Berberine Promotes Mouse Breast Cancer Metastasis to Lung via Inducing Epithelial–mesenchymal Transition / 肿瘤防治研究

Objective To study the effect and mechanism of berberine (BBR) on the lung metastasis of mouse breast cancer via epithelial-mesenchymal transition (EMT). Methods CCK-8 and Transwell migration assays were utilized to investigate the proliferation and migration properties of breast cancer 4T1 cells after BBR treatment.Mouse 4T1-Luc cells were injected into mice under the fourth mammary fat pad, and the mice were then randomly divided into the control and BBR groups.The mice in the BBR group received daily intraperitoneal injections of BBR working solution and those in the control group were continuously intraperitoneally injected with the same volume of the solvent used to dissolve BBR powder.Tumor metastasis in the lungs of living mice was detected by using an in vivo imaging system.After 42 days of administration, lung metastasis was measured via microscopy and HE staining.Western blot analysis was used to examine the effects of BBR on the expression of EMT-related proteins (Vimentin and Snail) as well as the activation of the Akt and ERK signaling pathways. Results BBR significantly promoted 4T1 cell migration (P < 0.05).In vivo experiments showed that the number of lung metastases in the BBR group had significantly increased compared with that in control group (P < 0.05) as observed under microcopy and histological staining.Compared with the control group, BBR upregulated the expression levels of Vimentin and Snail as well as the phosphorylated levels of p-Akt and p-ERK (P < 0.05). Conclusion BBR may promote EMT and lung metastasis of breast cancer 4T1 cells by activating the expression of proteins in the p-Akt and p-ERK pathways.

Clinical application of endoscope combined with microscope for the microvascular decompression in hemifacial spasm / 中华耳鼻咽喉头颈外科杂志

Objective@#To evaluate the effectiveness and safety of the endoscope combined with microscope for the microvascular decompression in hemifacial spasm.@*Methods@#A total of 26 patients underwent endoscope combined with microscopic facial nerve microvascular decompression through retrolabyrinthine approach from January 2013 to December 2016 were retrospectively reviewed in Ear Institute, Shanghai Jiaotong University School of Medicine. Among them, 9 were male and 17 were female, with a mean age of (51.9±11.4) years;15 cases of left side and 11 of right side patients were followed up for 1-3 years. The pre-and post-operative Cohen Classification was used for hemifacial spasm, House-Brackmann Grade for facial nerve function, hearing level and complication rates were reviewed. SPSS 19.0 software was used to analyze the data.@*Results@#All 26 patients were operated successfully. No recurrence was seen during 1-3 year follow-up. Post-operative Cohen Grade were as follows: 25 cases with Cohen Grade I and 1 case with Cohen Grade II. The difference in Cohen grade between pre-and post-operative was statistically significant (Z=-4.87, P<0.01). Post-operative facial nerve function was satisfactory in all patients (House-Brackmann Grade I-II in all patients). No hearing loss was observed. No facial paralysis and other lower cranial nerve dysfunction were observed. No postoperative complications such as cerebrospinal fluid leakage occurred.@*Conclusions@#Using an angled endoscope combined with microscope in microvascular decompression in hemifacial spasmis is safe and effective.

Antophagy inhibition can decrease AR42J cell apoptosis induced by exendin-4 / 中华肝胆外科杂志

Objective To explore whether exendin-4 inhibits AR42J cells and its mechanism.Methods AR42J cells were treated with exendin-4 under multiple concentrations(1,5,10 pmol/L) at 24,48,72,96,120 h to assess its cell viability by MTT assay and got the IC-50 and time points.Then checking whether exendin-4 could induce the AR42Jcells apoptosis by setting normal control (NC) group,exendin-4 (Ex-4) group and Ex-4+ z-VAD-fmk (apoptosis inhibitor) group,and exploring whether 3-MA which is autophagy inhibitor could inhibit the AR42J cells apoptosis induced by exendin-4 by setting NC group,Ex-4 group and Ex-4+3-MA group.Cell viability was analyzed by MTT and the cells apoptosis was detected by flow cytometry and the protein levels of caspase-3,LC3 and p62 were studied by Western blot.Results Concentration of 10 pmol/L exendin-4 and and time point 72 h were selected for the further study.z-VAD-fmk pretreatment can significantly inhibit the cell viability of exendin-4 by (81.2±3.3)％ vs.(49.4±3.0)％ (P＜0.05).Flow cytometry showed that exendin-4 could induce the AR42J cells apoptosis by (28.2± 1.4)％ vs.(3.6±0.8)％,and increased the caspase-3 level by Western blot,which both can be reversed by (79.1 ±2.3) ％ vs.(49.8±2.5)％ (P＜0.05) when the cells were treated for 72 h,as was apoptosis ratio by (14.5±2.1)％ vs.(29.2±3.2)％.Western blot showed that exendin-4 can upregulate protein levels of LC3B-Ⅱ,p62 和 caspase-3 and 3-MA,and pretreatment can inhibit the upregulation of LC3B-Ⅱ and caspase-3 but further increased the upregulation of p62 induced by exendin-4.Conclusions Exendin-4 can induce AR42J cells apoptosis and 3-MA pretreating can inhibit exendin-4 cytotoxicity through downregulating autophagy.So auto phagy inhibitor 3-MA could potentially extenuate the cytotoxicity of exendin-4 in pancreatic acinar cells.

Clinical analysis of non-acoustic lesions in internal auditory canal and cerebellopontine angle / 中国耳鼻咽喉头颈外科

OBJECTIVE To analyse the diagnosis of non-acoustic lesions in internal auditory canal(IAC) and cerebellopontine angle(CPA),and discuss the effects of imaging examinationon differential diagnosis.METHODS A retrospective study was carried out in 185 patients with non-acoustic lesions of IAC and CPA from January 2001 to December 2016,in which lower cranial schwannoma,facial nerve tumor,meningioma,cholesteatoma,malignant tumor,trigeminal schwannoma,cavernous hemangioma,arachnoid cyst,lipoma were diagnosed in 65,55,25,9,9,8,6,5 and 3 patients,respectively.All patients were performed surgeries,and preoperative diagnosis and surgical approach were decided according to clinical manifestation,CT and MRI findings.Postoperative diagnosis were confirmed by pathological examination.RESULTS Total removal of lesion was achieved in 185 patients [96 men and 89 women,11-77 years old,mean age (46.4±25.6) years] and mean follow-up time was (5.1 ±3.2) years.Postoperative complication was leakage of cerebrospinal (4 patients,2.2％).4 patients with malignancy were dead and 1 patient with cholesteatoma was found recurrent during the follow-up.All kinds of non-acoustic lesions in IAC and CPA had its characteristic imaging findings.Preoperative diagnostic accuracy rate was 93.5％(173/185).CONCLUSION Accurate preoperative diagnosis has great significance in developing treatment strategy for IAC and CPA lesions;Preoperative diagnosis should be achieved according to clinical manifestation,CT and MRI findings,which can significantly improve the accuracy rate of diagnosis.

Retrolabyrinthine approach for cerebellopontine angle region surgeries / 中国耳鼻咽喉头颈外科

OBJECTIVE To evaluate the application ofretrolabyrinthine approach in cerebellopontine angel(CPA) region surgeries.METHODS A total of 42 patients underwent microscopic-endoscopic cooperative surgeries for CPA lesions via retrolabytinthine approach were reviewed.They were hospitalized from January 1st 2011 to January 1st 2016 in our institution.The microscopic-endoscopic technique was applied in all surgeries.RESULTS Complete removal was obtained in all tumor resections and satisfactory symptom-relief was achieved in all microvascular decompressions and neurectomies.In cases with acoustic neuroma and cholesteatoma,useful hearing (AAO-HNS classes A,B and C) was obtained in 66.7％(6/9) patients.No facial paralysis and postoperative complications such as cerebrospinal fluid leakage occurred during follow-up.In cranial nerve rhizopathies cases,complete relief was achieved in all patients.No facial paralysis and other lower cranial nerve dysfunction occurred.CONCLUSION With the preservation of labyrinthine structures,the microscopic-endoscopic cooperative surgeries for CPA lesions via retrolabytinthine approach could increase the hearing preservation level without facial nerve injury.Retrolabyrinthine approach is a good option for cranial nerve rhizopathies and tumors smaller than 15 mm in diameter without involvement of the fundus of internal auditory canal in the CPA region.

Combined application and evaluation of two types of auditory monitoring in acoustic neuroma surgery / 中国耳鼻咽喉头颈外科

OBJECTIVE To explore the significance of intraoperative auditory monitoring(IAMA) in surgery of acoustic neuroma and to compare the value of auditory brainstem response(ABR) and cochlear nerve action potential(CNAP) in auditory monitoring.METHODS Retrospective analysis of 12 cases of acoustic neuroma from January 2016 to December 2016 was performed.All patients have a practical hearing(AAO-HNS,grade class a,b),the ABR waveform can be elicited,wave v differentiation,All tumors were removed via posterior sigmoid sinus approach.RESULTS ABR waveform of all patients were prolonged with different degrees of change(0.68±0.41) ms compared with the preoperative data.Amplitude of CNAP diverse in different individuals,with an average prolong compared to the data before operation(0.25±0.16) ms.In all 12 cases,8 (66.7％) patients remained usable hearing after the operation,4 cases(33.3％) failed to have a usable hearing.Among these 4 patients,3 showed disappearance of wave v,1 patient showed wave v latency prolong in the ABR,meanwhile,2 patients showed P1 dissapear,2 patients showed P1 latency prolong in CNAP.The intraoperative auditory monitoring could play a role in preventing the hearing damage in the procedure.Drilling,noise,surgical nerve stretch or thermal injury may cause the hearing damage.A 5 minutes pause could get some degree of regain,with the amplitude rise again.CONCLUSION A combination use of the ABR and CNAP monitoring has a certain significance in surgery of acoustic neuroma.ABR waveform is stable and reliable,but costs longer time;CNAP stack quickly and improve monitoring sensitivity,but waveform varies.Vibration and noise caused by drilling,nerve stretch during operation and heat damage can be monitored timely.Combined use of ABR and CNAP monitoring can enhance the auditory preservation rate during acoustic neuroma surgery.

Correlation of the expression of Noxa with hepatocellular carcinoma / 临床与实验病理学杂志

Purpose To explore the correlation of Noxa gene with clinical pathology and its effect on proliferation and apoptosis of HepG2 cells.Methods Noxa protein in 100 hepatocellular carcinoma tissues and 100 paracancerous tissues were detected by imnunohistochemical technique,clinicopathological parameters and follow-up data were statistically analyzed.The recombinant eukaryotic expression plasmid pIRES2-EGFP-Noxa was transiently transfected into HepG2 cells with lipofectamine.Both Noxa mRNA and protein were detected by RT-PCR and Western blot respectively.The inhibition of cell proliferation was evaluated by MTT assay.The cell apoptosis was detected by flow cytometry (FCM).Results Immunohistochemistry showed that in tumor tissue of hepatocellular carcinona the positive rate of Noxa protein expression was 50％,while it was 78％ in cancer adjacent normal mucosal tissue,with statistically significant difference (P ＜ 0.05).The expression of Noxa was related to TNM staging and the tumor differentiation.Exotic Noxa gene was expressed successfully in HepG2 cells after transfected with lipofectamine.The expression of Noxa mRNA and protein of HepG2 cells was significantly up-regulated after transfected 24 h,48 h and 72 h (P ＜ 0.05).MTT assay showed that the Noxa expression inhibited HepG2 cell proliferation in a time-dependent manner for 24 h,48 h and 72 h (P ＜ 0.05),which was significantly different from that of the control group (P ＜ 0.05).Apoptosis rate after transfected 24 h,48 h and 72 h was (15.5 ± 0.9)％,(24.6 ±0.8) ％ and (35.4 ±0.7) ％,respectively.There were significant difference between Noxa and the control group (P ＜ 0.05).Conclusion The expression of Noxa in hepatocellular carcinoma tissue is closely related to TNM stage and the tumor differentiation.Noxa gene overexpression is able to effectively inhibit the proliferation and promote the apoptosis of HepG2 cell line.

Observation on the effect of iliac artery to deep femoral artery angioplasty on patients with lower limb arteriosclerosis obliterans / 中国综合临床

Objective To explore the effect of iliac artery to deep femoral artery angioplasty on the improvement of postoperative lower limb ischemic symptoms and recovery in patients with lower limb arteriosclerosis obliterans(LEASO).Methods One hundred and four LEASO patients in Dongzhimen Hospital of Beijing University of Chinese Medicine from December 2013 to July 2016 were involved in the study and they were divided into control group and observation group according to the treatment program,each group 52 cases.The control group was treated with conservative treatment,and the observation group was treated with iliac artery to deep femoral artery angioplasty.After treatment,the limb ischemic injury degree Rutherford classification and clinical efficacy of the two groups were compared,all patients were followed up for 6 months to compare the survival quality score before and 6-month after treatment.Results (1) Rutherford classification: after treatment,Rutherford classification in the observation group was significantly higher than that of the control group,the result was statistically significant (Z=2.160,P=0.031);(2) Clinical efficacy: the total effective rate in the observation group (94.23% (49/52)) was higher than that of the control group (76.92% (40/52)),the difference was statistically significant (χ2=6.310,P=0.012);(3) Life quality: before treatment,there was no significant difference between the two groups in terms of the quality of life score ((55.01±6.32) points vs.(54.89±6.14) points,t=0.098,P=0.922),but 6 months after treatment,the score of the observation group became higher than that of the control group ((69.63±7.51) points vs.(63.15±6.98) points,t=4.558,P=0.000).Conclusion The treatment of LEASO using iliac artery to deep femoral artery angioplasty can effectively improve patient''s lower limb ischemic symptoms and life quality.

Comparison of Diagnostic Methods of Secretory Otitis Media in Children / 听力学及言语疾病杂志

Objective To investigate the diagnostic value of endotoscopy,tympanometry,pure tone audiometry (PTA) and high resolution temporal bone CT in children with secretory otitis media (SOM).Methods The study comprised 414 ears in 207 children with adenoid hypertrophy.Endotoscopy,tympanometry,PTA and high resolution temporal bone CT were conducted to evaluate the function of middle ear.Based on the imaging findings of tympanic cavity fluid by high resolution temporal bone CT,the diagnostic accordance rate of endotoscopy,tympanograms and PTA for SOM were studied.Results The diagnostic accordance rate of endotoscopy,tympanometry and PTA for SOM were 98.79％(409/414),98.07％ (406/414) and 88.41％ (366/414),respectively.The sensitivity of the three examinations were 99.20％(124/125),100％ (125/125),63.20％ (79/125),respectively.The specificity of the three examinations were 98.62％ (285/289),97.23％ (281/289),99.31％ (287/289),respectively.The diagnostic accordance rate of endotoscopy combined with tympanometry for SOM was significantly higher than any single examination or any combined examinations.Conclusion Endotoscopy combined with tympanometry shows a great value in diagnosing SOM,which is accurate and safe.

Surface interactions between two of the main periodontal pathogens: Porphyromonas gingivalis and Tannerella forsythia

PURPOSE: Porphyromonas gingivalis and Tannerella forsythia have been implicated as the major etiologic agents of periodontal disease. These two bacteria are frequently isolated together from the periodontal lesion, and it has been suggested that their interaction may increase each one's virulence potential. The purpose of this study was to identify proteins on the surface of these organisms that are involved in interbacterial binding. METHODS: Biotin labeling of surface proteins of P. gingivalis and T. forsythia and liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis was performed to identify surface proteins involved in the coaggregating activity between P. gingivalis and T. forsythia. RESULTS: It was found that three major T. forsythia proteins sized 161, 100, and 62 kDa were involved in binding to P. gingivalis, and P. gingivalis proteins sized 35, 32, and 26 kDa were involved in binding to T. forsythia cells. CONCLUSIONS: LC-MS/MS analysis identified one T. forsythia surface protein (TonB-linked outer membrane protein) involved in interbacterial binding to P. gingivalis. However, the nature of other T. forsythia and P. gingivalis surface proteins identified by biotin labeling could not be determined. Further analysis of these proteins will help elucidate the molecular mechanisms that mediate coaggregation between P. gingivalis and T. forsythia.

Exenatide induce the impairment of autophagy flux to damage rat pancreatic tissue / 中华内分泌外科杂志

Objective To explore the alteration and effect of autophagy in pancreas tissue of rat injected by exenatide.Methods Diabetes model rats were induced by two-month high-sugar and high-fat diet and streptozotocin injection (35 mg/kg) in normal rats.50 SD male rats were divided into four groups according to the principle of complete random design,namely normal control group (n=10),normal exenatide-injected group (n=10),diabetes-model control group (n=l5) and diabetes-model exenatide-injected group (n=15).Rats in exenatide-injected groups were subcutaneously injected with exenatide respectively in 5 μg/kg dose each time,twice a day,at 8 a.m.and 6 p.m.Animal weights were weighted weekly and the dose of exenatide was adjusted according to current weight.Rats in the two control groups were injected with the corresponding amount of saline.Mter 10 weeks of treatment,all rats were killed and pancreatic tissues were disposed.Immunohistochemistry was used to measure the expression of GLP-1R in pancreatic tissues.Western blot was used to test the expressions of LC3-Ⅰ,LC3-Ⅱ and p62 in pancreatic tissues,and LC3-Ⅱ/Ⅰ ratio and p62 were compared between any two groups.All specimens were stained with hematoxylin-eosin (HE).The data were expressed as means ± standard deviation and were analyzed by unpaired Student t test using SPSS 18.0 statistics software.P value ＜0.05 was considered to be statistically significant for all tests.Results The pancreatic tissues from 13 rats (6 from the normal exenatide-injected group and 7 from the diabetes-model exenatide-injected group) appeared pathological changes such as gland structure damage,pancreatic cells atrophy and cells compartment broadening.The expressions of GLP-1R,LC3-Ⅱ and p62,and LC3B-Ⅱ/Ⅰ ratio in the two exenatide-injected groups were higher than those in the respective control group,and the differences had statistical significance (P＜0.05).Conclusions Long-term subcutaneous injection of exenatide can upregulate the expression of GLP-1R in rat pancreatic acinar cells and may induce the impaiment of autophagy flux in rat pancreatic cell.

The value of serum soluble cluster differentiation CD163 to the prognosis of patients with stroke associated pneumonia / 中国中西医结合急救杂志

ObjectiveTo estimate the value of serum soluble scavenger receptor CD163 (sCD163) to the prognosis of patients with stroke associated pneumonia (SAP).Methods A prospective study was conducted. The clinically suspected SAP patients admitted to Department of Intensive Care Unit (ICU) and Emergency ICU (EICU) in Zhejiang Province Zhuji City Chinese Medicine Hospital from February 2014 to January 2015 were all enrolled. According to clinical pneumonia severity index (PSI), they were divided into SAP group and non SAP group according to the presence or absence of SAP, the patients of SAP group were subdivided into mild SAP group (PSI grade Ⅰ-Ⅲgrade) and severe SAP groups (PSI grade Ⅳ-Ⅴ grade) and according to the 28-day prognosis, the patients were subdivided into hospitalized death group and survival group. The clinical data were collected, including gender, age, history of stroke presence or absence, present stroke pattern, National Institutes of Health Stroke Scale score (NIHSS) on the day of stroke suspect diagnosis, Glasgow coma scale (GCS) score, acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score, clinical pulmonary infection score (CPIS), PSI score, body temperature, result of chest X-ray film, oxygenation index (PaO2/FiO2), result of sputum culture, serum levels of white blood cell (WBC) and C-reactive protein (CRP) in a period of 7 days after the suspected diagnosis, PCT, sCDl63 levels on days 1, 3, 5, 7 days, length of stay in ICU, the total time of hospitalization and 28-day survival situation, etc. The ability of each index to evaluate the prognosis of SAP was analyzed by the receiver operating characteristic curve (ROC curve). The risk factors influencing the prognosis of SAP patients were analyzed by multivariate logistic regression analysis.Results ① Seventy-eight patients were finally enrolled in the study, 44 patients were diagnosed as SAP, 34 were non SAP. In 44 patients with SAP, there were 28 cases of severe SAP and 16 cases of mild SAP. On the first day of the suspected diagnosis, the NIHSS score [13 (7, 22) vs. 8 (4, 17), the CPIS score [6 (4, 9) vs. 4 (3, 5), sCD163 [mg/L: 0.80 (0.59, 1.32) vs. 0.33 (0.22, 0.46)], CRP [mg/L: 84.2 (50.8, 114.9) vs. 51.4 (26.2, 79.9)] and 28-day mortality [38.6% (17/44) vs. 11.8% (4/34)] in SAP group were significantly higher than those in non SAP group (allP 0.05). ② The levels of sCD163 reached the peak value on the third day after the suspected diagnosis among SAP group and non SAP group, mild SAP group and severe SAP group, survival group and death group and then began to fall; the levels of sCD163, WBC, CRP, PCT within 7 days in SAP, severe SAP and death groups were higher than those in non SAP, mild SAP and survival groups (allP < 0.05). ③ROC curve analysis indicated: sCDl63 showed a better capacity for evaluating the 28-day prognosis of SAP [ROC curve (AUC) =0.673, 95% confidence interval (95%CI) = 0.515-0.807, sensitivity and specificity were 41.2% and 96.3% respectively and the cut-off was 2.65 mg/L]. However, the levels of other inflammatory indexes and scores on the first day after the suspected diagnosis had no value for early prognosis of SAP. The multiple logistic regression analysis showed that the level of sCD163 on the first day after the suspected diagnosis was the independent risk factor of death in hospital of SAP patients [dominance ratio (OR = 1.27, 95%CI = 1.06-1.52,P < 0.05]. Age (OR = 1.04, 95%CI = 1.01-1.06,P = 0.015), NIHSS score (OR = 2.86, 95%CI = 1.64-4.92,P = 0.010), CPIS score (OR = 1.52,95%CI = 1.28-1.90,P < 0.001) and APACHEⅡ score (OR = 2.06, 95%CI = 1.53-3.07,P < 0.001) were also the risk factors of influencing the death of patients with SAP.Conclusions Early sCD163 level is an independent risk factor in predicting the 28-day mortality of patients with SAP, and it has a certain value for the prognosis of SAP.

Constructing tissue-engineered bladder by vascular endothelial growth factor nanoparticle-bacterial cellulose composite scaffold with various kinds of cells / 中国组织工程研究

BACKGROUND:Traditional bladder repair methods have many problems such as damage to normal organ function and many postoperative complications. Tissue engineering technology provides a new way for bladder repair. OBJECTIVE:To explore the feasibility of constructing tissue-engineered bladder with vascular endothelial growth factor (VEGF) nanoparticle-bacterial celulose (BC) composite scaffold with rabbit lingual epithelial cels andtonguemuscle cels. METHODS:Rabbit lingual epithelial cels andmuscle cels were successively implanted onto the BC scaffold (control group) and VEGF-BC scaffold (experimental group). Six rabbits were taken to make bladder defect models and randomized into two groups: experimental group implanted with VEGF-BC scaffold carrying autologous lingual epithelial cels andtonguemuscle cels,and control group implanted with BC scaffold carrying autologous lingual epithelial cels andtonguemuscle cels. Specimens were taken from the two groups for urographic evaluation and histological examination at 3 months after implantation. Meanwhile, the urodynamic tests were performed. RESULTS AND CONCLUSION:The experimental group showed the relatively complete bladder, and the control group showed a smal-area filing defect of the bladder. The maximum bladder capacity and bladder compliance in both two groups were decreased after implantation, especialy significantly in the control group (P< 0.05). In the control group, it failed to build a complete epithelial cel layer, and the muscle layer and microvessels were formed a little. In the experimental group, the complete epithelial cel layer was formed, and a larger amount of muscle layers and capilaries appeared. These findings indicate that the VEGF-BC scaffold carrying lingual epithelial cels andtonguemuscle cels can be used to construct thetissue-engineered bladder.

A retrospective cohort comparison of esophageal carcinoma between thoracoscopic and laparoscopic esophagectomy and open esophagectomy / 中华外科杂志

<p><b>OBJECTIVE</b>To study the efficacy and safety of thoracoscopic and laparoscopic esophagectomy for esophageal carcinoma.</p><p><b>METHODS</b>Based on hospitalization data from March 2011 to March 2014, 62 cases of esophageal carcinoma treated with thoracoscopic and laparoscopic esophagectomy (minimally invasive group, with 45 male patients) and other 62 cases treated with open esophagectomy (open esophagectomy group, with 45 male patients) were analyzed in a retrospective cohort. The mean age of two groups were (62±9) years and (62±8) years, respectively. Quantitative data were analyzed using t-test, whereas qualitative variables were tested with χ2 test. There were no significant difference in age, tumor location, pathological type, tumor staging between two groups (P>0.05). Perioperative data and three-year clinic outcome were collected. The three-year survival curve were calculated with the Kaplan-Meier method and compared by the log-rank test between the two groups.</p><p><b>RESULTS</b>Compared with open esophagectomy group, minimally invasive group has less amount of bleeding during operations ((231±40) ml vs. (302±37) ml, t=4.63, P=0.000), pleural drainage after operations ((490±41) ml vs. (1 090±43) ml, t=-79.59, P=0.000), and postoperative hospital stay ((16±4) days vs. (17±4) days, t=-2.61, P=0.010). Meanwhile, minimally invasive group has more operation time ((272±39) minutes vs. (242±45) minutes, t=3.97, P=0.000) and total and thoracic cavity retrieved lymph nodes (30±5 vs. 28±4, t=2.39, P=0.018; 15±4 vs. 14±3, t=2.59, P=0.011). Nineteen and 31 patients had postoperative complications and statistical significance difference was found between two groups (χ2=4.83, P=0.028). The three-year survival rate was 73.2% in minimally invasive group and 71.4% in open esophagectomy group. There was no significance difference between two groups (χ2=0.170, P>0.05).</p><p><b>CONCLUSION</b>Thoracoscopic and laparoscopic esophagectomy had the advantages of amount of bleeding, postoperative hospital stay and complications, and had the same three-year survival rate with open esophagectomy.</p>

Comparative study on digestive reconstruction after tota1 gastrectomy / 中国基层医药

Objective To explore the type of the rational digestive reconstruction after total gastrectomy for gastric malignancy.Metlhods Three types of digestive reconstruction were performed after total gastrectomy in 121 cases with gastric carcinoma.The operating time,morbidity and mortality,digestive tract symptoms,nutritional status in 1 year after operation were compared.Results There were no signifioant differences among the three procedures in operative morbidity and mortality,postoperative food intake,nutritional status,incidences of diarrhea and dumping syndrome.Roux-en-Y esophajejunostomy and P-type esophajejunostomy had an advantage d anti-esophageal reflux,and are obviously superior to Lahey + Braun anastomosis.Roux-en-Y esophajejunostomy was simpler with shorter operating time and less complication.Condusion Roux-en-Y esophajejunostomy and P-type esophajejunostomy could be recommended as suitable methods for digestive reconstruction after total gastrectomy.

Bladder reconstruction with seeding adipose-derived stem cells onto bladder acellular matrix grafts / 中华泌尿外科杂志

ObjectiveTo assess the feasibility of seeding adipose-derived stem cells (ADSCs) onto bladder acellular matrix grafts (BAMGs) for bladder reconstruction in a rabbit model.MethodsAutologous ADSCs were isolated,expanded and identified by flow cytometry.In the experimental group,ADSCs were seeded onto BAMGS for reconstructing bladder defects in 12 male rabbits.Unseeded BAMGs were used for bladder reconstruction in the control group of 12 rabbits.Cystography was performed at 24 weeks after grafts implantation.Following cystography,the animals were scarified and grafts were harvested； H&E and immunohistochemical staining were performed with cytokeratin AE1/AE3,smooth muscle α-actin and S-100 markers.ResultsFlow cytometry demonstrated that the ADSCs expressed CD90,CD44,CD105,CD166 and CD34,but not CD45 or CD106.The cells demonstrated good biocompatibility with BAMGs.At 24 weeks,in the experimental group,the reconstructed bladders reached a mean volume of (94.68 ± 3.31 )％ of the precystectomy bladder capacity.Complete regeneration of smooth muscle and nerve tissue was evident.Regenerated SMCs,urothelium and nerve cells stained positively for α-smooth muscle actin,AE1/AE3 and S100.In the control group,the mean bladder volume was (69.33 ± 5.05 )％ of the pre-cystectomy volume.Histologically,the control group was characterized by multi-layered urothelium without evidence for organized muscle or nerve tissue.Conclusion The tissue engineering bladder constructed by ADSCs and BAMG can be used as an ideal biomaterial to replace and repair the bladder.

A comparison of different seeding methods for constructing three dimensional urethral tissue in vitro / 中华泌尿外科杂志

Objective To investigate and assess the best seeding method for constructing three dimensional urethral tissue in vitro. Methods High speed agitation decellular method was used for preparing the porcine acellular corporous spongiosum matrix (ACSM). Before seeding, the matrix was sterilized via soaking compound iodine solution. Rabbit tongue epithelial cells and cavernosal smooth muscle cells were isolated and cultured. Three different groups of seeding method was used in this study. Group A (sandwich seeding group): The smooth muscle cells and epithelial cells were seeded onto the different side of ACSM by static method. Group B (injection seeding group): The smooth muscle cells were injected into the scaffold. Then, epithelial cells were seeded onto the urethral surface of ACSM by static method. Group C (agitation seeding group): The smooth muscle cells were seeded into the scaffold by agitation method. Then, epithelial cells were seeded onto the urethral surface of ACSM by static method. After being seeded, all matrixes were cultured in vitro for 14 d. HE and immunoassay staining were used to examine the results of seeding. Results Looser matrix was obtained after using high speed agitation decellular method. Compound iodine solution could not only sterilize efficiently but also reserve the original structure of biomaterial. An intact epithelial cellular layer onto the surface of scaffold could be observed in HE staining section after 14 d culturing in vitro.Few smooth muscle cells could be found in big space of biomaterial in group A. In group B, smooth muscle cells were restrained in some regions of the matrix. Smooth muscle cells were well distributed into the scaffold in group C. Conclusions After using high speed agitation decellular method, an ideal matrix with three dimensional structure can be obtained. Combined with agitated seeding method, three dimensional urethral tissue can be constructed.

A preliminary investigation of constructing tissue engineering urethral graft using human lingual keratinocyes and natural derived scaffold / 中华泌尿外科杂志

Objective To investigate the feasibility of constructing tissue engineering urethral substituted graft using human lingual keratinocytes and natural derived scaffold.Methods From Oct.2009to Jan.2010,ten patients with anterior urethral stricture were enrolled in this study.A 0.5 × 0.8 cm lingual mucosa was harvested during the operation.Lingual keratinocytes were then isolated and cultured from the mucosa.AE1/AE3 antibody was used to identify the lingual keratinocytes.Keratinocytes were collected and seeded onto three types of scaffold including dehydrated BAMG,liquid stored BAMG and 4-layer SIS product,with the density of 1 × 107/ml at passage three.After being cultured for seven days in vitro,H&E staining and Electronic Scan Microscopy were used to evaluate the compound matrixes.Results No complication occurred in the patients after operation.The primary passage of confluence lingual keratinocytes appeared in a typical cobblestone shape after being cultured for 14 days in vitro.The proliferation rate of these cells increased rapidly during the three passages.However,it decreased significantly in the 4th passage.H&E and Electronic Scan Microscopy examinations showed that few cells grew on the surface of the liquid stored BAMG.Nevertheless,multiple keratinocytes layers could be seen in dehydrated BAMG and 4-layer SIS.Meanwhile,cellular infiltration could be observed in SIS sections.Conclusions Human lingual keratinocytes could be the alternative of seeding cells for constructing tissues for engineering the urethra.These cells exhibited good compatibility and are adhesive to the SIS or BAMG.The compound matrix,which used human lingual keratinocytes and natural derived scaffold,may meet the clinical need of urethral disease in the future.

Application of dynamic APACHEⅡscore and POSSUM score in patients with severe acute pancreatitis / 中国基层医药

Objective To discuss the value of combining the physiological and operative severity score for enumeration of mortality and morbidity(POSSUM)and acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)in severe acute pancreatitis(sAP).Methods 60 cases of SAP were divided into surgery group(n=15)and non-surgical group(n=45),Non-surgical group was vahde with APACHE Ⅱ score,the surgery group with POSSUM score,decided to continue conservative treatment or surgery treatment,Observation of two ways with the complications and death.Results The rates of compHcafions and death were(0.37±0.08)and(0.27±0.09)in Single-operation group(n=15)higher than(0.76±0.14)and(0.61±0.15)in surgical group(n=11)(t1=3.125,t2=3.211,P＜0.01);APACHEⅡ score of mortality in operation group and non-surgical group were no significant difference(x2=2.28,x2=1.98,P＞0.05);APACHE Ⅱ score were(10.12±6.27)in survival group(n=46)were lower than (25.75±7.90)in death group(n=14)(t=2.525,P＜0.05.Conclusion The score of dynamic APACHE Ⅱ has better effect to judge the timing of surgery,and the score of POSSUM has high value to predict post-operative complications and deaths occurred in patients with severe acute pancreatitis.

Study on changes of cytokines in patients with acute pancreatitis / 中国基层医药

Objective To study the clinical significance and changes of serum TNF-α、IL-6、IL-8、PAFand AGT-Ⅱ in patients with severe acute pancreatitis(SAP). Methods Serum TNF-α、IL-6、IL-8、PAF、AGT-Ⅱ values of all patients were measured by ELISA and radioimmunoassay. 30 cases with mild AP(MAP group),50 cases with SAP(SAP group) and 30 non-pancreatitis patients as control group. Results The level of TNF-α, IL-6, IL-8, PAF, AGT-Ⅱ of acute phase and recovery phase in SAP group and the MAP group were significantly higher than the normal control group(all P < 0.01); the level of TNF-α、IL-6、IL-8、PAF and AGT-Ⅱ of acute phase in SAP group were significantly higher than the MAP group(all P <0.05); the level of TNF-α、IL-6、IL-8、PAF and AGT-Ⅱ of re-covery phase in SAP group were significantly lower than the acute phase(all P <0.05);the level of TNF-α、IL-6、IL-8、PAF and AGT-Ⅱ of died in SAP group were significantly higher than the survivors (all P < 0.05～0.01). Conclu-sion The level of TNF-α、IL-6、IL-8 with the severity of SAP's condition and prognosis is closely related, The level of AGT-Ⅱ in SAP group were significantly higher than the MAP group.