[Analysis for the short-term efficacy and long-term prognosis of laparoscopic and laparotomy radical resection for gallbladder cancer].

Objective: To compare the short-term efficacy and long-term prognosis of laparoscopic and laparotomy radical resection for gallbladder cancer(GBC). Methods: From January 2010 to December 2020,the clinical data and survival information for 133 patients who underwent radical resection of GBC at the Department of Hepatopancreatobiliary Surgery,Zhejiang Provincial People's Hospital,were retrospectively collected. Eighty patients(23 males and 57 females) underwent laparoscopic radical resection and had a median age(M(IQR)) of 66.0(12.8)years(range:28.0 to 82.0 years). Fifty-three patients(45 males and 8 females) who received laparotomy were 63.0(6.0)years old(range:45.0 to 80.0 years old). There were no significant differences in age,gender,body mass index,preoperative albumin,preoperative total bilirubin,N stages,vascular invasion,peri-neural invasion or tumor differentiation between the laparoscopic and laparotomy group(all P>0.05). But there were significant differences in preoperative CA19-9(Z=-2.955, P=0.003), preoperative ALT level(Z=-2.801,P=0.031) and T stage (χ2=19.110,P=0.007) between the two groups. A non-parametric test was used for quantitative data. χ2 test or Fisher exact probability method was used for count data. Results: Patients in the laparoscopic group did not differ from those in the laparotomy group in terms of length of operation,number of lymph node yield,number of positive lymph nodes,the incidence of intraoperative gallbladder rupture,incidence of postoperative bile leakage,abdominal bleeding or abdominal infection,30-day mortality,90-day mortality, the incidence of incision implantation or peritoneal cavity metastasis(all P>0.05). Patients in the laparoscopic group showed less intraoperative bleeding(100.0(200.0)ml vs. 400.0(250.0)ml)(Z=-5.260,P<0.01),fewer days with drainage tube indwelling(6.0(3.8)days vs. 7.0(4.0)days)(Z=-3.351, P=0.001), and fewer postoperative days in hospital(8.0(5.0)days vs. 14.0(7.5)days)(Z=-6.079,P<0.01) than those in the laparotomy group. Patients in the laparoscopic group displayed better overall survival (P<0.01) and progression-free survival (P<0.01). Subgroup analysis for GBC of T1b-T2 and T3 stages revealed comparable overall survival and progression-free survival between the laparoscopic and laparotomy groups (P>0.05). Conclusions: Laparoscopic radical resection can achieve long-term survival for GBC comparable to that with open surgery. Laparoscopic radical resection has advantages over open surgery regarding surgical trauma and postoperative recovery.

[Effect of downregulation of phosphatase and tensin homolog gene expression on p130crk- related substrate protein and paxillin signal transduction in activated hepatic stellate cells in vitro].

Objective: To investigate the role of adenovirus-mediated short hairpin RNA (shRNA) in down-regulating the expression of phosphatase and tensin homologue deleted on chromosome ten (PTEN) on p130Crk-related substrates(p130Cas) and paxillin signal transduction to activate hepatic stellate cell (HSC) in vitro. Methods: The rat hepatic stellate cell line, HSC-T6 was cultured and activated in vitro. The adenovirus was used as a vector to transiently transfect shRNA targeting PTEN to activate HSC in vitro, and then PTEN low expression model of activated HSC in vitro was established. Western blot and real-time fluorescence quantitative PCR were used to detect the protein and mRNA expression of PTEN, p130cas and paxillin in activated HSC. The experiment was divided into control group (HSC were transfected with DMEM medium instead of adenovirus), Ad-GFP group (HSC were infected with empty the adenovirus expressing green fluorescent protein (GFP) alone), and Ad-shRNA/PTEN group (HSC were infected with the recombinant adenovirus containing both shRNA targeting PTEN and GFP gene). One-way analysis of variance was used for comparison of multiple groups, and LSD test was used for inter-group comparison. Results: shRNA targeting PTEN was successfully transfected and significantly down-regulated the PTEN protein and mRNA expression of HSC in vitro (P < 0.05), and the PTEN low expression model of HSC in vitro was successfully constructed. Compared with the expression of p130cas mRNA in the three groups of HSC, the expression fold of p130cas mRNA in the Ad-GFP group and the Ad-shRNA / PTEN group was 1.01 times and 1.52 times, respectively. The expression of p130cas mRNA in HSC of the Ad-shRNA / PTEN group was significantly higher than control group and Ad-GFP group (P < 0.05), but there was no statistically significant difference between the control group and the Ad-GFP group (P > 0.05). The expression of p130cas protein in the three groups was higher than that in the control group (0.74 ± 0.07) and the Ad-GFP group (0.72 ± 0.02); P < 0.05, but there was no statistically significant difference between the Ad-GFP group and the control group (P > 0.05). The expression of paxillin mRNA in the three groups of HSCs was compared with the expression of paxillin mRNA in the control group of HSC being 1, the expression folds of paxillin mRNA in the Ad-GFP group and Ad-shRNA / PTEN group were 0.97 times and 1.58 times, respectively. The expression of paxillin mRNA in the Ad-shRNA / PTEN group was higher than that in the control group and the Ad-GFP group (P < 0.05), and there was no statistically significant difference between the control group and the Ad-GFP group (P > 0.05). The expression of paxillin protein in the three groups of HSCs was higher in the Ad-shRNA / PTEN group (0.91 ± 0.05) than control group (0.46 ± 0.03) and Ad-GFP group (0.50 ± 0.04), P < 0.05, and there was no statistically significant difference between the Ad-GFP group and the control group (P > 0.05). Conclusion: Down-regulation of PTEN expression can significantly boost p130cas and signal transduction activity of paxillin protein in activated HSC in vitro.

[A prospective cohort study on the relationship between maternal prenatal depressive symptoms and children's behavioral problems at 2 years old].

Objective: To explore the associations between maternal and prenatal depressive symptoms and children's behavioral problems at 2 years old. Methods: In the present study, a total of 491 mother-child pairs were selected from the Shanghai-Minhang Birth Cohort Study (S-MBCS) which was conducted in Maternal and Child Health Hospital of Minhang District in Shanghai between April and December, 2012. Data from the Center for Epidemiologic Studies on Depression was gathered to assess the maternal depressive symptoms in the second and third trimester of pregnancy, as well as at 6 months and 12 months postpartum. Neurodevelopment at 2 years was assessed, using the Child Behavior Checklist. We used generalized linear models with a log-link function and a Binomial distribution to estimate the risk ratios (RRs) and 95%CIs, on children's behavioral problems at 2 years of age. Sensitivity analyses were performed among participants without postpartum depressive symptoms. Results: After adjustment on factors as maternal age, gestation week, average monthly income per person, parental education and children's gender etc., maternal depression in second trimester of pregnancy was found associated with higher risk of both developing emotional (RR=2.61, 95%CI: 1.36-4.99) and internalizing problems (RR=1.94, 95%CI: 1.22-3.08). However, maternal depression in third trimester was found to be associated with higher risks of developing emotional (RR=6.46, 95%CI: 3.09-13.53), withdrawn (RR=2.42, 95%CI: 1.16-5.02), aggressive (RR=2.93, 95%CI: 1.45-5.94), internalizing (RR=1.79, 95%CI: 1.01-3.16) or externalizing problems (RR=2.56, 95%CI:1.49-4.42). In sensitivity analysis, antenatal maternal depression was found positively associated with children's emotional, internalizing and externalizing problems and the differences all statistically significant. Conclusions: Maternal depression during pregnancy might increase the risks of children's behavioral problems. In order to decrease the incidence of children's behavioral problems and promoting both maternal and child health status, monitoring program regarding maternal mental health care should be strengthened.

[Effects of wild-type PTEN overexpression and its mutation on F-actin in activated hepatic stellate cells].

Objective: To investigate the effect of overexpression of wild-type phosphatase and tensin homolog (PTEN) deleted on chromosome 10 and its mutant G129E (exhibiting the activity of protein phosphatase and losing the activity of lipid phosphatase) on F-actin in activated hepatic stellate cells (HSCs) cultured in vitro. Methods: The activated hepatic stellate cell-T6 (HSC-T6) cells were cultured in vitro, and activated HSCs were transfected with adenovirus that carried wild-type PTEN gene and G129E gene using transient transfection. The HSCs were divided into the following groups: control group, which was transfected with DMEM medium instead of virus solution; Ad-GFP group, which was transfected with the empty adenovirus vector with the expression of green fluorescent protein (GFP); Ad-PTEN group, which was transfected with the recombinant adenovirus with wild-type PTEN gene and GFP expression; Ad-G129E group, which was transfected with the recombinant adenovirus with G129E gene and GFP expression. Western blot and quantitative real-time PCR were used to measure the protein and mRNA expression of PTEN in activated HSCs; under a laser scanning confocal microscope (LSCM), phalloidine labeled with the fluorescein tetramethylrhodamine isothiocyanate (TRITC) was used to observe the morphology of HSCs, distribution and fluorescence intensity of F-actin, and changes in pseudopodia and stress fibers, and a calcium fluorescence probe (Rhod-2/AM) was used to measure the changes in Ca(2+) concentration in HSCs. A one-way analysis of variance was used for comparison between multiple groups, and the least significant difference test was used for comparison between two groups. Results: Wild-type PTEN and G129E genes were highly expressed in activated HSCs. In the control group and the Ad-GFP group, HSCs had a starlike or polygonal shape, F-actin was reconfigured and formed a large number of stress fibers which stretched across the whole cell, and layered pseudopodia were seen around the cell. In the Ad-PTEN group and the Ad-G129E group, the HSCs had a fusiform shape, F-actin was mainly seen around the cell, a small number of stress fibers were seen inside the cell, and layered pseudopodia around the cell disappeared. The Ad-PTEN group and the Ad-G129E group had significant reductions in the fluorescence intensity of F-actin compared with the control group and the Ad-GFP group (357.67±13.39/377.25±14.55 vs 961.87±27.33/954.68±20.71, F = 1783.486, P < 0.05), while there were no significant differences between the Ad-PTEN group and the Ad-G129E group, as well as between the control group and the Ad-GFP group (P > 0.05). The Ad-PTEN group and the Ad-G129E group had significant reductions in the relative concentration of Ca(2+) compared with the control group and the Ad-GFP group (251.60±90.88/352.18±146.01 vs 1953.95±132.99/1937.57±115.17, F = 834.988, P < 0.05), while there were no significant differences between the Ad-PTEN group and the Ad-G129E group, as well as between the control group and the Ad-GFP group (P > 0.05). Conclusion: The overexpressed wild-type PTEN and its mutant G129E can significantly inhibit the formation and reconfiguration of cytoskeletal protein F-actin and reduce the concentration of Ca2+ in activated HSCs in vitro. In addition, there are no significant differences in the above effects between wild-type PTEN and G129E.

14-3-3ζ silencing retards tongue squamous cell carcinoma progression by inhibiting cell survival and migration.

Our study aimed to investigate the isoform-specific distribution of 14-3-3 in tongue squamous cell carcinoma (TSCC) and their association with cancer progression, and to further discuss their roles in cancer cell survival. In this study, 42 TSCC specimens and their matched normal para-carcinoma sections were collected. The immunohistochemistry analysis identified that 14-3-3σ and ζ isoforms presented significantly higher expression in cancerous tissues compared with the matched normal tongue tissue sections. 14-3-3ζ expression was associated with tumor T stage, lymph node metastasis and poor prognosis of TSCC. In vitro study revealed that 14-3-3ζ silencing alleviated the proliferation and migration of TSCC cells while promoted cancer cell apoptosis. 14-3-3ζ could bind to and inactivate FOXO3a transcription factor, in turn leading to the movement of the 14-3-3ζ-FOXO3a complex from nucleus to cytoplasm, which was inhibited after 14-3-3ζ silencing. Both 14-3-3ζ and FOXO3a silencing increased caspase 3 and 9 activation, while reduced inner mitochondrial membrane potential. Collectively, 14-3-3ζ may serve as a hallmark and prognostic marker of TSCC. 14-3-3ζ can bind to the FOXO3a transcription factor to promote the export of the complex to the cytoplasm, leading to enhanced proliferation and migration of tongue cancer cells.

Separation of oil/water emulsion using nano-particle (TiO(2)/Al(2)O(3)) modified PVDF ultrafiltration membranes and evaluation of fouling mechanism.

In the present study, nano-sized TiO(2)/Al(2)O(3) modified polyvinylidene fluoride (PVDF) membranes (MM) were fabricated and then utilized for oil/water emulsion separation. The results showed that, compared with PVDF membrane (OM), the contact angle of MM decreased and hydrophilicity increased. The ultrafiltration (UF) of oil in water emulsions with transmembrane pressure (TMP) increasing results in a sharp fall in relative flux with time. The cake filtration models did not always predict the performance over the complete range of filtration times very well. In the initial 30 min, all the four cake models can simulate this UF process to a certain extent, and the suitability was: cake filtration > intermediate pore blocking > standard pore blocking > complete pore blocking models. However, they were no longer adapted well with UF time extent to 60 min, but only cake filtration (R(2) = 0.9535) maintained a high adaptability. Surface and cross-sectional morphology of the membrane was investigated by SEM to make an advanced certificate of this UF mechanism.

Optimization of complex conditions by response surface methodology for APAM-oil/water emulsion removal from aqua solutions using nano-sized TiO2/Al2O3 PVDF ultrafiltration membrane.

This paper studies the cumulative effect of various parameters, namely anionic polyacrylamide (APAM) concentration, oil concentration, pH, trans-membrane pressure (TMP), and total dissolved solid (TDS), and obtains optimal parameters for the minimum relative flux (J/J(0)) declining in aqueous solutions with response surface methodology (RSM). In order to analyze the mutual interaction and optimal values of parameters affecting ultrafiltration, a central composite rotatable design (CCRD), one method of RSM, was employed. The analysis of variance (ANOVA) of the cubic polynomial model demonstrated that this model was highly significant and reliable. The results show that the effect of APAM and oil on J/J(0) has an inverse trend with pH value increasing. Moreover, the mutual interaction of initial APAM (oil) concentration (C(APAM(oil))) and pH (TMP) were negligible, while the mutual interaction of C(APAM) and C(oil) has an obvious effect, i.e. the effect of initial feed C(APAM) became more important at higher values of initial feed C(oil), and the J/J(0) was only about 4%. The favorable operate conditions in this ultrafiltration process were at low C(APAM), C(oil), pH, and TMP, which agreed with the conclusions of many authors, while considering water production, C(APAM) and C(oil) < 50 mg/L, pH < 4, and TMP < 0.075 MPa could be accepted.

Isotherm and kinetic behavior of adsorption of anion polyacrylamide (APAM) from aqueous solution using two kinds of PVDF UF membranes.

To determine the isotherm parameters and kinetic parameters of adsorption of anion polyacrylamide (APAM) from aqueous solution on PVDF ultrafiltration membrane (PM) and modified PVDF ultrafiltration membrane (MPM) is important in understanding the adsorption mechanism of ultrafiltration processes. Effect of variables including adsorption time, initial solution concentration, and temperature were investigated. The Redlich-Peterson equation of the five different isotherm models we chose was the most fitted model, and the R(2) was 0.9487, 0.9765 for PM and MPM, respectively; while, the pseudo-first-order model was the best choice among all the four kinetic models to describe the adsorption behavior of APAM onto membranes, suggesting that the adsorption mechanism was a chemical and physical combined adsorption on heterogeneous surface. The thermodynamic parameters were also calculated from the temperature dependence (Δ(r)G(m)(θ), Δ(r)H(m)(θ), Δ(r)S(m)(θ)), which showed that the process of adsorption is not spontaneous but endothermic process and high temperature favors the adsorption.

Examination of the semen quality of patients with uraemia and renal transplant recipients in comparison with a control group.

To examine the semen quality of patients with uraemia and renal transplant recipients, 40 patients with uraemia and 40 renal transplant recipients were included. According to their interval of post-transplantation, renal transplant recipients were subdivided into group A (22) < or =2 years and group B (18) >2 years. A total of 40 healthy men with normal fertility were included as the controls. Semen samples from all subjects were collected and analysed. The fertility index (FI) value was calculated. The FI value of the normal fertility men was 13.02 (14.26), that of the renal transplant recipient groups A and B were 5.53 (8.30) and 9.27 (22.49) respectively, while the FI of the patients with uraemia was 0.23 (0.76). Compared with the uraemia group, the FI values of renal transplant recipient group either group A or group B were significantly better (P < 0.01). However, compared with the normal control group, the FI values of renal transplant recipient group A were lower (P < 0.01), while there was no significant difference between group B and the control group (P > 0.05). In conclusion, the FI of renal transplant recipients was recovered close to the level of healthy men with normal fertility 2 years after transplantation.

Fluid therapy of acute brain edema in children.

The clinical experience with a new fluid therapy in children with acute brain edema complicated by infectious disease is reported. The clinical data of a retrospective group of 192 patients and a prospective study of 1,302 and 2,279 patients is summarized. One method of fluid therapy for children with acute brain edema is traditional; fluid intake is restricted to less than 1,200 mL/m(2) daily (60 mL/kg daily). Another method is the new fluid therapy regimen used in our prospective study, in which dehydration and fluid replenishment are individualized. On the first day the fluid intake of patients who survived varied from 40 to 208 mL/kg daily. The mortality rate in the two prospective groups was 19.66% in 1,302 patients and 17.2% in 2,279 patients, significantly lower than the 63.5% in the retrospective group (192 patients) (P <0.001). This result indicates that a wide range of fluid intake for children with acute brain edema is allowable during the first days of treatment. The appropriate dehydration and fluid replenishment should be individualized based on close observation of the patient's condition.