[Efficacy of cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy for pseudomyxoma peritonei].

Objective: To evaluate the efficacy and safety of cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of pseudomyxoma peritonei (PMP). Methods: In this descriptive case series study, we retrospective analyzed the records of PMP patients treated with CRS and HIPEC between January 2013 and June 2023 at Affiliated Cancer Hospital and Institute of Guangzhou Medical University. The inclusion criteria were as follows: (1) Aged 18 to 75 years and nonpregnant women. (2) Histologically confirmed diagnosis of pseudomyxoma peritonei. (3) Karnofsky Performance Scale (KPS)>70. (4) The functions of major organs such as the heart, liver, lungs, and kidneys can tolerate major surgery for long periods of time. (5) No evidence of extra-abdominal metastasis. Patients with extensive intra-abdominal adhesions or severe infectious diseases were excluded. The main outcomes were overall survival (OS) and postoperative major complications. The postoperative major complications were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (version 5.0). We used the peritoneal cancer index (PCI) score to quantitatively assess the peritoneal metastases and the completeness of cytoreduction (CCR) score at the end of surgery (CCR-0 and CCR-1 considered to be complete CRS). Results: A total of the 186 PMP patients with a median age of 56 (interquartile range extremes (IQRE), 48-64) years were included, 65 (34.9%) males and 121 (65.1%) females. The median peritoneal cancer index (PCI) score was 28 (20-34). Appendiceal origin accounted for 91.4%. Histological types were low grade in 99 patients (53.2%), high grade in 57 patients (30.6%), and 55 patients (29.6%) received complete cytoreduction (CCR-0/1). The median operative duration was 300 (211-430) minutes for all patients. Treatment-related 30-day mortality was 2.7%; 90-day mortality 4.3%; reoperation 1.6%; and severe morbidity 43.0%. Within the entire series, anemia(27.4%), electrolyte disturbance(11.6%), and hypoalbuminemia(7.5%) were the most frequent major complications (grade 3-4). The incidences of gastrointestinal anastomotic leakage, abdominal bleeding, and abdominal infection were 2.2%, 2.2%, and 4.3%, respectively. After a median follow-up of 38.1 (95%CI:31.2-45.1) months, the 5-year OS was 50.3% (95%CI: 40.7%-59.9%) with a median survival time of 66.1 (95%CI: 43.1-89.1) months. The survival analysis showed that patients with pathological low grade, low PCI, and low CCR score had better survival with statistically significant differences (all P<0.05). Further stratified into complete and incomplete CRS subgroups, the 5-year OS of the CCR-0 and CCR-1 subgroups was 88.9% (95%CI: 68.3%-100.0%) and 77.6% (95%CI: 62.7%-92.5%), respectively; and 42.0% (95%CI: 29.5%-54.5%) in the CCR-2/3 subgroup. Conclusions: CRS and HIPEC may result in a long-term survival benefit for PMP patients with acceptable perioperative morbidity and mortality. This strategy, when complete CRS is possible, could significantly prolong survival for strictly selected patients at experienced centers.

Antibacterial Effects of Schisandra chinensis Extract on Escherichia coli and its Applications in Cosmetic.

Schisandra chinensis (Turcz.) Baill (S. chinensis), an edible traditional medicine herb, has a strong constitution, which extract has good antibacterial activity. The study investigated its antibacterial properties on E. coli, to find a candidate for the development as new preservative. In vitro antibacterial assay showed that S. chinensis extract (SCE) effectively inhibited the growth of test bacteria with MBC of 18 mg/mL. In model cosmetic system of O/W emulsions, SCE possessed a great antibacterial capacity. The growth curves of E. coli treated with SCE exhibited an extended lag phase and restricted log phase. Scanning electron microscopy showed that the treated E. coli cells exhibited wrinkled and withered surfaces, and disappearing outmost layer, suggesting S. chinensis extract can damage S. aureus cell member and wall, in addition, the leakage of periplasm enzyme AKPase and the increased activities of Na+/K+-ATPase and Ca++-ATPase in cell membrane were also consistent with the microscopy results. Moreover, the S. chinensis extract can decrease the activities of dehydrogenase and total ATPase and the content of intracellular proteins, and bind with S. aureus DNA by electrostatic and groove binding. The results indicated that SCE might be a candidate cosmetic preservative for its good antibacterial activity and multiple targets on E. coli.

[Rationality of performing hyperthermic intraperitoneal chemotherapy 5-8 weeks after primary tumor resection for patients with locally advanced colorectal cancer-based on COLOPEC].

Hyperthermic intraperitoneal chemotherapy (HIPEC) has a unique effect on the prevention and treatment of peritoneal metastasis from malignancies. Recently, the first prospective, multicenter, randomized controlled clinical trial of HIPEC to prevent the development of peritoneal metastasis after curative surgery for patients with locally advanced colon cancer was published in the "Lancet Gastroenterol Hepatol" (COLOPEC). Regrettably, no significant difference was observed in 18-month peritoneal metastasis-free survival between postoperative adjuvant HIPEC and standard systemic chemotherapy for patients with T4 stage or perforated colon cancer. However, we wonder whether we might achieve better outcomes by further optimizing the following issues: (1) We propose that the inclusion criteria for that trial may not be entirely reasonable, which included pT4N0-2M0 and perforation. Additionally, we found that 91% of patients underwent HIPEC 5-8 weeks after primary tumor resection. (2) The imbalance in starting time of postoperative systemic chemotherapy between the two groups may have a negative impact.(3) Nine patients with peritoneal metastasis preceding HIPEC might weaken the potential efficacy of HIPEC. (4) We wonder whether HIPEC using high-dese oxaliplatin (460 mg/m(2)) perfusing 30 minutes for one cycle is the optimal regimen. Therefore, we are planning to conduct a randomized controlled trial (HIPEC-06) in accordcance with the characteristics of Chinese patients, to explore the clinical efficacy of curative surgery combined with HIPEC in the treatment of cT4 colorectal cancer.

[Clinical research of different characteristics of fungal ball sinusitis].

Objective:The aim of this study is to investigate the clinical features of different subtypes of fungal ball sinusitis. Method:Four hundred and forty-nine cases with fungal ball rhinosinusitis (FBS) were involved in this retrospective analysis. The clinical features including symptoms, signs, and imaging scans, pathological results were all collected for each patient and the patients were classified into different subtypes according to these clinical features and the follow-up treatment. Result:In this retrospective study, 449 patients who diagnosed with fungal ball sinusitis were involved. According to clinical features, these patients were divided into 5 subtypes respectively: ①Subtype 1 simple FBS: there were 299 patients in this subtype. Main symptoms were one side headache, purulent rhinorrhea, nasal obstruction. CT scans showed the classical features of FBS. ②Subtype 2 FBS with nasal polyps: there were 78 patients in this subtype. Main symptoms were bilateral or unilateral nasal obstruction, purulent rhinorrhea. Histopathologic results showed nasal polyps with acute or chronic inflammation by inflammatory cell infiltration. Eosinophils infiltration was the most common phenomenon. Postoperative therapy was as same as the treatment to chronic rhinosinusitis. ③Subtype 3 FBS with allergic rhinitis:there were 51 patients in this subtype. During the operation, infected nasal sinus mucosa with serious edema could be found, often with asubmucosa cyst. Postoperative medical therapy with antihistamines during follow-up. ④Subtype 4 FBS with purulent cyst: there were 6 cases. Main symptoms were nasal obstruction, purulent rhinorrhea and facial pain. Sinus CT scans showed that the typical features of both fungal ball sinusitis and mucous cyst. Antibiotic saline nasal irrigation should be used intraoperatively and postoperatively, other than systemic antibiotic treatment. ⑤Subtype 5 mixed type: there were 15 cases. All of these patients were diagnosed with fungal ball sinusitis with nasal polyps combined with allergic rhinitis. The clinical features of diagnosis and treatment were combination of the two types. Conclusion:According to the different clinical features, fungal ball sinusitis could be classified with five different clinical features. This classification would help to standardize the treatment, reduce the postoperative recurrence rate, and improve the prognosis.

Attenuation of renal ischemic reperfusion injury by salvianolic acid B via suppressing oxidative stress and inflammation through PI3K/Akt signaling pathway.

Salvianolic acid B (SAB) is one the major phytocomponents of Radix Salvia miltiorrhiza and exhibit numerous health promoting properties. The objective of the current study was to examine whether SAB exerts a renoprotective effect by attenuating oxidative stress and inflammatory response through activating phosphatidylinositol 3-kinase/serine-threonine kinase B (PI3K/Akt) signaling pathway in a renal ischemic reperfusion rat model. Forty Sprague-Dawley male rats (250-300 g) were obtained and split into four groups with ten rats in each group. The right kidney of all rats was removed (nephrectomy). The rats of the Control group received only saline (occlusion) and served as a sham control group, whereas rats subjected to ischemic reperfusion (IR) insult by clamping the left renal artery served as a postitive control group. The other 2 groups of rats were pretreated with SAB (20 and 40 mg·kg-1·day-1) for 7 days prior IR induction and served as treatment groups (SAB 20+IR; SAB 40+IR). Renal markers creatinine (Cr) and blood urea nitrogen (BUN) were significantly lower in the groups that received SAB. Pretreatment with SAB appears to attenuate oxidative stress by suppressing the production of lipid peroxidation products like malondialdehyde as well as elevating antioxidant activity. The concentration of inflammatory markers and neutrophil infiltration (myeloperoxidase) were significantly decreased. Meanwhile, PI3K protein expression and pAkt/Akt ratio were significantly upregulated upon supplementation with SAB, indicating its renoprotective activity. Taken together, these results indicate that SAB can therapeutically alleviate oxidative stress and inflammatory process via modulating PI3K/Akt signaling pathway and probably ameliorate renal function and thus act as a renoprotective agent.

Prospective, randomized trial comparing 5-FU/LV with or without oxaliplatin as adjuvant treatment following curative resection of gastric adenocarcinoma.

BACKGROUND: To investigate the efficacy and toxicity of FOLFOX4 regimen and LV5Fu2 regimen in patients with advanced gastric adenocarcinoma after curative gastrectomy. METHODS: Eighty patients with gastric adenocarcinoma after curative gastrectomy were randomized to receive a 2-h infusion of leucovorin (LV; 200mg/m(2)/d) followed by a 5-fluorouracil (5-FU) bolus (400mg/m(2)/d) and 22-h infusion (600 mg/m(2)/d) for 2 consecutive days every 2 weeks, either alone or together with oxaliplatin 85 mg/m(2) as a 2-h infusion on day 1 (FOLFOX4 regimen or LV5Fu2 regimen). The observation points were recurrence free survival, overall survival and toxicity of the two groups. RESULTS: All patients had received curative gastrectomy (R0 resection) before received either of the two regimens. The 3-year recurrence free survival rate and the 3-year overall survival rate in FOLFOX4 group were all significantly better than those in the control group (median, 30.0 months vs. 16.0 months, P<0.05; 36.0 months vs. 28.0 months, P<0.05). COX multivariant analysis was used to evaluate the prognostic factors and oxaliplatin was found to be the independent prognostic factor and could improve the survival rate in FOLFOX4 group. Grade 3/4 peripheral neuropathy occurred in 19% in FOLFOX4 group. There was no significant difference between the two groups in neutropenia, leukopenia, anemia, gastrointestinal reaction and so on. Three patients in each group were lost to follow up during treatment. CONCLUSION: FOLFOX4 regimen showed good efficacy and an acceptable safety profile for patients with advanced gastric adenocarcinoma after curative gastrectomy compared with the control group. It may prove to be a suitable alterative regimen in this indication.

A study of acupuncture in Asian patients: clinical aspects and effects on cortical excitability.

OBJECTIVE: To determine the effect of acupuncture on the phosphene threshold, by transcranial magnetic stimulation (TMS), and the clinical effect of acupuncture on headache frequency, duration and severity. METHODS: Twenty-one patients (16 women; mean age 46 years; range 23-61 years, 17 Chinese, 2 Malays, 2 Indians) underwent 10 acupuncture sessions scheduled twice a week for 5 weeks. The lowest TMS intensity to elicit phosphene perception is defined as the phosphene threshold. TMS was performed before the first and last sessions, and at 2 months' follow-up. RESULTS: Acupuncture resulted in reduction of headache frequency, duration and severity over the course of treatment. However, this was not accompanied by a corresponding increase in the phosphene threshold over a similar time course. The baseline threshold before acupuncture treatment had no predictive value for outcome of treatment. CONCLUSIONS: Although acupuncture was effective in treating migraine, the use of occipital cortex excitability as an adjunctive parameter to evaluate treatment response was not suitable. The relief of migraine with acupuncture may be related to separate neural pathways independent of occipital or visual processes in the human brain.

Potentiating effect of spinosin, a C-glycoside flavonoid of Semen Ziziphi spinosae, on pentobarbital-induced sleep may be related to postsynaptic 5-HT(1A) receptors.

Previous results have suggested that spinosin, a C-glycoside flavonoid of Semen Ziziphi spinosae, potentiates pentobarbital-induced sleep via the serotonergic system. The present study investigated whether spinosin potentiates pentobarbital-induced sleep via serotonin-1A (5-hydroxytryptamine, 5-HT(1A)) receptors. The results demonstrated that spinosin significantly augmented pentobarbital (35 mg/kg, i.p.)-induced sleep in rats, reflected by reduced sleep latency and increased total sleep time, non-rapid eye movement (NREM) sleep time, and REM sleep time. With regard to NREM sleep duration, spinosin mainly increased slow-wave sleep (SWS). Additionally, spinosin (15mg/kg, i.g.) significantly antagonized 5-HT(1A) agonist 8-OH-DPAT (0.1mg/kg, i.p.)-induced reductions in total sleep time, NREM sleep, REM sleep, and SWS in pentobarbital-treated rats. These results suggest that spinosin may be an antagonist at postsynaptic 5-HT(1A) receptors because these effects of 8-OH-DPAT were considered to be mediated via postsynaptic 5-HT(1A) receptors. Moreover, co-administration of spinosin and the 5-HT(1A) antagonist 4-iodo-N-{2-[4-(methoxyphenyl)-1-piperazinyl]ethyl}-N-2-pyridinylbenzamide (p-MPPI), at doses that are ineffective when administered alone (spinosin 5mg/kg, p-MPPI 1mg/kg), had significant augmentative effects on pentobarbital-induced sleep, reflected by reduced sleep latency and increased total sleep time, NREM sleep, and REM sleep. In contrast to the attenuating effects of p-MPPI on REM sleep via presynaptic 5-HT(1A) autoreceptors, 15mg/kg spinosin significantly increased REM sleep. These results suggest that the effect of spinosin on REM sleep in pentobarbital-treated rats may be related to postsynaptic 5-HT(1A) receptors.

The effect of acupuncture on motor cortex excitability and plasticity.

Acupuncture has been used extensively in facilitating motor recovery after stroke. Its mechanism of action remains uncertain. In this sham-controlled study, we demonstrate for the first time that acupuncture has a real and enduring effect on motor cortex functional changes, in terms of cortical excitability and output mapping using transcranial magnetic stimulation.

Acupuncture and the modulation of cortical excitability.

Although acupuncture is increasingly utilized for medical therapy, its mechanism of action remains uncertain. We used transcranial magnetic stimulation to demonstrate lateralized effects of motor cortex excitability with this technique. Right-sided reduction in motor cortex excitability and a tendency to the opposite effect on the left side was seen with acupuncture. Sham needle insertions did not result in significant changes of motor cortex excitability. These findings provide new neurophysiological evidence of cortical excitability modulation complementary to findings derived from functional neuroimaging studies.

Petrochemical exposure and menstrual disturbances.

BACKGROUND: An exploratory, cross-sectional retrospective study was conducted to examine the effects of benzene exposure on menstrual problems. METHODS: The study was based on a survey administered to over 3,000 women who worked in a large petrochemical company in Beijing, China. An abnormal menstrual cycle length (AMCL), defined as an average menstrual cycle length of greater than 35 days or less than 21 days, is the major outcome of interest. RESULTS: After 7 years of benzene exposure, the adjusted odds ratio of having AMCL for each additional 5 years of exposure was 1.71 (95% CI 1.27-2.31). Feeling stressed at work was also an important predictor. CONCLUSIONS: This study suggests a significant association of benzene exposure and perceived stress with menstrual disturbance. A prospective study is needed to confirm this finding.

[Development of a peristaltic inhibition model in mice].

Diphenoxylate was administered to mice at the dose of 5 mg/kg BW for the development of peristaltic inhibition model for formulating the examination procedure of health foods. An ink solution containing 5% charcoal was then administered 30 minutes later. The length of ink progradation of the small intestine of mice was calculated 25 minutes after the administration of ink. The results in this model was stable and reliable, and it was recommended to use this model to verify the function of health foods.

Acupuncture treatment at Ang Mo Kio Community Hospital--a report on our initial experience.

BACKGROUND: We report our initial experience with acupuncture treatment at the Ang Mo Kio Community Hospital's Acupuncture Research Clinic. PATIENTS: One thousand one hundred and twenty-eight patients received a total of 12,172 acupuncture treatment sessions during the period between September 1995 and December 1996. The majority were Chinese (94%), between 40-70 years (70%) with either dialect or Mandarin (68%) as the main spoken language. However, one third of the patients were English speaking, and educational level did not seem to be a factor among our patients accepting acupuncture treatment. Most had either painful conditions (58%) or stroke-related dysfunction (23%). Amongst the painful conditions, arthritis (25%), low back pain (22%) and other musculo-skeletal pain (12%) were the most common. RESULTS: Prior to treatment, about three-quarter of patients believed acupuncture would benefit them while 40% had tried acupuncture before. After completion of treatment, 70% of all patients considered acupuncture safe, 54% were satisfied with the overall result, 51% felt acupuncture was beneficial, while 54% would recommend acupuncture to others with similar conditions. In a subgroup of patients treated for painful conditions, > 90% reported improvement. Near-syncope occurred in 2 patients (0.18%) or during 2 treatment sessions (0.02%). There was no other acupuncture-related complication. CONCLUSION: Our preliminary experience showed that acupuncture is safe, and appears to be beneficial to patients with painful conditions. An overview of acupuncture treatment is presented, and the issues of safety, efficacy and a need to conduct randomised controlled clinical trials are discussed.

[Influence of icariin on cell membrane of highly metastatic human lung tumor cell line].

In this study, flow cytometry (FCM) and fluorescent probe technique were used to explore the influence of icariin (ICA) on cell membrane of PG. The data suggested that ICA could inhance membrane fluidity of PG and increase the expression of membrane HLA-ABC antigen. This could be one of the anticancer mechanisms of ICA.

Association of petrochemical exposure with spontaneous abortion.

OBJECTIVES: To assess the association between petrochemical exposure and spontaneous abortion, a retrospective epidemiological study in a large petrochemical complex in Beijing, China was conducted. METHODS: Plant employment records identified 3105 women who were married, were 20-44 years of age, and had never smoked. Of those, 3070 women (98.8%) reported at least one pregnancy. From this group, 2853 (93%) of the women participated in the study. According to their plant employment record, about 57% of these women workers reported occupational exposure to petrochemicals during the first trimester of their pregnancy. Trained interviewers administered a standardised questionnaire to this group of women and their husbands, collecting information on reproductive history, pregnancy outcomes, employment history, occupational exposure, smoking habits, alcohol consumption, indoor air pollution, and demographic variables. The results from the womens' first pregnancies were analysed. RESULTS: There was a significantly increased risk of spontaneous abortion for women working in all of the production plants with frequent exposure to petrochemicals (8.8%; range of 5.8%-9.8%) compared with those working in nonchemical plants (2.2%; range of 0.0%-7.1%). Also, when a comparison was made between exposed and non-exposed groups within each plant, exposure to petrochemicals was consistently associated with an increased risk of spontaneous abortion. The overall odds ratio (OR) was 2.7 (95% confidence interval (95% CI) 1.8 to 3.9) after adjusting for potential confounders. When the analysis was performed with the exposure information obtained from the women' interview responses for (self reported) exposures, the estimated OR for spontaneous abortions was 2.9 (95% CI 2.0 to 4.0). The analysis was repeated by excluding those 452 women who provided inconsistent reports between recalled exposure and work history, and a comparable risk of spontaneous abortion (OR 2.9; 95% CI 2.0 to 4.4) was found. In analyses for exposure to specific chemicals, an increased risk of spontaneous abortion was found with exposure to most chemicals, and the results for benzene (OR 2.5; 95% CI 1.7 to 3.7), gasoline (OR 1.8; 95% CI 1.1 to 2.9), and hydrogen sulphide (OR 2.3; 95% CI 1.2 to 4.4) were significant. CONCLUSION: An increased risk of spontaneous abortion was found associated with the exposure to petrochemicals, including benzene, gasoline, and hydrogen sulphide.

[Experimental study on effect of altitude xishi capsule in treating oleic acid induced lung injury in acute hypoxia rats].

OBJECTIVE: To explore the effect and pathophysiological mechanism of Altitude Xishi Capsule (XSC) on lung injury during acute hypoxia. METHODS: A new model of acute lung injury was established by administering oleic acid into superior vena cava in experimental rat during acute hypoxia, which was formed by putting the animal in a hypobaric room, and reduced the pressure gradually in uniform speed till a simulated environment of 6000 m above sea level was formed and lasted for 12 hours. XSC was given orally to the rat before oleic acid administration. The effect of XSC on the model was observed by determination of PaO2, wet/dry ratio of lung and pathologic examination at 1, 2, 3 and 4 hours separately. RESULTS: The respiratory frequency of model animal increased markedly, with the water content of lung reduced and aggravated as the hypoxia prolonged. XSC could obviously improve the pulmonary edema and inflammatory cell infiltration in lung. CONCLUSIONS: The aforesaid acute lung injury model with successful rate of 100%, it resembles the clinical acute lung injury and was useful for research on pathophysiology and treatment of ARDS or acute lung injury, XSC could improve the oleic acid induced lung injury in hypoxia rats by reducing the pulmonary edema and inflammatory cell infiltration.

[Effects of Curcuma phaeocaulis on learning and memory and lipid peroxide in mice].

Nine months mice were inoculated and the method of water maze test and lipid peroxide determination to study the effects of extract of Curcuma phaeocaulis Valeton on learning and memory ability and retarding of senescence. Results showed that in water maze test the time for the group with Curcuma phaeocaulis Valeton needed from initial position to the end was significantly shortened compared with old control. The error numbers for the group of Curcuma phaeocaulis Valeton were significantly decreased compared with old control after starting experiment for 18 days and 24 days and for 35 days no significance difference was showed between groups. The levels of brain, liver and red blood cells lipid peroxide in the group with Curcuma phaeocaulis Valeton were considerably lower than old control, hemoglobin content was considerably increased than old control.

[The effect of cimeiguo on micronuclei in mice induced by cooking lampblack].

The effect of Cimeiguo on micronuclei in mice induced by cooking lampblack is studied. The results show that the number of micronulei induced by cooking lampblack are increased sighificantly (P > 0.01) with dose-response relationship and inhibited by Cimeiguo.

[Observation of relationship between function and structure of experimental pulmonary artery hypertension in rats and inhibitory effect of garlicin and other herbal medicines].

The paper deals with the treatment of the pulmonary artery hypertention in rats caused by monocrotaline with garlicin, liqustrazine and berbamine and studies the relationship between the function and structure of pulmonary artery and pulmonary artery hypertension before and after use of hypotensive agents. The results show that there is a close relationship between the function and structure of pulmonary artery and pulmonary hypertension, and the inhibitory effect of garlicin is the strongest among the three herbal medicines. The pathogenesis is also studied.