Ulinastatin protects rats with myocardial infarction by activating Nrf2/NOS pathway.

OBJECTIVE: The aim of the study was to explore the pharmacological role of ulinastatin in rats with myocardium infarction (MI) and its underlying mechanism. MATERIALS AND METHODS: Rats were randomly assigned into sham group, MI group, and ulinastatin group, with 8 rats in each group. MI model in rats was constructed and specific drug administrations were performed in each group. Electrocardiogram and hemodynamics were detected before and after animal procedures. Myocardium function in rats was accessed by determining serum levels of creatine kinase-MB (CK-MB) and lactate dehydrogenase (LDH). Hematoxylin and eosin (HE) staining was performed to detect the infarct area in rat myocardium. Terminal Deoxynucleotidyl Transferase dUTP Nick-end Labeling (TUNEL) assay was conducted to calculate the ratio of apoptotic cells in rat myocardium. Subsequently, relative oxidative stress indicators in rats were accessed, including total antioxidant capacity (T-AOC), catalase (CAT), glutathione (GSH), Superoxide Dismutase (SOD), malondialdehyde (MDA), and reactive oxygen species (ROS). Western blot was conducted to detect protein levels of nuclear factor E2-related factor 2 (Nrf2), Nuclear Factor κB (NF-Κb), heme oxygenase-1 (HO-1), and NAD(P)H:quinone oxidoreductase 1 (NQO1) in rat myocardium. RESULTS: No significant differences in heart rate, the voltage of the QRS wave and Q-T interval were observed among rats in sham group, MI group, and ulinastatin group prior to the animal procedures. However, at the end of the animal procedures, rats in ulinastatin group showed higher heart rate and voltage of QRS wave, as well as shorter Q-T interval than those in MI group. Rats in ulinastatin group presented lower serum levels of CK-MB and LDH compared with those in MI group, whereas they did not return to baseline. Rats in ulinastatin group showed higher levels of LVSP, dP/dtmax, LVEDP, and -dP/dtmax than those in MI group. Larger infarct area was observed in MI group compared with that of sham group, whereas ulinastatin treatment remarkably reduced the infarct area. HE staining showed remarkable pathological lesions in MI rats, whereas ulinastatin group showed milder lesions in rat myocardium. TUNEL assay showed fewer TUNEL-positive cells in ulinastatin group than those of MI group. Levels of T-AOC, CAT, GSH, and SOD were remarkably higher in myocardium homogenate of MI group than sham group, whereas ulinastatin treatment significantly decreased these levels. Ulinastatin group showed less ROS accumulation and decreased MDA level in rats than those of MI group. Ulinastatin treatment upregulated Nrf2, HO-1, and NQO1, whereas downregulated NF-κB expression. CONCLUSIONS: Ulinastatin protects MI rats by inhibiting inflammatory response through activating Nrf2/NOS pathway.

[A case report of primary ectopic meningioma on occipital subcutaneous soft tissue].

A 65 years old male patient found one lump (A) located in left occipital subcutaneous soft tissue, which was gradually enlarging since thirty years ago. And the patient found another lump (B) located in left shoulder since five years ago. The pathological results showed typical features and immunophenotype of (A) lump resembling intracranial meningothelial meningioma, and (B) lump was a lipoma. No local recurrence or metastasis could been found for 2 months after excision.

[Clinical efficacy of enhanced recovery after surgery in atrial caval shunting for type â ¡ Budd-Chiari syndrome].

Objective: To investigate the clinical efficacy of enhanced recovery after surgery(ERAS) in atrial caval shunting (ACS) for type Ⅱ Budd-Chiari syndrome(BCS). Methods: The clinical data of patients underwent ACS for type Ⅱ BCS in the Henan Province People's Hospital from January 2014 to June 2016 were prospectively analyzed.Randomized and single-blind, controlled study was performed among the patients, and all of them underwent ACS and were divided into control group (patients underwent traditional perioperative management) and ERAS group (patients underwent ERAS perioperative management) based on a random number table.Operational and postoperative data, levels of inflammatory cytokines, stress state evaluation and postoperative complications were observed.The comparison between the two groups was evaluated with an independent sample t test.The trend analyses for variables were done using repeated measures ANOVA.The count data were analyzed using the chi-square test or Fisher exact. Results: Eighty-two patients were screened for eligibility, and allocated into the control group (40 patients) and the ERAS group (42 patients). All patients underwent ACS successfully with no death.Comparison of intraoperative status: operation time, volume of intraoperative blood and number of patients receiving blood transfusion were (211.0±12.9) minutes vs. (207.7±10.7) minutes, (167.5±28.3) ml vs. (165.0±28.4) ml and 3 cases vs. 1 case between the control group and the ERAS group, respectively, showing no difference between the two groups (t=0.90, 0.29, χ2=0.32, all P>0.05). Comparison of postoperative status: time of gastric tube removal, time of catheter removal, time of chest tube, time to flatus, time of food intake, duration of postoperative infusion, duration of postoperative hospital stay and numeric rating scale were (3.7±0.5)days vs. (0.0±0.0)days, (2.3±0.7)days vs. (1.4±0.5)days, (3.7±0.7)days vs. (2.3±0.5)days, (75.2±3.8)hours vs. (46.6±4.2)hours, (75.7±4.7)hours vs. (21.4±2.1)hours, (10.0±1.0)days vs. (5.8±0.9)days, (11.4±1.0)days vs. (7.8±0.6)days, 2.9±0.4 vs. 1.9±0.6 between the control group and the ERAS group, respectively, with statistically differences (t=35.03, 4.36, 8.10, 22.89, 47.78, 14.75, 14.22, 6.13, all P<0.05). Stress state evaluation: the levels of IR were (2.7±0.1) vs.(2.7±0.1), (8.8±0.7) vs. (5.2±0.3), (11.0±0.5) vs. (7.3±0.5), (4.9±0.2) vs. (3.9±0.1), and the levels of C-reaction protein were (14.6±1.3)mg/L vs.(14.6±1.1) mg/L, (101.2±13.6) mg/L vs. (89.5±6.9) mg/L, (62.7±8.6) mg/L vs. (56.4±8.4) mg/L, (46.4±6.7) mg/L vs. (40.0±5.6) mg/L from pre-operation to postoperative day 1, 3 and 5 between the control group and the ERAS group, respectively, with statistically significant differences in changing trends(F=136.61, 4.97, both P<0.05). Comparisons of levels of inflammatory cytokines: the levels of IL-6 were (43.1±2.7) ng/L vs. (43.6±3.6) ng/L, (135.1±6.4) ng/L vs. (117.4±5.7) ng/L, (145.4±6.7) ng/L vs. (128.5±5.5) ng/L, (93.3±3.7) ng/L vs. (88.0±3.9) ng/L, and the levels of TNF-α were (10.4±0.3)mmol/L vs. (10.4±0.3) mmol/L, (14.4±0.4) mmol/L vs. (12.6±0.4) mmol/L, (15.6±0.4) mmol/L vs. (13.8±0.4) mmol/L, (12.3±0.7) mmol/L vs. (11.4±0.6) mmol/L from pre-operation to postoperative day 1, 3 and 5 between the control group and the ERAS group, respectively, with statistically significant differences in changing trends (F=15.15, 21.45, both P<0.05). Comparison of postoperative complications: incidence of complications was 30.0%(12/40) in the control group and 11.9%(5/42) in the ERAS group, and the numbers of patients with nausea and vomiting, respiratory complications and cardiovascular complications were 4, 3, 5 cases in the control group and 3, 1, 1 case in the ERAS group, respectively, showing statistically differences in the incidence of complications(χ2=4.08, P<0.05). All the 82 patients were followed up for 2 to 22 months (median time, 12 months), no patients received reoperation or re-admitted to the hospital duo to complications. Conclusion: ERAS management in the perioperative period of ACS for BCS is beneficial to postoperative recovery of patients, and can relieve postoperative stress state and inflammatory response, reduce the duration of hospital stay, and incidence of postoperative complications.

[Feasibility analysis of predicting the risk of pancreatic fistula after pancreatoduodenectomy by preoperative CT].

Objective: To study the preoperative computed tomography (CT) data of patients with pancreaticoduodenectomy (PD) and to explore the effective of predicting the risk of postoperative pancreatic fistula (POPF). Methods: CT images of patients with PD were analyzed retrospectively from June 2010 to January 2017 in Zhengzhou University of People's Hospital. The pancreas index, pancreatic duct width, pancreas CT value, pancreas-spleen CT value, and pancreas thickness were collected. The relationship between the indicators and the POPF was determined, and the receiver operation characteristic (ROC) curve was calculated and the area under the curve (AUC) was evaluated. The maximum predictive performance of the critical value was determined by using the different cut-off values to calculate the Youden index and other indicators. Results: A total of 154 patients with PD were involved in the study and 27 (17.5%) had POPF. Seven indicators were significantly associated with POPF. The pancreas index had the largest AUC (AUC: 0.865, P<0.001) and pancreatic duct width (AUC: 0.834, P<0.001) also had a higher predictive value. The pancreatic duct (P<0.001) was significantly associated with POPF. Pancreas thickness, pancreas and spleen CT ratio, abdominal wall fat thickness, pancreas CT value, pancreatic abdominal aorta CT ratio and POPF were also related. Using 0.15 as the cut-off value, the sensitivity, specificity, Jordan index, and accuracy of pancreatic index were 83%, 86%, 0.69, and 0.88 respectively, with the highest performance prediction. Abdominal circumference, spleen CT value and other six indicators had no correlation with POPF. Conclusion: Analysis of preoperative CT indicators of patients can predict the risk of POPF in patients after PD. The pancreas index has the greatest predictive efficacy, while pancreatic duct width, pancreatic spleen density ratio and other indicators also associated with POPF.

Down-regulation of microRNA-143 is associated with colorectal cancer progression.

OBJECTIVE: Colorectal cancer (CRC) is one of the most prevalent carcinomas worldwide. Tumor metastasis and recurrence are leading causes of CRC-related deaths. Given the role of microRNA (miRNA) in CRC invasion and metastasis, we explored the association between miRNA-143 expression and clinicopathologic characteristics in CRC, as well as the effects of miRNA-143 on CRC cell invasion in vitro. MATERIALS AND METHODS: Quantitative real-time PCR was conducted to assess the expression of miR-143 in tissue specimens and cell lines. CCK-8 test and transwell assay were conducted to explore the effects of miR-143 on the proliferation and invasion of CRC cell lines, respectively. Luciferase reporter assay and transfection technique were used to validate the correlation between miR-143 and epidermal growth factor receptor 3 (ERBB3) in CRC. RESULTS: miR-143 was down-regulated in human CRC tissues, its expression negatively correlated with CRC metastasis. miR-143 negatively regulated ERBB3 expression by directly targeting its 3'UTR in human colorectal cancer cells. Overexpression of miR-143 inhibited CRC cells invasion but did not affect its proliferation in vitro. Knockdown of ERBB3 also significantly suppressed CRC cells invasion. CONCLUSIONS: These data suggest that miR-143 suppressed the invasion and metastasis ability by suppressing ERBB3 expression in CRC cells, providing a novel and promising therapeutic target for the prevention and treatment of CRC.

GAS5 is downregulated in gastric cancer cells by promoter hypermethylation and regulates adriamycin sensitivity.

OBJECTIVE: GAS5 is a tumor suppressive lncRNA that is downregulated in gastric cancer. In this study, we firstly investigated whether epigenetic regulation contributed to GAS5 downregulation and further investigated the role of GAS5 in Adriamycin (ADM) sensitivity in gastric cancer cells. MATERIALS AND METHODS: GAS5 expression in 15 paired gastric cancer tissues and adjacent normal tissues and in gastric cancer cells were detected using qRT-PCR. Methylation-Specific PCR (MSP) was performed with the use of 5-AZA-dC to detect the methylation status of GAS5 promoter. SGC-7901 and SGC-7901/ADM cells were transfected for GAS5 overexpression and were further used for analysis of ADM sensitivity. RESULTS: GAS5 expression was significantly downregulated in gastric cancer tissues and cancer cell lines and was further downregulated in ADM resistant cells. SGC-7901/ADM cells had significantly higher level of promoter methylation than SGC-7901 cells. 5-AZA-dC treatment significantly reduced the level of methylation and restored GAS5 expression in both SGC-7901 and SGC-7901/ADM cells. SGC-7901/ADM cells with enforced GAS5 expression had significantly decreased the growth rate and increased the ratio of apoptosis after ADM treatment, suggesting that GAS5 can sensitize gastric cancer cells to ADM. CONCLUSIONS: GAS5 is significantly downregulated in gastric cancer cells and further decreased in ADM resistant cancer cells at least partly due to promoter hypermethylation. The enforced GAS5 expression can sensitize gastric cancer cells to ADM.

[Observation on the efficacy of modified Appleby operation for carcinoma of the body and tail of the pancreas].

OBJECTIVE: To evaluate the security, feasibility and therapeutic efficacy of modified Appleby operation for carcinoma of the body and tail of pancreas. METHODS: From March 2010 to February 2015 modified Appleby operation was performed in 17 patients with carcinoma of the body and tail of the pancreas. The biochemical indices of fasting plasma blood (FPB), body weight (BW), visual analogue pain intensity scale (VAS score) and the quality of life index were evaluated before and 1 day , 1, 2, 6weeks after surgery. Survival time, tumor recurrence time, hospitalization time and treatment-related complications were analyzed. RESULTS: There was no hospital mortality in this study. Pancreatic fistula and diarrhea were the major complications. The overall complication rate was 47.1%. The liver function index of ALT and AST were increased on postoperative day 1, and they were restored to normal after one week. Blood glucose has no obvious abnormal increase and abdominal pain was completely relieved. The VAS score decreased after surgery comparing with before (1.9±3.6 vs 83.2±8.5, P<0.05). Life quality assessment was significantly higher. The body weight of patients after surgery has a mean increment of (4.1±1.3)kg than that before surgery (68.1±4.3 vs 64.0±6.7, P<0.05). A significant rise of the overall quality of life index was observed after surgery (93.8±9.7 vs 68.6±6.7, P<0.05). The recurrence rates of 1, 2, 3 and 5 years were 22.9%, 58.9%, 72.6% and 72.6%, respectively. Median recurrence time was (20.0±3.8 m) (95%CI: 12.6-27.4 m). The survival rates of 1, 2, 3 and 5 years were 80.4%, 54.2%, 32.5% and 16.3%, respectively. The median survival time was (26.0±6.0)m (95%CI: 14.2-37.8 m). CONCLUSIONS: Modified Appleby operation for pancreatic cancer is safe and feasible. It can relieve abdominal pain, improve the quality of life, improve the survival rate and prolong the survival time.

[Portazygos disconnection in the treatment of portal hypertension].

Since January 1988 to February 1993, 116 cases of cirrhotic portal hypertension were treated with portazygos disconnection. 37 cases were treated with Hassab's procedure, 36 cases were treated with amplification Hassab's procedure, 33 cases were treated with pericardial devascularization with circular interruption of blood flow of fundus, 10 cases were treated with transthoracic portazygos disconnection. The operative mortality was 6.9%. The hemorrhage rate was 8.6% in one month after the operation. All of 108 patients discharged from the hospital were followed up for 14 months to 75 months. The recurrent hemorrhage rate was 18.5% in the period. The one-year and three-year survival rate after the operation were 94.2% and 81.8%, respectively. The results we have got indicate that amplification Hassab's procedure and transthoracic portazygos disconnection have good effect.

[Anastomotic coarctation in the treatment of serious encephalopathy following splenosystemic shunt].

In this study, 11 cases of serious encephalopathy following splenorenal or splenocaval shunt were treated by anastomotic coarctation, in 4 of the 11 cases, portoazygos disconnection was added. All symptoms and signs disappeared soon after the procedure. The portal hepatopetal blood flow increased. Liver function improved. Blood ammonia concentration decreased. Follow-up of 6 to 48 months found, no recurrent encephalopathy or variceal bleeding. Anastomotic coarctation is effective method to treat serious post-splenosystemic shunt encephalopathy.

[Staged surgery in the treatment of Budd-Chiari's syndrome of mixed type].

9 patients with Budd-Chiari's syndrome of mixed type were operated upon. Among them 3 cases were treated by percutaneous transluminal angioplasty using balloon catheters, and 1 to 2 weeks after followed by Hassab's procedure and Linton's procedure. Two cases were treated by incision and plasty of IVC, and 1 month after followed by Hassab's procedure and Linton's procedure. The remaining 4 were treated by prehepatic cavoatrial shunt, succeeded by Hassab's procedure and Linton's procedure one month after. 6 to 24 months' follow up of the 9 cases revealed satisfactory results.

[The structure of versicolactone A from Aristolochia versicolar S.M. Hwang].

A novel sesquiterpene lactone, versicolactone A, with 12-carbon ring skeleton, was isolated from the roots of Aristolochia versicolar S. M. Hwang. Versicolactone A, C15H20O2, colorless prisms, mp 130-132 degrees C, [alpha]6D +486 degrees (c 0.1276, CHCl3). Its structure was established by spectroscopic methods, mainly 2D-NMR (1H-1H COSY, 1H-13C COSY, COLOC), HRMS and metastable ion measurement.

Furanoid lignans from Larrea tridentata.

From the leaves and stems of Larrea tridentata six new furanoid lignans, compounds 1-6, have been isolated and their structures determined through interpretation of physical and spectroscopic properties. The use of 1D and 2D nOe experiments was of particular importance in assigning the stereochemistry.

[Experimental study on the relation of estrogens to gallstone formation].

Estradiol and progesterone were given intramuscularly to seventeen and sixteen male rabbits respectively on every other day for six weeks. After six weeks, gallstone formation were found in all of the rabbits. In two of them there were cholesterol stones in main hepatobiliary ducts. According to the data resulting from estimation of trace elements and lipid components of the gallbladder bile and findings of microscopic and ultramicroscopic examination on the gallbladder wall, the authors suggest that the mechanisms of gallstone formation are probably due to: 1. Estrogens promote nucleation of gallstones; 2. Estrogens raise lithogenic index of the bile; 3. Estrogens cause stagnation of the gallbladder bile.

[The structure of versicolactone D].

The extracts of Aristolochia versicolar S.M. Huang root afforded a new dimeric sesquiterpene lactone, versicolactone D, with a novel skeleton. Its structure was established by spectroscopic methods, mainly X-ray and 2D-NMR.