (mutation group) (P = 0.710); tumor recurrence and metastasis rate after surgery was significant higher in the mutation group than that in wild type group (P = 0.010); as for imatinib response with different c-kit mutation types, the results showed the incidence of clinical response (complete response + partial response) was significantly higher in mutation group than that in wild type group (P = 0.009), but the imatinib resistance rate was lower in mutation group (P = 0.000); three studies provided data for imatinib resistance with c-kit second mutations, the results showed the second mutations mainly focus on exon 13, 14, 17.</p><p><b>CONCLUSIONS</b>C-kit mutation is related closely with the incidence of recurrence and metastasis in GIST after surgery. The mutations of c-kit influences the therapeutic effects of imatinib.</p>

Analysis of clinicopathology and prognosis in 181 patients with gastrointestinal stromal tumors / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the therapeutic experience of gastrointestinal stromal tumors (GIST) and to analyze the pathological features and prognostic factors of GIST.</p><p><b>METHODS</b>The clinicopathological and follow-up data of 181 patients with GIST admitted in Renji Hospital between January 1999 and December 2007 were analyzed retrospectively. All the cases were grouped according to Fletcher's risk scheme. Life table and COX regression model were used to evaluate the prognostic factors.</p><p><b>RESULTS</b>Out of 181 tumors, 107(59.1%) were located in stomach, 51 (28.2%) in intestine and 23(12.7%) in colorectum or other sites. Distant metastases,including liver metastases were found in 7 patients intraoperatively. Tumor size ranged from 0.5 to 30 cm with the mean of 7.02 cm. The positive rate of CD117 was 94.5% (171/181) and that of CD34 was 86.2% (156/181). One hundred and seventy-six patients underwent complete resections, including multi-organ resections in 26 patients. The other patients underwent palliative operations. The 1-, 3- and 5-year overall survival rates of 181 patients were 95.2%, 87.9% and 78.5% respectively. Univariate analysis revealed age, tumor size, primary organ of tumor, mitotic count, Fletcher's classification and multi-organ resection were associated with survival rate. No significant difference of sex was existed among groups. COX hazard proportional model revealed that advanced stage and large tumor size indicated worse prognosis. Eight patients with high risk of recurrence and 3 patients with recurrence and metastasis were stable after receiving imatinib therapy.</p><p><b>CONCLUSIONS</b>The diagnosis of GIST depends on endoscope and CT. Fletcher's classification is simple and effective to evaluate GIST behavior and prognosis. Surgical resection is still the main therapy for GIST and targeted therapy will play a more important role for prognosis in the future.</p>

The construction of siRNA-tTG lentivirus vector and its effect on activated hepatic stellate cells / 中华外科杂志

<p><b>OBJECTIVE</b>To construct the lentivirus vector of siRNA-tTG and investigate the effects and mechanism of lentivirus mediated tTG RNA interference (RNAi) on the hepatic stellate cell (HSC).</p><p><b>METHODS</b>The effective RNAi sequences targeted the tTG gene were designed and Lenti-siRNA-tTG was constructed by plasmid transfection. The rats were distributed into three groups:negative control (CON) group, siRNA-GFP (GFP) group and siRNA-tTG (rtTG) group. After the infection of lentivirus mediated siRNA-tTG, the mRNA and protein expression of tTG, alpha-SMA and collagen-1, and the cell proliferative status of HSC were observed in the three groups respectively.</p><p><b>RESULTS</b>The lentivirus vector of siRNA-tTG was constructed successfully. After the infection of lentivirus mediated siRNA-tTG, the mRNA expression of tTG and collagen-1 was decreased significantly (P < 0.05), and the protein expression of tTG, lysine and collagen-1 was also decreased significantly (P < 0.01), in the same time the proliferative ability of HSC was decreased significantly (P < 0.05).</p><p><b>CONCLUSIONS</b>Lentivirus mediated siRNA-tTG can inhibit the proliferation of HSC by inhibition of the expression of tTG and attenuate the synthesis of collagen-1 and lysine. Thus, it may have a potential anti-fibrosis effect.</p>

Rosuvastatin attenuates vascular endothelial adhesiveness in apolipoprotein E-deficient mice / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the anti-inflammatory effects on the vessel wall of rosuvastatin in apolipoprotein E-deficient mice.</p><p><b>METHODS</b>Eight-week-old apolipoprotein E-deficient mice fed a normal chow diet were treated with vehicle or various doses of rosuvastatin (1, 5, or 20 mg/kg) by subcutaneous injection for 2 or 6 weeks prior to sacrifice. Endothelial adhesiveness for monocytes was determined by functional binding assay. The expressions of vascular cell adhesion molecule-1 and monocyte chemotactic protein-1 in the vessel wall were detected by quantitative real-time polymerase chain reaction.</p><p><b>RESULTS</b>Endothelial adhesiveness for monocytes was significantly attenuated after 2 or 6 weeks treatments with 5 or 20 mg/kg rosuvastatin. Rosuvastatin also significantly reduced the expressions of vascular cell adhesion molecule-1 and monocyte chemotactic protein-1 in the vessel wall.</p><p><b>CONCLUSION</b>The anti-inflammatory effects of suvastatin might be responsible for attenuating the pathogenesis of atherogenesis in apolipoprotein E-deficient mice.</p>

The clinical analysis of 51 patients with thoracic aortic dissection / 中华外科杂志

<p><b>OBJECTIVE</b>To summarize the clinical experience about surgical treatment of aortic dissection.</p><p><b>METHODS</b>The clinical data of 51 patients with aortic dissection admitted from December 2004 to December 2006 were analyzed retrospectively. There were 35 male and 16 female patients with a mean age of 55.7 years (ranged from 18 to 83-years-old). Twenty-seven patients of type I was performed under deep hypothermic circulatory arrest and selected cerebral perfusion with stent-graft which was implanted into the descending aorta through aorta arch. Five patients of type II was performed including Bentall operation in 3 patients, Wheat operation in 1 patient, ascending aorta replacement in 1 patient. Nineteen patients of type III was performed with stent-graft which was implanted into the descending aorta through aorta arch under deep hypothermic circulatory arrest.</p><p><b>RESULTS</b>The time of cardiopulmonary bypass (CPB) in type I patients was 250 to 290 min with an average of (274 +/- 53) min, and the arrest time was 40 to 59 min with an average of (53 +/- 14) min. CPB time of type II patients was 130 to 159 min with an average of (146 +/- 43) min, and the cross clamp time was 60 to 79 min with an average of (66 +/- 15) min. CPB time of type III patients was 240 to 280 min with an average of (260 +/- 28) min, and the arrest time was 20 to 27 min with an average of (24 +/- 3) min. The mean hemorrhage volume of the entire group was (500 +/- 250) ml. The mean ICU retention time was (5.0 +/- 1.5) d and the length of stay was (15.0 +/- 2.5) d. Three patients died during perioperative period. Two patients appeared cerebrovascular accident after operation. One patient appeared descending aorta dilation in the follow-up of 2 to 21 months.</p><p><b>CONCLUSION</b>Different clinical manifestations and treatment should be selected according to the different condition of aortic dissection aneurysm.</p>

The efficacy of preoperative portal vein embolization for extended hepatectomy: a meta-analysis / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical value of preoperative portal vein embolization (PVE) for extended hepatectomy.</p><p><b>METHODS</b>A comprehensive Pubmed, Medline and Ovid database search to identify all registered literature on portal vein embolization. Meta-analysis was performed to assess the result of PVE.</p><p><b>RESULTS</b>A total of 9 literatures provided data sufficiently enough for analysis involving in 494 patients. The results showed that postoperative liver failure was higher in the non-PVE group than the PVE group, but there was no difference in postoperative mortality between the PVE and non-PVE group; in sub-category analysis of hepatocellular carcinoma and liver metastasis of colorectal cancer, there was no difference in postoperative 1, 3 and 5-year survival rate between the PVE group and non-PVE group; 1 literature about liver metastasis of colorectal cancer show there was significant difference in postoperative metastasis between the PVE and non-PVE group; several patients after PVE didn't performed hepatectomy due to disease progress.</p><p><b>CONCLUSIONS</b>PVE is a safe and effective procedure to prevent postresection liver failure due to insufficient liver remnant, but surgeon should be cautious to choose the patient for PVE.</p>