Human Platelet-Rich Plasma-Derived Exosomes Promote the Proliferation of Schwann Cells Cultured in Vitro / 中国医学科学院学报

Objective To investigate the effect of human platelet-rich plasma-derived exosomes(PRP-exos)on the proliferation of Schwann cell(SC)cultured in vitro. Methods PRP-exos were extracted by polymerization-precipitation combined with ultracentrifugation.The morphology of PRP-exos was observed by transmission electron microscopy,and the concentration and particle size distribution of PRP-exos were determined by nanoparticle tracking analysis.Western blotting was employed to determine the expression of the marker proteins CD63,CD81,and CD9 on exosome surface and the platelet membrane glycoprotein CD41.The SCs of rats were isolated and cultured,and the expression of the SC marker S100β was detected by immunofluorescence staining.The fluorescently labeled PRP-exos were co-cultured with SCs in vitro for observation of their interaction.EdU assay was employed to detect the effect of PRP-exos on SC proliferation,and CCK-8 assay to detect the effects of PRP-exos at different concentrations(0,10,20,40,80,and 160 μg/ml)on SC proliferation. Results The extracted PRP-exos appeared as uniform saucer-shaped vesicles with the average particle size of(122.8±38.7)nm and the concentration of 3.5×1012 particles/ml.CD63,CD81,CD9,and CD41 were highly expressed on PRP-exos surface(P<0.001,P=0.025,P=0.004,and P=0.032).The isolated SCs expressed S100β,and PRP-exos could be taken up by SCs.PRP-exos of 40,80,and 160 μg/ml promoted the proliferation of SCs,and that of 40 μg/ml showed the best performance(all P<0.01). Conclusions High concentrations of PRP-exos can be extracted from PRP.PRP-exos can be taken up by SCs and promote the proliferation of SCs cultured in vitro.

Light/dark box as an animal model of state anxiety in Kunming mouse: Conditions and factors / 中国药理学通报

Aim To explore the factors on behavior patterns of light/dark box(LDB)as an animal model of state anxiety in Kunming mice.Methods The behavior of adult,male,Kunming mice in LDB was recorded for five minutes,respectively.The following parameters were evaluated:percentage of time in the light area(Ltime%),percentage of squares crossing in the light area(Lcross%),percentage of rears in the light area(Lrear%),total number of squares crossing in the whole apparatus(Cross),total number of rears in the whole apparatus(Rear),total(Cross plus Rear),transitions between two areas(Transition),and number of fecal bolis in light box and dark box(Fbs).Subsequently,the factors,such as day-night rhythm,illumination area(L3/5 or L2/5 for ratio between Light box and Dark box:3:2 or 2:3,respectively),illumination color(in Dark box)and illumination intensity(in Light box),were investigated to screen the best experimental conditions.Results t-test showed that compared with night cycle,there was no significant difference in all LDB parameters during day cycle(P>0.05),while compared with 3/5 and 2/5,LDB parameters during day cycle such as Lcross%(t=5.363,P0.05),but a statistical influence of illumination area on Ltime%(F(1,20)=18.361,P0.05).Conclusions LDB as an animal model of state anxiety in Kunming mice can evaluate anxiety-,locomotion-exploration and emotionality- related behaviors,which cannot be affected by day-night rhythm,but illumination area(Ltime%,Lcross%,Lrear%),illumination color(Rear)and illumination intensity(Cross,Total).So it is recommended to adopt the uniform and fixed conditions,such as illumination area,color and intensity(less than 100 W).

Efficacy of anti-VEGF therapy combined with iontophoresis of Xueshuantong injection on retinal vein obstruction with macular edema / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To study the clinical effects and safety of iontophoresis of xueshuantong injection combined with anti-vascular endothelial growth factor(VEGF)in the treatment of retinal vein occlusion(RVO)with macular edema(ME). <p>METHODS: Totally 106 patients(106 eyes)with RVO and ME in the hospital between June 2017 and June 2019 were divided into observation group and control group according to the random number table method with 53 cases(53 eyes)in each group, and they were all given intravitreal injection of conbercept, and observation group was additionally given iontophoresis of Xueshuantong injection for intervention, and they were treated for 3mo. Both groups were followed up for 1a and given supplementary therapy according to the condition of the disease. The best corrected visual acuity(BCVA), central retinal thickness(CRT)in macular area, supplementary therapy status, VEGF level in aqueous humor and adverse drug reactions were observed and compared between the two groups before and after treatment. <p>RESULTS: After treatment, the BCVA of the two groups was significantly improved(<i>P</i><0.05)while the CRT in macular area was significantly thinned(<i>P</i><0.05), and the BCVA on the 3, 6 and 12mo of treatment in observation group was better than that in control group while the CRT was thinner than that in control group(<i>P</i><0.05). The macular volume and VEGF level in aqueous humor were significantly reduced in the two groups after treatment(<i>P</i><0.05), and the macular volume and VEGF level on the 1, 3, 6 and 12mo of treatment in observation group were lower than those in control group(<i>P</i><0.05). The injection frequencies of conbercept and triamcinolone acetonide and the proportion of patients with laser photocoagulation in observation group were lower than those in control group(<i>P</i><0.05). During treatment, there was 1 eye of intraocular pressure increase and 3 eyes of subconjunctival hemorrhage in observation group, and there were 2 eyes of subconjunctival hemorrhage and 1 eye of endophthalmitis in control group(<i>P</i>>0.05).<p>CONCLUSION: Xueshuantong iontophoresis combined with intravitreal injection of conbercept for RVO with ME can effectively inhibit the expression of VEGF, reduce the ME and improve the visual acuity of the affected eyes. The efficacy and safety are worthy of recognition.

Establishment and gene expression analysis of drug-resistant cell lines in hepatocellular carcinoma induced by sorafenib / 北京大学学报(医学版)

OBJECTIVE@#To establish the drug-resistant cell lines of hepatocellular carcinoma (HCC) induced by sorafenib, and to screen out the high expression genes in drug-resistant cell lines of HCC induced by sorafenib, then to explore the genes related to sorafenib resistance in hepatocellular carcinoma.@*METHODS@#The human PLC and Huh7 cell lines were obtained, then the PLC and Huh7 drug-resistant cell lines were induced with sorafenib by using intermittent induction in vitro. CCK8 assay was used to detect the IC50 value of sorafenib for evaluation of drug sensitivity of hepatocellular carcinoma cell lines in PLC and Huh7. All the up regulated genes in PLC and Huh7 drug-resistant cell lines induced by sorafenib were screened out using high-throughput cDNA sequencing (RNA-Seq), Ualcan database was used to analyze the correlations between the up regulated genes in PLC and Huh7 drug-resistant cell lines induced and four clinical biological characteristics of hepatocellular carcinoma, including the gene expressions between normal samples and tumor samples, tumor stage, tumor grade, and patient overall survival, to find the genes that might be involved in the mechanism of sorafenib resistance of hepatocellular carcinoma.@*RESULTS@#All the up regulated genes detected by the using high-throughput cDNA sequencing (RNA-Seq) in PLC and Huh7 drug-resistant cell lines were further screened out by following conditions:(1) genes co-expressed in PLC and Huh7 drug-resistant cells induced by sorafenib, (2) the fold change was more than 4 times and the difference was statistically significant (P <0.05), the top 12 up regulated genes in PLC and Huh7 drug-resistant cell lines were found, which were TPSG1, CBX4, CLC, CLEC18C, LGI4, F2RL1, S100A6, HABP2, C15ORF48, ZG16, FOLH1, and EPCAM. Compared with the correlations between the twelve genes and the clinical biological characteristics by Ualcan database, the potentially significant gene CBX4 was screened out.@*CONCLUSION@#The human PLC and Huh7 drug-resistant cell lines of hepatocellular carcinoma induced by sorafenib were successfully established. CBX4, the gene related to sorafenib resistance in hepatocellular carcinoma, was screened out by the high-throughput cDNA sequencing (RNA-Seq) and further analysis using Ualcan database, which is providing a powerful basis for further research on the mechanism of sorafenib resistance of hepatocellular carcinoma.

Values of Apparent Diffusion Coefficient and Fractional Anisotropy in the Diagnosis of Brucella Spondylitis / 中国医学科学院学报

To compare the differences in apparent diffusion coefficient (ADC) and fractional anisotropy (FA) between brucella spondylitis (BS) groups at different stages before treatment and the normal control group and to evaluate the change trend of ADC value and FA value at different time points before and after treatment. Totally 53 patients suspected of BS by conventional magnetic resonance imaging (MRI) and later confirmed as BS patients by serological tests were enrolled in this study. These patients underwent conventional MRI and diffusion tensor imaging scans,and the ADC value and FA value were measured. Independent sample test was used to compare the ADC value and FA value between the BS group and the control group,the ADC value and FA value between the BS group at each stage. Repeated measurement ANOV was used to compare the ADC values and FA values at different time points before and after treatment. FA imaging showed that the color code of BS was different from that of the normal control group,and the color code of FA imaging showed increased singal. The ADC values of BS in the acute,subacute,and chronic stages [(1.45±0.02)×10 mm /s,(1.35±0.03)×10 mm /s,(1.26±0.05)×10 mm /s,respectively] were significantly higher than those in the control group [(1.06±0.09) ×10 mm /s](=2.538,=0.009;=1.998,=0.032;=1.575,=0.004),and the FA value (0.55±0.02,0.65±0.03,0.71±0.04,respectively) were significantly lower than those of the control group (0.78±0.02) (=2.440,=0.012; =1.847,=0.041;=2.102,=0.003). Repeated measurement analysis showed that there were statistically significant differences in ADC values and FA values at different time points before and after treatment in the acute,subacute,and chronic stages (ADC:=12.100,<0.001;=8.439,=0.005;=9.704,=0.004,respectively;FA:=7.080,=0.002;=6.607;=0.003;=8.868,=0.001,respectively). The ADC values at different time points after treatment were significantly lower than those before treatment or at a previous time point after treatment (=332.14,<0.001),and the FA values were significantly higher than those before treatment or at a previous time point after treatment (=134.26,<0.001). FA color code can intuitively display differences in BS and normal vertebral bodies and show change of color code before and after treatment. Also,the ADC values and FA values can quantitatively reveal differences between BS and normal vertebral body in different time points and quantify BS vertebral lesion changes before and after treatment. In particular,in BS patients who are recovering from treatment,it can quantify microscopic edema. Therefore,diffusion tensor imaging may be useful objective indicator in evaluating the effectiveness of a specific treatment for BS.

Quantitative Evaluation of Sciatic Nerve Crush Injury with Conventional Ultrasound Combined with Shear-wave Elastography in Rabbit Models / 中国医学科学院学报

To explore the value of conventional ultrasound combined with shear-wave elastography in the quantitative evaluation of sciatic nerve crush injury in rabbit models. Forty healthy male New Zealand white rabbits were randomly divided into four groups (=10 in each group):three crush injury (CI) groups (2,4,and 8 weeks after crush) and control group (without injury). The thickness and stiffness of the crushed sciatic nerves and denervated triceps surae muscles were measured at different time points and compared with histopathologic parameters. Inter-reader variability was assessed with intraclass correlation coefficients. Compared with the control group,the inner diameters of the sciatic nerves significantly increased in the 2-week CI group [(1.65±0.34) mm (0.97±0.15) mm,=0.00] but recovered to the nearly normal level in the 8-week CI group [(1.12±0.18) mm (0.97±0.15) mm,=0.06];however,compared with control group [(8.75±1.02)kPa],the elastic modulus of the nerves increased significantly in all the CI groups [2-week:(14.77±2.53) kPa;4-week:(19.12±3.46) kPa;and 8-week:(28.39±5.26) kPa;all =0.00];pathologically,massive hyperplasia of collagen fibers were found in the nerve tissues. The thickness of denervated triceps surae muscle decreased gradually,and the elastic modulus decreased 2 weeks after injury but increased gradually in the following 6 weeks;pathologically,massive hyperplasia of collagen fibers and adipocytes infiltration were visible,along with decreased muscle wet-weight ratio and muscle fiber cross-sectional area. The inter-reader agreements were good. Conventional ultrasound combined with shear-wave elastography is feasible for the quantitative evaluation of the morphological and mechanical properties of crushed nerves and denervated muscles.

Identification of a Rare Ael05/B101 Subtype and Selection of Blood Transfusion Strategy / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the mechanism of ABO discrepancy in a patient by ABO genotyping and the reasonable blood transfusion strategy.</p><p><b>METHODS</b>Routine serological test was carried out to analyze ABO blood group. The presence of the blood group determinants on the red blood cells were determined by adsorption-elution test. Exons 1-7 and adjacent introns of the ABO gene were amplified by PCR and sequenced.</p><p><b>RESULTS</b>The patient showed ABO forward and reverse typing discrepancy. ABO forward typing defined as B, however, the reverse typing indicated that the patient was AB subtype. Absorption-elution test confirmed weak A antigens on the patient's red blood cells. The ABO gene sequencing showed a T>C exchange at position in exon 7 which resulted in a isoleucine to threonine substitution at codon 256. The ABO blood group genotype was ABO*Ael05/B101.</p><p><b>CONCLUSION</b>The 767 T>C substitution in the gene of α-1,3-N-acetyl galactose is the molecular mechanism leading to the decrease expression of A antigen of the Ael05 subtype.</p>

Research Progress of Yunnan Unexplained Sudden Death / 法医学杂志

Yunnan unexplained sudden death (YUSD) has obvious spatial and temporal aggregations.With the features of sudden onset and rapid death,its causes remain unclear.However,the onset of YUSD is related to the geological and climatic conditions in specific range of altitude of incidence area,which is also influenced by the existed susceptibility gene loci or several multiple mutations in SNP loci,long-term fatigue,low dietary nutrition,trace element deficiency,poor living condition and hygienic habit,and infection by etiologic microorganism or virus among the residents live in the incidence area of YUSD.Under the continuous influence of factors above,the crowd of incidence area finally occurred unexplained sudden death that prominently shown by myocardial injury.Improvements of public health administration,living conditions,villagers' health,living habits and enhancement of indicator measurement of myocardial enzyme and electrocardiogram for the residents in the incidence area of YUSD are effective measures for prevention of YUSD.Timely identification of cause of death and in-depth genetic research are important ways to explore the causes of YUSD,enhance the effectiveness of treatment and reduce the death rate.

Protective mechanism of ginsenoside Rg1 on hippocampus of aging mice induced by D-galactose / 中草药

Objective To investigate the protective mechanism of ginsenoside Rg1 on hippocampus of aging mice induced by D-galactose. Methods Forty nestin-green fluorescent protein (GFP) transgenic mice, aged 6-8 weeks, were randomly divided into four groups: control group, ginsenoside Rg1 control group, ginsenoside Rg1 therapy group, and model group. Learning and memory abilities were measured by Morris water maze after the modeling completed. Frozen sections were made to survey the hippocampus fluorescence intensity. Senescence-associated β-galactosidase (SA-β-Gal) staining was used to detect the aging level of hippocampus. The activities of superoxide dismutase (SOD), total antioxidant capacity (T-AOC), and contents of malonaldehyde (MDA) in hippocampus were tested by chromatometry. Enzyme-linked immunosorbent assay (ELISA) was used to test the levels of interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α proinflammatory cytokins in hippocampus. The levels of p53 and p21 were detected by Western blotting. Results The learning and memory capacities of the aging model group were decreased compared with those of the drug therapy group; The fluorescence intensity in the dentat gyrus (DG) of hippocampus of the drug therapy group was increased compared with that of the model group; The SA-β-Gal positive granules in section of brain tissue of the aging model group were increased compared with those of the drug group and drug therapy group; The activitives of SOD and T-AOC of the drug therapy group were increased compared with those of the aging model group while the content of MDA was decreased. The levels of IL-1β, IL-6, and TNF-α were decreased in the drug therapy group compared with those in the aging model group. The levels of p53 and p21 were decreased in the drug therapy group compared with those in the aging model group. Conclusion Ginsenoside Rg1 can antagonistic D-galactose and delay the aging of hippocampus. In addition, improvement of anti-oxidant ability and regulation of the level of p53-p21 pathway may be the underlying anti-aging mechanism of ginsenoside Rg1.

Prescription rules of preparations containing Crataegi Fructus in Chinese patent drug / 中国中药杂志

To analyze the prescription rules of preparations containing Crataegi Fructus in the drug standards of the People's Republic of China Ministry of Public Health-Chinese Patent Drug(hereinafter referred to as Chinese patent drug), and provide some references for clinical application and the research and development of new medicines. Based on TCMISS(V2.5), the prescriptions containing Crataegi Fructus in Chinese patent drug were collected to build the database; association rules, frequency statistics and other data mining methods were used to analyze the disease syndrome, common drug compatibility and prescription rules. There were a total of 308 prescriptions containing Crataegi Fructus, involving 499 kinds of Chinese medicines, 34 commonly used drug combinations, and mainly for 18 kinds of diseases. Drug combination analysis was done with "Crataegi Fructus-Citri Reticulatae Pericarpium" and "Crataegi Fructus-Poria" as the high-frequency herb pairs and with "stagnation" and "diarrhea" as the high-frequency diseases. The results indicated that the Crataegi Fructus in different herb pairs had a roughly same function, and its therapy effect was different in different diseases. The prescriptions containing Crataegi Fructus in Chinese patent drug had the effect of digestion, and they were widely used in clinical application, often used together with spleen-strengthening medicines to achieve different treatment effects; the prescription rules reflected the prescription characteristics of Crataegi Fructus for different diseases, providing a basis for its clinically scientific application and the research and development of new medicines.

Evaluation of effect of supplementing Qi and activating blood decoction based on combined model of "intestinal out-cardiac muscle cells" and discussion of its mechanism / 中国中药杂志

This research firstly establishes the oxidative damage model of H9c2 induced by H2O2 and screens the concentration range of intestines absorption liquid of Qi benefiting and blood circulation activating formula which possess external myocardium protection function. Then, the thesis chooses 4 dosages to conduct experiments：examining the protection function of intestines absorption liquid of Qi benefiting and blood circulation activating formula on H9c2 to provide reference for clinical prevention and curing of relative heart diseases of oxidative stress injury; as well as examining the H9c2 cardiac muscle cell vigour, cellular morphology, SOD, MDA and other indexes to primarily evaluate and discuss the functional mechanism of intestines absorption liquid of Qi benefiting and blood circulation activating formula. The results show that the intestines absorption liquid of Qi benefiting and blood circulation activating formula has relatively better protection function toward the H9c2 cardiac muscle cell damage induced by H2O2 and presents concentration dependency to some extent. The intestines absorption liquid of Qi benefiting and blood circulation activating formula can increase SOD vigour, and decrease MDA emission, thus decreasing the formation of abnormal cell and strengthening the oxidation resistance of cardiac muscle cell. The intestines absorption liquid of Qi benefiting and blood circulation activating formula has protection function to some extent.

Relationships between quality of life and functional status in patients with malignant bone tumors / 现代临床护理

Objective To explore the relationships of quality of life ( QOL ) and functional status in patients with malignant bone tumors after operation. Methods European organization for research and treatment of cancer quality of life questionnaire C30 (EORTC-QLQ-C30), social support revalued scale (SSRS) and Karnofsky performance scale (KPS) were used to investigate the levels of QOL, social support and functional status. The correlations between them were explored. Results The overall score by QOL was (58.33 ± 18.94). The score by KPS was positively related to somatic function, role function, social function, and general health status (P<0.01), but negatively related to tiredness, pains, insomnia and financial burden (P<0.01). Conclusions The QOL in patients with malignant bone tumors after operation is at a lower level and the function is at a medium level. Nurses should assess the function and make out interventional measures for them so as to improve their QOL.

Mechanism of sophocarpine in treating experimental colitis in mice / 中国中药杂志

To study the preventive effect of sophocarpine (Soc) on dextran sulfate sodium (DSS)-induced colitis in mice, in order to analyze the influence of Soc on toll like receptor 4 (TLR4)/mitogen-activated protein kinases (MAPKs) and janus tyrosine kinase 2 signal transducer and activator of transcription 3 (JAK2/STAT3) signal pathways in mice intestinal tissues. The mice was given 2.5% DSS for 6 days to induce the acute colitis model. The Soc-treated group was intraperitoneally injected with sophocarpine 30 mg · kg(-1) · d(-1) since the day before the experiment to the end. The disease activity index (DAI) was assessed everyday, and the colonic morphology and histological damage were observed with HE staining. The mRNA expressions of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and interleukin-6 (IL-6) were detected by real-time RT-PCR. The changes in key protein kinase p38 mitogen-activated protein kinase (p38MAPK), c-Jun NH2-terminal protein kinase1/2 (JNK1/2), extracellular signal-regulated kinase1/2 (ERK1/2), JAK2, STAT3 in TLR4/MAPKs and JAK2/STAT3 signaling pathways were detected by western blot. The result showed that the model group showed statistical significance in body weight, DAI, colon length and histopathological changes compared with the normal group (P <0.05); however, the Soc-treated group showed significant improvements in the above indexes compared with the model group (P <0.05). TNF-α, IL-1β and IL-6 in the model group was significantly higher than that in the normal group (P <0.05), but lowered in the Soc-treated group to varying degrees (P <0.05). In the normal group, the expressions of TLR4 and the phosphorylation of P38, JNK1/2, JAK2, STAT3 were at low levels; in the model group, the phosphorylation of P38, JNK1/2, JAK2, STAT3 increased; the Soc-treated group showed a decrease in TLR4 expression compared with the model group, with notable declines in the phosphorylation of TLR4, P38, JNK1/2, JAK2, STAT3. These findings indicate that Soc can inhibit TLR4/MAPKs, K2/STAT3 signaling pathway activation, reduce the expression of proinflammatory cytokines TNF-α, IL-1β and IL-6 and relieve inflammatory reactions, so as to effectively prevent experimental colitis.

Prevention and treatment of AD by over-expression of neuroglobin via ac-tivating PI3K/Akt signaling pathway / 中国病理生理杂志

AIM: To study the neuroprotective roles of neuroglobin (NGB) over-expression in the SH-SY5Y cells transfected with pAPPswe.METHODS:The plasmid pEGFP-NGB was successfully constructed and transfected into the SH-SY5Y cells, which were pretreated with pAPPswe.MTT assay was applied to detect the effect of NGB over-expres-sion on the cell survival rates.JC-1 staining was used to detect the level of mitochondrial transmembrane potential.The cell apoptosis was analyzed by flow cytometry.The effects of NGB over-expression on the protein level of p-Akt, Akt and caspase-3/9 were determined by Western blotting.The generation of Aβ42 in the cells was measured by ELISA.RE-SULTS:The cell survival rate was remarkably increased after transfection with NGB compared with control group and emp-ty plasmid group (P<0.05).The over-expression of NGB significantly inhibited the decrease in mitochondrial membrane potential induced by pAPPswe.The over-expression of NGB inhibited the apoptosis of the cells.Furthermore, over-expres-sion of NGB not only inhibited the expression of caspase-3 and caspase-9, but also induced the production of p-Akt, which was prevented by LY294002, an inhibitor of PI3K/Akt.The generation of Aβ42 was inhibited in the cells with the over-ex-pression of NGB.CONCLUSION: Over-expression of NGB significantly inhibits the SH-SY5Y cell injuries induced by pAPPswe and inhibits the expression of caspase-3/9, which is tightly related with cell apoptosis.Furthermore, the neuro-protective roles of NGB may be via activating PI3K/Akt signaling pathway.

Controlled study of ultrasound-guided acupotomy on spinal and articular diseases / 中国针灸

<p><b>UNLABELLED</b>OBJECTIVEL to study the visualization of acupotomy therapy and to summarize differences of interventional ultrasound combined with acupotomy on spinal and articular diseases.</p><p><b>METHODS</b>With randomized block design, 20 cases of shoulder periarthritis, 20 cases of knee arthritis, 20 cases of lumbar disc herniation and 20 cases of cervical disc herniation were divided into an ultrasound-guided group and regular group, 10 cases of each diseas in each group. The ultrasound-guided acupotomy and regular acupotomy were given for one time, respectively. Efficacy was observed after one week. Visual analogue scale (VAS) and fuction score were applied for efficacy assessment, including Wang's funtion evaluation table for cervical disc herniation, modified lumbago assessment by Japanese Orthopaedic Association for lumbar disc herniation, modified lumbago assessment arthritis and CMC shoulder funtion scale for shoulder periarthritis. The changes of scores of patients in two groups were observed before and after the treatment.</p><p><b>RESULTS</b>Each disease in each group achieved favorable efficacy; compared before and after treatment, differences of VAS and each function score all were statistically significant (allP<0.01). The efficacy of lumbar disc herniation and cerical disc herniation in two groups was not obviously different (both P>0.01). The efficacy of lumbar disc herniation and cervical disc herniation in two groups was not obviously different (bothP>0.05), while VAS and fuction scores improvements of shoulder periarthritis and knee +/-5.75 vs 75.72+/-8.56; knee arthritis: 90.40+/-7.35 vs 75.54+/-9.21, both P<0.05).</p><p><b>CONCLUSION</b>Whether ultrasound guidance is applied during acupotomy therapy made no obvious influence on efficacy of lumbar disc herniation and cervical disc herniation, but for shoulder periarthritis and knee arthritis better results could be acchieved with ultrasound guidance.</p>

Xuefu zhuyu decoction containing serum in vitro induced expressions of desmin and alpha-actin: an experimental research / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe whether Xuefu Zhuyu Decoction (XZD) could induce the differentiation of mesenchymal stem cells (MSCs) into cardiac myoid cells, thus seeking for safe and effective inducers.</p><p><b>METHODS</b>The serum pharmacological method was used to induce. XZD containing serum was prepared. MSCs were isolated and cultured. The serum cytotoxicity was detected by MTT. The third generation of favorably grown cells was selected in this experiment. Cells were divided into three groups, i.e., the vehicle control group, the XZD containing serum induced group, and the 5-azacytidine induced group. Expressions of Desmin and alpha-actin were detected by immunocytochemical staining method.</p><p><b>RESULTS</b>Before induction protein expressions of Desmin and alpha-actin were negative, and few was weakly positive. There was no statistical difference in the weak positive expression rate among the 3 groups (P > 0.05). After induction protein expressions of Desmin and alpha-actin were negative, and few was weakly positive in the vehicle control group. Protein expressions of Desmin and alpha-actin were positive in the XZC containing serum induced group and the 5-azacytidine induced group. There was statistical difference in the positive expression rate when compared with the vehicle control group (P > 0.05).</p><p><b>CONCLUSIONS</b>XZD played a role in in vitro inducing differentiation MSCs to cardiac myoid cells. It might participate in expressions of Desmin and alpha-actin.</p>

Significance of No.14v lymph node dissection for advanced gastric cancer undergoing D2 lymphadenectomy / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To elucidate the necessity of No.14v lymph node dissection in D2 lymphadenectomy for advanced gastric cancer.</p><p><b>METHODS</b>Clinicopathological data of 131 cases of advanced gastric cancer receiving D2 or D2+ plus No.14v lymph node dissection were reviewed retrospectively. Clinicopathological factors associated with No.14v lymph node metastasis were analyzed and prognostic value of No.14v lymph node metastasis was evaluated.</p><p><b>RESULTS</b>Of the 131 patients, 24 (18.3%) had positive No.14v lymph node. The incidence of 14v metastasis was associated with tumor location, tumor size, depth of invasion, N staging, TNM staging, No.1, No.6, and No.8a lymph nodes metastasis. Tumor location and N staging were independent risk factors for No.14v metastasis (all P<0.05). The 5-year survival rate was 8.3% and 37.8% in patients with and without No.14v metastasis respectively. The difference was statistically significant (P<0.01). Multivariate analysis revealed that metastasis of No.14v was an independent prognostic factor for advanced gastric cancer after D2 lymphadenectomy (P=0.029, RR=1.807, 95%CI:1.064-3.070).</p><p><b>CONCLUSIONS</b>For advanced middle and lower gastric cancers, especially those with larger size, serosa invasion and possibility of No.6 lymph node metastasis, it is necessary and feasible to remove the No.14v lymph node.</p>

Prognostic value of metastatic lymph node ratio for gastric cancer patients with less than 15 lymph nodes dissection / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the prognostic value of metastatic lymph node ratio (MLR) for gastric cancer patients with less than 15 lymph nodes dissected.</p><p><b>METHODS</b>Clinical data of 610 gastric cancer patients undergoing operation in Tianjin Cancer Hospictal from January 2003 to July 2007 were analyzed retrospectively. Patients were divided into two groups: <15 lymph nodes dissected group (n=320) and ≥ 15 lymph nodes dissected group (n=290). MLR was classified based on the following intervals: rN1 ≤ 10%, rN2 10%-30%, rN3 30%-60% and rN4 >60%. Survival was determined by Kaplan-Meier method and difference was assessed by Log-rank test. Multivariate analysis was performed using Cox proportional hazard regression model. Survival rates were compared between two groups in pN and rN stages respectively.</p><p><b>RESULTS</b>In <15 nodes group, all the survival differences among various rN stages were not significant (all P>0.05), while in same rN stage, all the survival differences among various pN stages were not significant (all P>0.05). Significant differences of 5-year cumulative survival rates were found between the two groups in pN2 and pN3a stage patients (both P<0.05) while no significant differences were found among different rN stages (all P>0.05). Multivariate analysis demonstrated rN stage was an independent prognostic factor for gastric cancer patients with <15 lymph nodes dissected (P=0.012, RR=1.617, 95%CI:1.111-2.354).</p><p><b>CONCLUSION</b>The rN staging system based on MLR can predict the prognosis of gastric cancer patients with less than 15 lymph nodes dissected.</p>

Analysis of clinicopathologic characteristics and prognosis on mixed histology type of gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the clinicopathologic characteristics and prognosis of mixed histological type (MHT) gastric cancer.</p><p><b>METHODS</b>Clinical and follow-up data of 1108 gastric cancer patients undergoing radical operation in Tianjin Cancer Hospital between 2003 and 2006 were analyzed retrospectively. Clinicopathologic characteristics of MHT gastric cancer were summarized and the prognosis was analyzed by Kaplan-Meier analysis and COX regression.</p><p><b>RESULTS</b>Among the 1108 patients, 144 (13.0%) had mixed histology type of gastric cancer. Compared to the unitary histological type (UHT), MHT gastric cancer had bigger tumor size, higher proportion of T4 tumor, and was easier for lymph node and distant metastasis (all P<0.05). The 3- and 5-year survival rates of patients with MHT were 26.5% and 10.8% respectively, which were lower than those with UHT (58.8% and 35.0%, P<0.01). Univariate and multivariate analyses showed TNM classification was an independent prognostic factor (P<0.01).</p><p><b>CONCLUSIONS</b>MHT gastric cancer shows worse prognosis than UHT gastric cancer. There is no difference in prognosis among various combination of MHT gastric cancer. TNM classification is an independent prognostic factor of MHT gastric cancer.</p>

The prognostic influence of D2 lymphadenectomy with para-aortic lymph nodal dissection for gastric cancer in N3 stage / 中华外科杂志

<p><b>OBJECTIVE</b>To elucidate the necessity of para-aortic lymph nodal dissection in D2 lymphadenectomy for gastric cancer in N3 stage.</p><p><b>METHODS</b>A total of 278 gastric cancer patients staged N3 who underwent gastrectomy between January 2003 and December 2007 were enrolled. There were 180 male and 98 female patients, and the patients' age were 26-93 years (median was 61 years). All patients had undergone surgical treatment. There were R0 resection in 246 cases and R1 resection in 32 cases. Lymph node dissection included D1 lymphadenectomy with 125 cases, D2 lymphadenectomy with 109 cases and D2+para-aortic lymph nodal dissection(PAND) with 44 cases. The surgical approach were total gastrectomy (98 cases) and subtotal gastrectomy (180 cases). Potential prognostic factors were analyzed.</p><p><b>RESULTS</b>The lymph node metastasis of each station was high in gastric cancer patients staged N3 and 34.1% patients had the para-aortic lymph nodal metastasis. Borrmann type (HR = 1.350, 95%CI: 1.018-1.790, P = 0.037), curability (HR = 1.580, 95%CI: 1.076-2.322, P = 0.020), depth of invasion (HR = 1.697, 95%CI: 1.005-2.864, P = 0.048), metastatic lymph node ratio (HR = 1.631, 95%CI: 1.261-2.111, P = 0.000), extranodal metastasis (HR = 1.336, 95%CI: 1.027-1.738, P = 0.031), postoperative adjuvant chemotherapy (HR = 1.312, 95%CI: 1.015-1.696, P = 0.038), extent of lymphadenectomy (HR = 1.488 and 2.114, P = 0.054 and 0.000) and number of retrieved lymph node (HR = 1.503 and 2.112, P = 0.025 and 0.000) were found to be factors correlated to overall survival. In multivariate analysis, only Borrmann type (HR = 1.399, 95%CI: 1.050-1.863, P = 0.022), metastatic lymph node ratio (HR = 1.353, 95%CI: 1.016-1.802, P = 0.039) and extent of lymphadenectomy (HR = 1.725, 95%CI: 1.111-2.678, P = 0.015) were independent prognostic factors for gastric cancer patients in N3 stage.</p><p><b>CONCLUSIONS</b>Patients in N3 stage should at least have 30 lymph node examined. D2 lymph node dissection plus PAND may improve the overall survival for gastric cancer patients in N3 stage.</p>