Chang Wei Qing Decoction enhances the anti-tumor effect of PD-1 inhibitor therapy by regulating the immune microenvironment and gut microbiota in colorectal cancer / 中国天然药物

The anti-tumor effect of anti-PD-1 antibody has long been shown to be strongly related to the tumor immune microenvironment (TIME). This study aimed to mechanistically assess whether Chang Wei Qing (CWQ) Decoction can enhance the anti-tumor effect of PD-1 inhibitor therapy. PD-1 inhibitor therapy showed the significant anti-tumor effect in patients with mismatch repair-deficient/microsatellite instability-high (dMMR/MSI-H) colorectal cancer (CRC), rather than those with mismatch repair-proficient/microsatellite stable (pMMR/MSS) CRC. Hence, immunofluorescence double-label staining was utilized to explore the difference in the TIME between dMMR/MSI-H and pMMR/MSS CRC patients. Flow cytometry was used to analyze T-lymphocytes in tumors from mice. Western blot was used to measure the expression of PD-L1 protein in mouse tumors. The intestinal mucosal barrier of mice was evaluated by hematoxylin-eosin staining and immunohistochemistry. 16S rRNA-gene sequencing was used to examine the structure of the gut microbiota in mice. Subsequently, Spearmanapos;s correlation analysis was used to analyze the relationship between the gut microbiota and tumor-infiltrating T-lymphocytes. The results showed that dMMR/MSI-H CRC patients had more CD8+T cells and higher expression of PD-1 and PD-L1 proteins. In vivo, CWQ enhanced the anti-tumor effect of anti-PD-1 antibody and increased the infiltration of CD8+ and PD-1+CD8+ T cells in tumors. Additionally, the combination of CWQ with anti-PD-1 antibody resulted in lower inflammation in the intestinal mucosa than that induced by anti-PD-1 antibody alone. CWQ and anti-PD-1 antibody co-treatment upregulated PD-L1 protein and reduced the abundance of Bacteroides in the gut microbiota but increased the abundance of Akkermansia,Firmicutes, andActinobacteria. Additionally, the proportion of infiltrated CD8+PD-1+, CD8+, and CD3+ T cells were found to be positively correlated with the abundance of Akkermansia. Accordingly, CWQ may modulate the TIME by modifying the gut microbiota and consequently enhance the anti-tumor effect of PD-1 inhibitor therapy.

The influence of humanistic management atmosphere on nurses′ intention to stay / 中华医院管理杂志

Objective:To explore the influence of humanistic management atmosphere on nurses′ intention to stay in hospital, so as to provide reference for stabilizing nursing team.Methods:The convenience sampling method was used to investigate 1 044 clinical nurses in 5 tertiary hospitals in Shandong province by using the general information questionnaire, nurses′ perception of humanistic management questionnaire and nurses′ intention to stay questionnaire in May 2019.Four dimensions of demographic factors and nurses′ perception of hospital humanistic management were used as independent variables, and the total score of nurses′ intention to stay was used as dependent variable for stepwise regression analysis.Results:The total scores of humanistic management perception and intention to stay were 166.70±29.42 and 23.30±4.29 respectively. There was a positive correlation between humanistic management perception and intention to stay( P<0.05). The three dimensions of human management perception, emotional management perception and cultural management perception, as well as the professional title, working years and employment form could explain 27.5% of variation. Conclusions:The nurses′ intention to stay is in the middle and upper level, which is related to the hospital′s humanistic management. The perception of humanistic management of nurses has a positive predictive effect on the intention to stay, especially in talent management, emotional management and cultural management. Hospital managers should improve the humanistic management mode, enhance nurses′ perception of humanistic management in order to stabilize the nursing team and improve nurses′ intention to stay.

Preparation of discharge readiness scale for patients with enterostomy and reliability and validity test / 中国实用护理杂志

Objective:To prepare a discharge readiness scale suitable for patients with enterostomy and to test the reliability and validity, so as to provide an effective measurement tool for the assessment of discharge readiness of patients.Methods:On the basis of the existing Chinese version of the discharge readiness scale, items related to enterostomy nursing problems were added to form the scale entry pool, and a draft of the scale was formed by expert consultation. 132 patients with preventive enterostomy admitted to the Affiliated Hospital of Qingdao University were pre-investigated with the original scale to test the reliability and validity.Results:The discharge readiness scale of enterostomy patients contained 18 items. The content validity of the scale was 0.969, and the content validity of each item was 0.824 - 1.000. Four common factors were extracted from the scale, and the cumulative variance contribution rate was 79.503%. Cronbach alpha coefficient of the total scale was 0.923, and each dimension was 0.806 - 0.947.Conclusions:The discharge readiness scale of patients with enterostomy has good reliability and validity, which can be used as an evaluation tool for patients at discharge.

Practice of palliative medicine education in the teaching of geriatrics / 中华医学教育探索杂志

This article introduces the development history of palliative medicine at home and abroad, investigates the existing problems of palliative medicine teaching in geriatrics, explores the improvement of geriatric palliative medicine education, and elaborates adopting theoretical teaching and clinical practice, including PBL teaching, case teaching and narrative medicine teaching, to carry out palliative medical education for geriatrics graduate students. The results showed that 67.9% of the students have increased the learning sense of palliative medicine, 92.5% of them think that palliative medicine is very important, and 75% of them think that they have enhanced their ability of language expression and communication with patients with advanced diseases, namely, the ability of end-of-life care.

Effects of mild hypothermia on the expression of high mobility group protein B1 in lung tissues of septic mice / 中国综合临床

Objective:To investigate the effects of naturally occurring mild hypothermia and artificial mild hypothermia on the expression of high mobility group box 1(HMGB1) in lung tissues of septic mice.Methods:One hundred and twenty BALB/C mice (SPF level) were randomly numbered.Twelve mice with integer multiples of 10 were used as the normal control (NC) group, and the remaining 108 mice were chosen as the septic group.The septic mouse model was established by intra abdominal injection of lipopolysaccharide (LPS) 10 mg/kg.The NC group was given the same dose of normal saline.Anal temperature of the septic mice were measured 1 hour after the model was established successfully, and then were divided into naturally occurring mild hypothermia group and non-mild hypothermia group according to T≤36℃ and T>36℃.In the naturally occurring mild hypothermia group, the mice with T<34℃ were eliminated, and the remaining septic mice were randomly divided into the naturally occurring mild hypothermia(NOMH) observation group and the keep normothermia (KN) group.NOMH group was not given preheating intervention, while KN group was placed in an incubator to maintain the anal temperature between 36.0℃ and 37.5℃.Septic mice in the non-mild hypothermia group were randomly divided into the nonhypothermia (NH) observation group and the artificial mild hypothermia (ATMH) group.The NH group was not treated with hypothermia, while the ATMH group was treated with physical hypothermia, so that the anal temperature of the mice were maintained at 34℃-36℃.Four mice in each group were randomly selected at 6 and 12 hours after modeling, and the concentrations of tumor necrosis factor-α(TNF-α), interleukin-6(IL-6) and HMGB1 in serum were detected by enzyme-linked immunosorbent assay(ELISA). At 12 hours, the survival rate of each group of mice was observed.Then 4 mice of each group were sacrificed and lung tissues were taken.The pathological changes of lung tissues were observed by hematoxylin-eosin (HE) staining, and the expression of HMGB1 in lung tissues was observed by immunohistochemical staining.Real time fluorescence quantitative PCR and Western blot were used to detect the relative expression of HMGB1 at mRNA and protein levels.Results:(1)Twelve hours after modeling, the survival number of NOMH group, ATMH group, KN group and NH group were 36(40), 6(11), 27(40), 4(11), respectively, and there were differences between the four groups (χ 2=32.286, P=0.002). Compared with the other three groups of septic mice, the survival rate was highest in the NOMH group (compared with ATMH group: χ 2=5.222, P=0.022; compared with the KN group: χ 2=6.050, P=0.013; and the NH group: χ 2=11.672, P=0.001), but the differences between the other two groups were not statistically significant (all P>0.05). (2)Compared with the NC group, the concentrations of serum TNF-α, IL-6 and HMGB1 of septic mice in each group were significantly increased at 6 h and 12 h (all P<0.05). Compared with NOMH group, the concentrations of TNF-α, IL-6 and HMGB1 in ATMH group, KN group and NH group were significantly increased at 6 h and 12 h(all P<0.05), and the concentrations of TNF-α, IL-6 and HMGB1 in NH group were the highest at all time points (all P<0.05). The concentrations of TNF-α at 12 h decreased compared with 6 h (all P<0.05), while the concentrations of IL-6 and HMGB1 at 12 h increased compared with 6 h (all P<0.05). (3)HE staining showed that the lung tissue damage were minimal in NOMH group, followed by ATMH group.(4)Immunohistochemical staining showed that the expression of HMGB1 protein was in order of NOMH group, ATMH group, KN group and NH group; (5)The relative expressions of HMGB1 protein in lung tissues of septic mice in NOMH group, ATMH group, KN group, and NH group was 0.280±0.013, 0.320±0.016, 0.340±0.018, and 0.380±0.014, respectively, and the relative expression level of HMGB1 mRNA was 4.86±0.22, 6.02±0.18, 6.26±0.20, and 7.98±0.28, respectively, compared with NC group (HMGB1 protein content was 0.240±0.013, and the relative expression level of HMGB1 mRNA was 2.21±0.12) significantly increased (all P<0.05). Cmpared with NOMH group, the relative expression levels of HMGB1 protein and HMGB1 mRNA in the lung tissues of the ATMH group, KN group and NH group were significantly increased(all P<0.05), with the highest expression level in the NH group(all P<0.05). Conclusion:Mild hypothermia may reduce lung tissue damage by down-regulating the expression of HMGB1 in lung tissues of septic mice, and the improvement of spontaneous mild hypothermia was more significant.

Comparison of four score modes in prognosis assessment of AECOPD patients with respiratory failure / 实用医学杂志

Objective To explore the predictive effect of modified DECAF,DECAF,CAPS and APACHEⅡin the assessment of prognosis of AECOPD patients with respiratory failure. Methods Clinical data of 186 AECOPD cases complicated with respiratory failure were analyzed and four score modes were used within 24 hours of admission. Clinical endpoints were patients′ survival status 28 days after admission. The discriminative power of the four score modes was evaluated by the area under the receiver operating characteristic curve (AUC). Results AUC of the modified DECAF(0.777,95%CI:0.710-0.835) and DECAF (0.766,95%CI:0.699-0.825) for prognosis was significantly greater than that of CAPS(0.699 ,95%:0.628-0.764) and APACHEⅡ(0.715,95%:0.645-0.779). Conclusion The modified DECAF and DECAF have predictive values on assessing the prognosis of AECOPD patients with respiratory failure ,which are simple and efficient.

Clinical analysis of sodium nitroprusside on the treatment of senile heart failure with pulmonary edema / 中国生化药物杂志

Objective To investigate the clinical efficacy of sodium nitroprusside on the treatment of pulmonary edema in elderly patients with heart failure. Methods 50 elderly cases with heart failure and pulmonary edema From January 2015 to January 2017 were divided into the control group and the observation group according to the different treatment methods. The control group were received conventional therapy, the observation group were given conventional drug combined with sodium nitroprusside. The experimental data was recorded and compared. To investigate the effect of sodium nitroprusside on the rescue of elderly heart failure and pulmonary edema. Results The clinical effect in the observation group is better than that in the control group. The protein related indexes about heart failure and pulmonary edema were significantly improved (P<0.05). The difference of adverse reaction rate in the two groups has no statistically significat. Conclusion Conventional drug therapy combined with sodium nitroprusside were used on the treatment of elderly patients with heart failure, pulmonary edema, which can improve the clinical symptoms, related serum protein, without increasing the incidence of adverse reactions, it is worthy of clinical application.

Comparative analysis five kinds of serological detection methods about Brucella / 中华预防医学杂志

<p><b>OBJECTIVE</b>To evaluation the specificity and sensitivity of 5 kinds of serological detection methods about brucellosis.</p><p><b>METHODS</b>To investigate in the 4 autonomous banner (Cha You Hou Qi, Right-Wing Central Banner of Kerqin Region, Linxi County and Siziwangqi Banner) of Inner Mongolia autonomous region from January to December, 2013. Accepting criteria: professionals of breeding cattle and sheep, and slaughter,accompanied by Bloom's disease suspected symptoms such as fever, fatigue,arthralgia, ranging in age from 25 to 55 years old. To collect suspected patients venous blood 3-5 ml in the morning, a total of 236 samples were collected. To detect the Brucella antibody by using plate agglutination test (PAT), tiger red plate agglutination test (RBPT), standard test tube agglutination test (SAT), enzyme-linked immunosorbent assay (ELISA) and immune colloidal gold method (GICA), SAT was taken as a golden standard, analyzed the sensitivity and specificity of RBPT and SAT, ELISA and GICA.</p><p><b>RESULTS</b>SAT method of positive patients: 136 cases (57.6%). PAT method positive patients: 150 cases (63.6%). RBPT positive patients: 159 cases (67.4%), and 143 patients with ELISA method: positive (60.6%), 147 patients with positive GICA method (62.3%). The detection rate of Brucella antibody positive was different by different testing methods.There was no significant difference (χ(2)=0.52,P=0.264). To take the SAT method as the gold standard, PAT, RBPT, ELISA and GICA method of the sensitivity were 97.7% (133/136), 98.5% (134/136), 94.8% (129/136) and 94.1% (128/136), respectively. The specificity was lower,the rate were 70.0% (70/100), 75.0% (75/100), 86.0% (86/100) and 81.0% (81/100), respectively. The total coincidence rate were 86.0% (203/236), 88.5% (209/236), 91.1% (215/236) and 88.5% (209/236), respectively.</p><p><b>CONCLUSION</b>The specificity and sensitivity of ELISA and GICA method is higher in the diagnosis of disease. The two methods are rapid, GICA method can be used on-site testing, large sample test is suitable for using ELISA.</p>

Determination of Nectandrin B in Uygur Medicine Arillus Myristicae by HPLC / 中国药师

Objective:To establish an HPLC method for determining nectandrin B in Uygur medicine Arillus Myristicae. Meth-ods:The analysis was performed on a SunFireTM C18 column (150 mm × 4. 6 mm, 5 μm) at 30°C using methanol /water (52 ∶48) as the mobile phase at a flow rate of 1. 0 ml·min-1 with the UV detection wavelength at 228. 4 nm. Results:The linear range of nectan-drin B was 3. 98 -79. 60 μg·ml-1(r=0. 999 2). The average recovery was 99. 89% with RSD of 1. 11%(n=6). Conclusion:The method is accurate, convenient and reproducible in the determination of nectandrin B in Uygur medicine Arillus Myristicae.

The efficacy and safety analysis for endoscopic multi-band mucosectomy in the treatment of early esophageal cancer and intraepithelial neoplasia / 中国医师进修杂志

Objective To investigate the safety and efficacy of endoscopic multi-band mucosectomy (EMBM) in the treatment of early esophageal cancer and intraepithelial neoplasia.Methods A retrospective analysis was made on the clinical data of 34 cases diagnosed with early esophageal cancer and intraepithelial neoplasia.All the patients accepted EMBM.The therapeutic effects and safety were summarized.Results A total of 34 patients with 36 lesions were successfully completed in the treatment of one session.The entire biopsy specimen was tested by pathological examination.High-grade intraepithelial neoplasia in 24 lesions,low-grade intraepithelial neoplasia in 4 lesions,intramucosal cancer in 6 lesions,a submucosal shallow cancer and a submucosal deep cancer were diagnosed.Clamps electric coagulation hemostasis was used during the operation in 2 bleeding cases.No delayed postoperative bleeding,subcutaneous emphysema and esophageal perforation happened.Two cases appeared esophageal stenosis after EMBM.Bougienage were used to relieve dysphagia.One case confirmed with deep submucosal lymphovascular invasion accepted surgery later in department of thoracic surgery.No local recurrence and metastasis were found in the other 33 cases during the 6-24 months of follow-up time.Conclusions EMBM is a minimally invasive,safe and effective method for the treatment of early esophageal cancer and intraepithelial neoplasia.EMBM is worthy of promotion.

Clinical significance of drug sensitive test for the eradication of Helicobacter pylori infection and peptic ulcer / 中国生化药物杂志

Objective To explore the value of Helicobacter pylori( Hp) drug sensitivity test for clinical treatment of Hp infection and peptic ulcer. Methods Selected from February 2013 to October 2014 gastroenterology clinic in the hospital inpatient treatment and 120 patients( Steering Group) , of which 69 cases of gastric ulcer, duodenal ulcer 51 patients, mucosal lesions in patients took tissue culture Hp, Hp strain cultured to antibiotic susceptibility testing by disk diffusion method and based on susceptibility testing to guide treatment , alternative 120 cases of peptic ulcer patients as a routine group, ulcer treatment effect was observed between two groups and Hp eradication therapy.Results Steering group of 120 patients, 75 patients were successfully cultured Hp, susceptibility test results: the most sensitive to gentamicin(94.67%), followed furazolidone(88.00%), the lowest sensitivity to metronidazole(8.00 %);reviewed 4 weeks after treatment, ulcer healing rate of steering group of patients 93.33% was significantly higher than the end of treatment 4 weeks after the ulcer healing rate of regular group of 81.67%, steering group of patients with abdominal pain short time (3.5 ±1.5)d was significantly shorter than conventional group of patients(4.3 ±1.7) d; Hp eradication of steering group patients was 89.17%significantly higher than conventional group were 78.33% and the difference was statistically significant ( P<0.05 ) .Conclusion According Hp susceptibility testing, can choose Hp sensitive proton pump inhibitor combination of antibiotics amoxicillin treatment, can achieve more significant clinical effect.

Effect of post-liver transplantation administration of ursodeoxycholic acid on serum liver tests and biliary complications: a randomized clinical trial / 中华肝脏病杂志

<p><b>OBJECTIVE</b>Endogenous hydrophobic bile acids may be a pathogenetic factor of biliary complications after orthotopic liver transplantation (OLT).This study was designed to investigate the effects of hydrophilic ursodeoxycholic acid (UDCA), when administered early after OLT, on serum liver tests and on the incidence of biliary complications.</p><p><b>METHODS</b>A total of 112 adult patients undergoing OLT were randomly assigned to one of two groups for receipt of UDCA (13 to 15 mg/kg/d for 4 weeks, n=56) or a placebo (n=56). All patients underwent serum liver testing and measurement of serum bile acids during the 4 weeks following OLT.Patients with T-tube underwent measurement of biliary bile acids during the 4 weeks following OLT.Biliary complications, as well as patient and graft survival rates, were analyzed during the follow-up period (mean of 65.6 months).</p><p><b>RESULTS</b>At post-OLT days 7, 21 and 28, the UDCA-treated patients showed significantly lower levels of alanine aminotransferase, aspartate aminotransferase and gamma glutamyl transpeptidase (all P less than 0.05).In addition, the UDCA-treated patients showed significantly lower incidence of biliary sludge and casts within the first year post-OLT (3.6% vs.14.3%; x2=3.953, P=0.047). However, there were no significant differences for the incidence of other biliary complications at post-OLT years 1, 3 and 5.The graft and patient survival rates were also similar between the two groups.</p><p><b>CONCLUSION</b>UDCA, when administered early after OLT, improves results from serum liver tests and decreases the incidence of biliary sludge and casts within the first postoperative year.</p>

Observing effect of treatment of the second branchial fistula with endoscopic resection / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore synergic effect of treatment of the second branchial fistula with endoscopic resection.@*METHOD@#All patients of the second branchial fistula were scanned in neck with CT (computed tomography), we injected ioversol-320 from the entrance of the second branchial fistula in front of sternocleidomastiod into the second branchial fistula, then scanned the neck with CT (computed tomography), and rebuilding the picture of the second branchial fistula, to prepare for the operation. 9 patients of the second branchial fistula were operated under general anesthesia with endoscopic resection.@*RESULT@#All of 9 patients were cured. no one recurred after follow-up of 6 months.@*CONCLUSION@#It is minimally invasive and complete to resect the second branchial with endoscopic resection, the operation is simply and easy to promote.

SIRT1 differently regulates oncogenesis by diverse p53 types in hepatocellular carcinoma / 中华普通外科杂志

Objective To understand how SIRT1 differently regulates oncogenesis in hepatocellular carcinoma (HCC) with wild type and mutant type p53.Methods HCC cell line PLC5 cells (249 site mutated p53),and HepG2 cells (wild type p53) were infected with lentivirus containing shSIRT1.Western blotting was used for signaling pathway detection.Cell growth and proliferation assay,colony formation assay and tumor xenograft assay were performed to test the tumor growth ability of HepG2 cells,HepG2-shSIRT1 cells,PLC5 cells and PLC5-shSIRT1 cells respectively.Results SIRT1 silencing resulted in significant inhibition of cell proliferation in HepG2 cells but stimulating cell proliferation in PLC5 cells (t =3.595,P ＜0.01).Acetylation of p53 was found in HepG2 (HepG2-shSIRT1) and p21 was up-regulated,however,in PLC5 (PLC5-shSIRT1) cells,acetylation of p53 was found but p21 was not induced despite of p53 activation.Silence of SIRT1 resulted in no change of AMPK function in HepG2 cells but a lower activity of AMPK in PLC5 cells (t =4.268,P ＜ 0.01).Conclusions In HCC cell lines the function following SIRT1 activation is largely determined by p53 mutant status.

Analysis of influencing factors for standardized resident training / 中华医院管理杂志

Objective To identify the influencing factors for the quality and efficiency of standardized resident training in order to scientifically select and train qualified resident physicians.MethodsThe exam passing rate served as the indicator to measure the quality of training; the year(s) used to pass the exam the indicator to measure the efficiency,while such methods as descriptive study,chi-square test,logistic regression,rank sum test and stratified analysis were used for data analysis and processing. ResultsThe exam passing rate of research postgraduates is lower than clinical postgraduates,the year(s) needed to pass the exam of research postgraduates is longer than clinical postgraduates. Conclusion Clinical postgraduates deserve higher priority in selecting clinicians.Research-based postgraduates shifted to clinical work require a longer training time.

The clinical efficacy and safety of intravenous cefmetazon for prevention of postoperative infections and treatment of infectioons in general surgery / 中华普通外科杂志

ObjectiveTo evaluate the clinical efficiency and safety of cefmetazon in the prevention Department of General Surgery,First People's Hospital,Shanghai Jiaotong University,Shanghai 200080,Chinaand or treatment of infections in general surgery. MethodsA multicenter,prospective and open-labeled trial was conducted. In the prevention group,1700 patients were enrolled in clean-infection surgery,cefmetazon was given 1 g iv half an hour before the surgery started,and 1 g iv twice daily after the surgery for 3 days.Clinical response was evaluated in terms of both cure ( disappearance of pre treatment symptoms)and pathogen. In the treatment group,897 patients were diagnosed as peritonitis, cholecystitis and cholangitis,the patients were given cefmetazon 2 g iv twice a day for 7 - 14 days,clinical response and microbiological efficacy were assessed.ResultsIn prophylactic group,1449 patients were finally included.The clinical efficacy was 100％ (1449/1449).In the treatment group,a total of 897 patients were enrolled,and 110 patients failed for assessment of clinical efficacy,787 patients were included in the PPS population,the clinical efficacy was 90.7％ (714/787); Bacterial eradication rate was 92％ (46/50).Adverse reaction rates in prevention group and treatment group were 1.3％ (22/1700) and 1.2％ (11/897),including mild nausea and vomitting.ConclusionsCefmetazon is effective and safe in prevention and treatment of Postoperative infections in general surgery.

Synergic effect of alprostadil injection and ginaton in treating sudden deafness / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore synergic effect of Alprostadil injection and ginaton in treating sudden deafness.@*METHOD@#ninety one patients with sudden deafness were divided into group A, group B and group C at random; 33 ears of group A were treated with 70 mg ginaton by vein, 30 ears of group B were treated with 10 microg Alprostadil injection by vein, 31 ears of group C were treated with 10 microg Alprostadil injection and ginaton by vein,once a day, the time of treatment is 14 days.@*RESULT@#the effective rate of group A is 60.61%, the effective rate of group B is 60.00%, the effective rate of group C is 87.09% the treating effect was significantly different in the group A and C (P < 0.05), it was significantly different in the group B and C (P < 0.05)).@*CONCLUSION@#It is effective for Alprostadil injection and ginaton to treat sudden deafness, and it has significantly Synergic effect in treating sudden deafness with Alprostadil injection and ginaton.

The mutation and expression of MUS81 gene in laryngeal squamous cell carcinoma / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the association of mutations and expression of MUS81 gene with the tumorigenesis and progression of laryngeal squamous cell carcinoma (LSCC).</p><p><b>METHODS</b>PCR-SSCP and DNA sequencing were carried out to examine mutations at exons 9 and 10 of MUS81 gene in 42 LSCC samples, with paired adjacent normal laryngeal tissues (PANLs) as control. Semi-quantitative RT-PCR and Western blot were used to detect the expression of MUS81 gene in the specimens.</p><p><b>RESULTS</b>No mutation was detected in the control group. Among the 42 LSCC specimens, nineteen (45.2%) were found to harbor mutations, including 11(26.2%) occurring within exon 9, and 8 (19%) within exon 10. Seventeen (40.48%) samples showed lower mRNA level of the MUS81 gene (P<0.01), and same proportion of samples had lower protein level (P<0.01), suggesting that MUS81 gene was similarly down-regulated at both mRNA and protein levels in the LSCC samples. Furthermore, mutations of MUS81 gene did not significantly correlate with TNM stages, age and lymphoid node metastasis (P>0.05). Nor did the expression of MUS81 gene with the TNM stages, age and lymphoid node metastasis in LSCC (P>0.05).</p><p><b>CONCLUSION</b>Mutations and abnormal expression of MUS81 gene in the LSCC tissues were observed, which suggested that abnormalities of MUS81 gene may play an important role in the tumorigenesis of LSCC.</p>

Hepatic microcirculatory disturbances in patients with chronic hepatitis B / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To document morphological changes in hepatic microcirculation in liver tissue with hepatitis B and the pathogenesis of hepatic microcirculatory disturbances.</p><p><b>METHODS</b>Liver tissue samples were obtained from patients with hepatitis B by liver biopsy. These samples were examined with a light microscope and transmission electron microscope.</p><p><b>RESULTS</b>Hepatic microcirculatory disturbances existed in patients with hepatitis B, including those with normal liver function, manifested by red blood cell aggregation in sinusoids seen under light microscope and sinusoidal capillarization seen under electron microscope. Weibel-Palade bodies in sinusoidal endothelial cells were seen in 26 out of 53 cases. Intimate contacts were found between lymphocyte/Kupffer cells and sinusoidal endothelial cells.</p><p><b>CONCLUSIONS</b>Hepatic microcirculatory disturbances exist in patients with hepatitis B. The appearance of Weibel-Palade bodies in sinusoidal endothelial cells may be a key step in the development of hepatic microcirculatory disturbances.</p>

Simultaneous kidney-pancreatic transplantation with portal venous and enteric drainage:a report of 6 cases / 中国普通外科杂志

Objective To evaluate clinical effect of simultaneous kidney-pancreatic transplantation(SKPT) with portal venous and enteric drainage. Method Between June 2001 and June 2004, six insulin-dependent diabetes mellitus(IDDM) and renal failure patients underwent this procedure. The venous drainage of the graft was established between donor′s portal vein and recipient′s superior mesenteric vein. The exocrine secretion was drained into proximal jejunum via side-to-side anastomosis between donor′s duodenum and recipient′s proximal jejunum. Steroids, mycophenolate mofetil, tacrolimus and Zenapax were used as immunosuppressants. Results Procedures were successful in all 6 cases. Excellent renal function and euglycemia were achieved in 4 cases. Follow-up of 4-34 months on the 4 survivers found excellent kidney-pancreatic function without any rejection episode. Two patients died perioperatively due to sepsis secondary to pancreatic leakage and drug toxicosis of excessive FK506. Conclusion Our preliminary experience suggests that simultaneous pancreas-kidney transplantation with enteric and portal drainage is reliable procedure for the treatment of IDDM with renal failure.