Head-to-head comparisons of enhanced CT, 68Ga-PSMA-11 PET/CT and 18F-FDG PET/CT in identifying adverse pathology of clear-cell renal cell carcinoma: a prospective study

ABSTRACT Objectives: Accurate preoperative prediction of adverse pathology is crucial for treatment planning of renal cell carcinoma (RCC). Previous studies have emphasized the potential of prostate-specific membrane antigen positron emission tomography / computed tomography (PSMA PET/CT) in differentiating between benign and malignant localized renal tumors. However, there is a scarcity of case reports elucidating the identification of aggressive pathological features using PET/CT. Our study was designed to prospectively compare the diagnostic value of enhanced CT, 68Ga-PSMA-11 and 18F-fluorodeoxyglucose (18F-FDG) PET/CT in clear-cell renal cell carcinoma (ccRCC) with necrosis or sarcomatoid or rhabdoid differentiation. Materials and Methods: A prospective case series of patients with a newly diagnosed renal mass who underwent enhanced CT, 68Ga-PSMA-11 and 18F-FDG PET/CT within 30 days prior to nephrectomy was included. Complete preoperative and postoperative clinicopathological data were recorded. Patients who received neoadjuvant targeted therapy, declined enhanced CT or PET/CT scanning, refused surgical treatment or had non-ccRCC pathological indications were excluded. Radiological parameters were compared within subgroups of pathological characteristics. Bonferroni corrections were used to adjust for multiple testing and statistical significance was set at a p-value less than 0.017. Results: Seventy-two patients were available for the final analysis. Enhanced CT demonstrated poor performance in identifying necrosis, sarcomatoid or rhabdoid differentiation and adverse pathology (all P > 0.05). The maximum standardized uptake value (SUVmax) of 68Ga-PSMA-11 PET/CT was more effective than 18F-FDG PET/CT in identifying tumor necrosis and adverse pathology, with an area under the curve (AUC) of 0.85 (cutoff value=25.26, p<0.001; Delong test z=2.709, p=0.007) for tumor necrosis and AUC of 0.90 (cutoff value=25.26, p<0.001; Delong test z=3.433, p<0.001) for adverse pathology. However, no significant statistical difference was found between 68Ga-PSMA-11 and 18F-FDG PET/CT in predicting sarcomatoid or rhabdoid feature (AUC of 0.91 vs.0.75, Delong test z=1.998, p=0.046). Subgroup analyses based on age, sex, tumor location, maximal diameter, stage and WHO/ISUP grade demonstrated that 68Ga-PSMA-11 PET/CT SUVmax had a significant predictive value for adverse pathology. Enhanced CT value and SUVmax demonstrated strong reliability [intraclass correlation coefficient (ICC) > 0.80], indicating a robust correlation. Conclusions: 68Ga-PSMA-11 PET/CT demonstrates distinct advantages in identifying aggressive pathological features of primary ccRCC when compared to enhanced CT and 18F-FDG PET/CT. Further research and assessment are warranted to fully establish the clinical utility of 68Ga-PSMA-11 PET/CT in ccRCC.

Efficacy of 3D-printed guide plate assisted versus freehand placement of cannulated screws for the treatment of Sanders type II and III calcaneal fractures / 中华创伤杂志

Objective:To compare the efficacy of 3D-printed guide plate assisted versus freehand placement of cannulated screws for the treatment of Sanders type II and III calcaneal fractures.Methods:A retrospective cohort study was conducted to analyze the clinical data of 29 patients with Sanders type II and III calcaneal fractures admitted to Chonggang General Hospital from June 2020 to October 2022. Among them, there were 18 males and 11 females, with an age range of 22-69 years [(40.1±11.5)years]. Nineteen patients were treated with individualized 3D-printed guide plate assisted placement of cannulated screws (3D-printed group) and 10 were treated with freehand placement of cannulated screws (freehand group). The surgical time, fluoroscopy times, postoperative 6-month calcaneal morphology (length, width, height, B?hler angle and Gissane angle), and American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Maryland functional score assessed at 3, 6 months after operation and at the final follow-up were compared between the two groups. The incision healing and complications were observed.Results:The patients were followed up for 6-24 months [(11.3±2.5)months]. The surgical time and fluoroscopy times in the 3D-printed group were (53.4±9.1)minutes and (7.3±1.1)times, respectively, which were shorter than (90.2±16.0)minutes and (16.0±3.2)times in the freehand group (all P<0.01). At 6 months after operation, there was no significant difference in calcaneal length between the two groups ( P>0.05); the calcaneal width, height, B?hler angle and Gissane angle in the 3D-printed group [(34.0±1.8)mm, (47.2±1.6)mm, (27.8±1.0)°, (129.2±2.8)°] were superior than those in the freehand group [(37.5±2.0)mm, (43.0±2.7)mm, (25.8±1.5)°, (125.9±2.5)°] (all P<0.01). At 3, 6 months after operation and at the final follow-up, the values of AOFAS ankle-hindfoot score in the 3D-printed group [(72.2±2.3)points, (79.7±2.3)points, (86.5±4.4)points] were higher than those in the freehand group [(64.2±6.9)points, (73.4±4.2)points, (81.8±3.1)points] (all P<0.05); the values of Maryland score in the 3D-printed group [(71.4±7.7)points, (84.7±2.6)points, (91.5±2.5)points] were higher than those in the freehand group [(65.2±5.6)points, (79.1±3.8)points, (87.1±2.9)points] (all P<0.05). All surgical incisions were healed in stage I. In the 3D-printed group, there were no complications regarding infection, iatrogenic vascular or nerve injury, or fixation failure after surgery. In the freehand group, one patient with lateral sural cutaneous nerve injury was resolved spontaneously without specific treatment. Conclusion:Compared with freehand placement of cannulated screws, 3D-printed guide plate assisted placement of percutaneous placement has the advantages of shorter surgical time, fewer fluoroscopy times, lower reduction loss, better ankle joint function recovery, and less complications in treating Sanders type II and III calcaneal fractures.

Effect of bile on intestinal alkaline phosphatase in intestinal mucosa / 中华肝胆外科杂志

Objective:To investigate the expression of intestinal alkaline phosphatase (IAP) in intestinal mucosa with bile deficiency and the effect of bile on the expression of IAP in intestinal epithelial Caco-2 cell model.Methods:Thirty healthy male SD rats were randomly divided into control group (Ctrl, n=10), external drainage group (ED, n=10) and obstructive jaundice group (OJ, n=10). Ileum specimens were collected on the 7th day after modeling. Western blot and immunohistochemical staining were used to determine the expression of IAP in rat intestinal mucosa. Different concentrations of human bile were used to treat on Caco-2 cells, and Western blot was used to detect the changes in IAP expression in Caco-2 cells. Results:Rat models were successfully established. The expression level of IAP in the intestinal mucosa of ED group [(9.19±1.67)%] was significantly lower than that of the Ctrl group [(15.09±0.61)%, P<0.05]; the expression of IAP in the intestinal mucosa of OJ group [(6.86±1.07)%] was significantly lower than that of the Ctrl group ( P<0.05). Through in vitro cell experiments, expression of IAP in Caco-2 cells was increased in a time and dose-dependent manner when treated with human bile. Conclusions:Bile deficiency in the intestine can cause inhibition of IAP in the intestinal mucosa. Bile can promote the expression of IAP in intestinal mucosal epithelial cells.

Safety and efficacy of primary closure in patients with normal diameters of common bile duct after laparoscopic common bile duct exploration / 中华肝胆外科杂志

Objective:To study the safety and efficacy of primary closure of non-dilaed common bile ducts (CBD) after laparoscopic common bile duct exploration.Methods:A retrospective study was conducted on the clinical data of 120 patients who underwent primary closure of CBD after laparoscopic CBD exploration (LCBDE) at the Shengjing Hospital of China Medical University from April 1, 2014 to November 30, 2019. There were 44 males and 76 females, aged 22.0 to 88.0 years, (average age of 57.2 years). These patients were divided into the dilated CBD group (diameter of CBD >8 mm) and the normal CBD group (diameter of CBD ≤8 mm). The following factors, including operating time, intraoperative bleeding, postoperative hospitalization stay, abdominal drainage tube indwelling time and postoperative complications were compared.Results:The dilated CBD group consisted of 76 patients, with 25 males and 51 females, and a median age of 62.5 years. The normal CBD group consisted of 44 patients, with 19 males and 25 females, and a median age of 57.5 years. There were no significant differences in gender, age, albumin level, total bilirubin and other baseline data between groups ( P>0.05). The operation times of the two groups were: the normal CBD group [106.6(87.3, 146.3] min vs the dilated CBD group [112.0(90.5, 134.5)] min; intraoperative blood loss [the normal CBD group 20(10, 30)ml vs dilated CBD group 20(10, 20)ml]; postoperative hospital stay [the normal CBD group 7.0 (5.3, 9.0) d vs the dilated CBD group 7.0 (5.0, 7.0) d]; and postoperative abdominal drainage tube removal time [the normal CBD group 6 (4, 7) d vs the dilated CBD group 5 (4, 6)d]. The differences were all not significant ( P>0.05). There was also no significant difference in the incidences of postoperative complications (including bile leakage, biliary stricture, and stone recurrence between groups, all P>0.05). Conclusion:In patients with a normal diameter (≤8 mm) common bile duct, it was safe and efficacious to perform primary closure after laparoscopic common bile duct exploration.

Cupping treatment combined with antibiotics for bacterial pneumonia in children: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the clinical efficacy of cupping treatment combined with antibiotics and antibiotics alone for bacterial pneumonia in children.@*METHODS@#A total of 72 children with bacterial pneumonia were randomly divided into an observation group (36 cases, 1 case dropped off) and a control group (36 cases). The children in the control group were treated with intravenous drip of cefodizine sodium [80 mg/(kg•d)] for 7 days. Based on the treatment of the control group, the children in the observation group were treated with cupping treatment on the bladder meridian of the back on the first day and the fourth day of antibiotic treatment; each cupping treatment was given for 5-10 min; the treatment of observation group was given for 7 days. The days for complete fever reduction, TCM syndrome scores and Canadian acute respiratory illness flu scale (CARIFS) scores before and after treatment were observed, and the clinical efficacy was evaluated.@*RESULTS@#The days for complete fever reduction in the observation group were shorter than that in the control group (@*CONCLUSION@#Cupping treatment combined with antibiotics has similar efficacy with antibiotics alone for bacterial pneumonia in children, but shows better effect in shortening the duration of fever and improving pulmonary symptoms.

Effects of bile acids and their related nuclear receptors on intestinal mucosal barrier / 中华肝胆外科杂志

Bile acids are the end product of cholesterol metabolism,which is the main component of bile.Bile acids can not only promote the absorption of fat and fat-soluble vitamins but also be used as the important signal molecules to activate nuclear receptors.It regulates metabolism of bile acids and intestinal homeostasis.The bile acids' effect on intestinal mucosal barrier function has been controversial until now.Bile acids is both hydrophilic and hydrophobic simultaneously.Hydrophilic bile acid can promote cell proliferation,while hydrophobic bile acid can promote cell apoptosis.The stronger the hydrophobicity is,the greater the cellular damage effect will be.The activation of nuclear receptor by bile acids can protect intestinal mucosal barrier.New research progress of the bile acid regulation in intestinal mucosal barrier function is reviewed in this article.

Fruitflow，a Water-soluble Tomato Concentrate，Inhibits Platelet Activation，Aggregation and Thrombosis by Regulating the Signaling Pathway of PI3K/Akt and MAPKs / 中山大学学报(医学科学版)

@#【Objective】Platelet hyper- reactivity plays an important role in thrombosis and cardiovascular diseases. As a dietary supplement，Fruitflow，a water-soluble tomato concentrate，plays an important role in preventing cardiovascular diseases，but the mechanisms have been poorly understood，and there is no direct evidence about the effect of Fruitflow on thrombosis. This study intends to explore the effects of Fruitflow on platelet aggregation，activation and thrombosis in healthy people，and explore its possible mechanism.【Methods】Platelets from healthy men and women were incubated with different concentrations（0，20，40，80 mg/L）of Fruitflow，and the platelet aggregation was measured by platelet aggregometer. Platelet αIIbβ3 activation and fibrinogen binding to the activated platelets was measured by flow cytometry. The thrombosis in FeCl3- induced mesenteric artery thrombosis model in mice was observed by stereoscopic fluorescence microscope. The bleeding time was measured by tail clipping in mice. The total and phosphorylation levels of platelet Akt， Erk1/2 and JNK were determined by Western blotting.【Results】After the stimulation of ADP，Fruitflow could significantly attenuate platelet aggregation in the dose of 20，40，80 mg/L. Compared with that in the control group（43.75±5.91）%， platelet aggregation in the 80 mg/L group decreased to（8.25 ± 4.57）%（P < 0.000 1）. Fruitflow also inhibited the activation of platelet αIIbβ3. Compared with that in the control group（79.36±6.26），the platelet αIIbβ3 in the 80 mg/L group decreased to（65.79±5.73，P < 0.01）. Fruitflow reduced the platelet fibrinogen binding to the activated platelets. Compared with that in the control group（69.34 ± 6.63），platelet fibrinogen binding to the activated platelets in the 80 mg/L group decreased to（56.70±8.86，P < 0.05）. Fruitflow attenuated the thrombosis in FeCl3-induced mesenteric artery thrombosis model. Compared with that in the control group（22.50±4.86），the vessel occlusion in the 80 mg/L group was extended to（39.20 ± 4.61，P < 0.01）. There was no statistical difference between the control group （5.95 ± 0.69） and the 80 mg/L group（5.74 ± 0.76）in bleeding time（P > 0.05）. Fruitflow down- regulated the phosphorylation levels of platelet Akt， Erk1/2 and JNK proteins. Compared with the control group，P- Akt/Akt decreased from 0.97 ± 0.07 to 0.33 ± 0.13（P <0.001），P-Erk1/2/Erk1/2 decreased from 0.89±0.09 to 0.24±0.02（P < 0.01），and P-JNK/JNK decreased from 0.97±0.12 to 0.45±0.04（P < 0.01）in the 80 mg/L group.【Conclusion】Inhibition of platelet PI3K/Akt and MAPKs signaling pathway may be one of the mechanisms that Fruitflow inhibits platelet aggregation ，activation and thrombosis.

Isolation and identification of exosomes derived from bone marrow mesenchymal stem cells / 基础医学与临床

Objective To develop a method of isolation and identification of exosomes of bone marrow mesenchymal stem cells.Methods The mesenchymal stem cells were cultured by whole bone marrow adherence method.A new reagent -exosomes extraction kit was used to isolate and collecte exosomes.The exosomes were identified by elec-tron microscopy,particle size detection,flow cytometry and Western blot.Results The expression of CD45 on the surface of the third generation bone marrow mesenchymal stem cells was negative,and CD73 and CD105 were posi-tive;exosomes derived from bone marrow mesenchymal stem cells were round or oval,the size is non-uniform,the diameter is 30~100 nm,have a complete membrane structure,and containing low-density substances;Particle size detection particle diameter of the main peak was 61.25 nm, in which the diameter of particles was about 20-200 nm accounted for 72.4%;exosome expressed CD63 and CD81;The expression of CD9 and CD63 from cell cul-ture supernatants was positive.Conclusions The exosomes can be collected in the medium of mesenchymal stem cells.The exosomes derived from bone marrow mesenchymal stem cells can be identified by electron microscopy, particle size detection,flow cytometry and Western blot.

Prognostic value of serum CXCL12 and IL-33 levels in patients with acute ischemic stroke / 中国免疫学杂志

Objective:To explore the prognostic value of serum CXCL12 and IL-33 levels in patients with acute ischemic stroke. Methods:From December 2014 to June 2016,the patients with acute ischemic stroke in our hospital as the case group(122 cases) and healthy volunteer were recruited as normal group ( 59 cases ) . According to the mRS scores patients were divided into favorable outcomes group(86 cases) and unfavorable outcomes group(36 cases). On admission the serum CXCL12 and IL-33 levels of objects were measured by ELISA. Receiver operating characteristic curve( ROC) and AUV were used to evaluate the prognostic value serum CXCL12 and IL-33 in patients with acute ischemic stroke. The serum CXCL12 levels were significantly higher in the patients with acute ischemic stroke compared to the control group[8. 0 ng/ml(IQR,6. 7-8. 9) VS 3. 0 ng/ml(IQR,2. 3-3. 8),P<0. 001],and serum IL-33 levels were also significantly higher than those in the control group [ 65. 25 ng/L ( IQR,56. 05-71. 08 ) VS 35. 30 ng/L (IQR,26. 73-42. 55),P<0. 001]. The serum CXCL12 levels were significantly lower in patients with a favorable outcome group[7. 4 ng/ml(IQR,6. 3-8. 3)] compared with patients with an unfavorable outcome group[9. 3 ng/ml(IQR,8. 3-11. 1)],and IL-33 levels were also significantly lower than that of unfavorable outcomes group[66. 81 ng/L(IQR,61. 12-73. 29)VS 55. 38 ng/L(IQR,46. 75-64. 71),P<0. 001] . Pearson correlation analysis showed that serum CXCL12 and IL-33 levels were respectively positively and negatively correlated with mRS score(r=0. 524,P<0. 001;r=-0. 443,P<0. 001). The serum CXCL12 and IL-33 levels as an indicator for prognosis of functional outcome. The area under the curve was 0. 835,0. 784 respectively. The sensitivity was 77. 8%,83. 4%respectively and specificity was 73. 3%,66. 7% respectively. Conclusion:Serum CXCL12 and IL-33 levels can be used as markers for the prognosis of patients with acute ischemic stroke.

Prognostic value of serum CXCL12 and IL-33 levels in patients with acute ischemic stroke / 中国免疫学杂志

Objective:To explore the prognostic value of serum CXCL12 and IL-33 levels in patients with acute ischemic stroke. Methods:From December 2014 to June 2016,the patients with acute ischemic stroke in our hospital as the case group(122 cases) and healthy volunteer were recruited as normal group ( 59 cases ) . According to the mRS scores patients were divided into favorable outcomes group(86 cases) and unfavorable outcomes group(36 cases). On admission the serum CXCL12 and IL-33 levels of objects were measured by ELISA. Receiver operating characteristic curve( ROC) and AUV were used to evaluate the prognostic value serum CXCL12 and IL-33 in patients with acute ischemic stroke. The serum CXCL12 levels were significantly higher in the patients with acute ischemic stroke compared to the control group[8. 0 ng/ml(IQR,6. 7-8. 9) VS 3. 0 ng/ml(IQR,2. 3-3. 8),P<0. 001],and serum IL-33 levels were also significantly higher than those in the control group [ 65. 25 ng/L ( IQR,56. 05-71. 08 ) VS 35. 30 ng/L (IQR,26. 73-42. 55),P<0. 001]. The serum CXCL12 levels were significantly lower in patients with a favorable outcome group[7. 4 ng/ml(IQR,6. 3-8. 3)] compared with patients with an unfavorable outcome group[9. 3 ng/ml(IQR,8. 3-11. 1)],and IL-33 levels were also significantly lower than that of unfavorable outcomes group[66. 81 ng/L(IQR,61. 12-73. 29)VS 55. 38 ng/L(IQR,46. 75-64. 71),P<0. 001] . Pearson correlation analysis showed that serum CXCL12 and IL-33 levels were respectively positively and negatively correlated with mRS score(r=0. 524,P<0. 001;r=-0. 443,P<0. 001). The serum CXCL12 and IL-33 levels as an indicator for prognosis of functional outcome. The area under the curve was 0. 835,0. 784 respectively. The sensitivity was 77. 8%,83. 4%respectively and specificity was 73. 3%,66. 7% respectively. Conclusion:Serum CXCL12 and IL-33 levels can be used as markers for the prognosis of patients with acute ischemic stroke.

Effects of Calcium Sulfate Combined with Platelet-rich Plasma on Restoration of Long Bone Defect in Rabbits / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The treatment for long bone defects has been a hot topic in the field of regenerative medicine. This study aimed to evaluate the therapeutic effects of calcium sulfate (CS) combined with platelet-rich plasma (PRP) on long bone defect restoration.</p><p><b>METHODS</b>A radial bone defect model was constructed through an osteotomy using New Zealand rabbits. The rabbits were randomly divided into four groups (n = 10 in each group): a CS combined with PRP (CS-PRP) group, a CS group, a PRP group, and a positive (recombinant human bone morphogenetic protein-2) control group. PRP was prepared from autologous blood using a two-step centrifugation process. CS-PRP was obtained by mixing hemihydrate CS with PRP. Radiographs and histologic micrographs were generated. The percentage of bone regenerated bone area in each rabbit was calculated at 10 weeks. One-way analysis of variance was performed in this study.</p><p><b>RESULTS</b>The radiographs and histologic micrographs showed bone restoration in the CS-PRP and positive control groups, while nonunion was observed in the CS and PRP groups. The percentages of bone regenerated bone area in the CS-PRP (84.60 ± 2.87%) and positive control (52.21 ± 4.53%) groups were significantly greater than those in the CS group (12.34 ± 2.17%) and PRP group (16.52 ± 4.22%) (P < 0.001). In addition, the bone strength of CS-PRP group (43.10 ± 4.10%) was significantly greater than that of the CS group (20.10 ± 3.70%) or PRP group (25.10 ± 2.10%) (P < 0.001).</p><p><b>CONCLUSION</b>CS-PRP functions as an effective treatment for long bone defects through stimulating bone regeneration and enhancing new bone strength.</p>

Effect of silencing Gab1 expression on cholangiocarcinoma cell line HUCCA-1 and its correlation with PI3K/Akt pathway / 天津医药

Objective To explore the functionalternation of human cholangiocarcinoma cell line HUCCA-1 by silenc?ing Gab1 expression;to detect its effect on PI3KCA and Akt1 expression at protein and mRNA levels and to explore the role of Gab1,PI3KCA and Akt1 expressions in the malignant behavior of cholangiocarcinoma. Methods Gab1 siRNA was trans? fected into cholangiocarcinoma cell line HUCCA-1. Proliferation, apoptosis, migration/invasion of cells were examined by MTT, flow cytometry and Transwell assay respectively after transfection. PI3KCA and Akt1 expressions were detected by Western blotting and qPCR. Results Transfection efficiency was satisfactory and reaches 65%~70%;PI3KCA and Akt1 expressions were down-regulated at both protein and mRNA levels upon silencing of Gab1. Meanwhile, proliferations of HUCCA-1 cells were inhibited (P<0.01);apoptosis rate increases(P<0.05);and migration and invasion were both inhibit?ed upon Gab1 silencing(P<0.05). Conclusion The proliferation, migration and invasion are all inhibited while apoptosis is attenuated after Gab1 was down-regulated by Gab1 siRNA transfection. PI3KCA and Akt1 expressions are up-regulated with down-regulation of Gab1. Therefore, Gab1 may enhance the maglinant behavior of cholangiocarcinoma cells through up-regulating PI3KCA and Akt1 expression and it can be used as a candidate for cholangiocarcinoma therapy.

Effect of Zhusha Anshen pill, cinnabar, HgS, HgCl2 and MeHg on gene expression of renal transporters in mice / 中国中药杂志

<p><b>OBJECTIVE</b>To study the effect of Zhusha Anshen pill, cinnabar, HgS, HgCl2 and MeHg on the gene expression of renal transporters in mice.</p><p><b>METHOD</b>Healthy male mice were given equivalent physiological saline, Zhusha Anshen pill (1.8 g · kg(-1), containing 0.17 g · kg(-1) of mercury), cinnabar (0.2 g · kg(-1), containing 1.7 g · kg(-1) of mercury), high dose cinnabar (2 g · kg(-1), containing 1.7 g · kg(-1) of mercury), HgS (0.2 g · kg(-1), containing 0.17 g · kg(-1) of mercury), HgCl2 (0.032 g · kg(-1), containing 0. 024 g · kg(-1) of mercury), MeHg (0.026 g · kg(-1), containing 0.024 g · kg(-1) of mercury), once daily, for 30 d, measuring body mass gain. 30 days later, the mice were sacrificed. The mercury accumulation in kidneys was detected with atomic fluorescence spectrometer. Expressions of Oat1, Oat2, Oat3, Mrp2, Mrp4, Urat1 were detected with RT-PCR.</p><p><b>RESULT</b>Compared with the normal control group, a significant accumulation of Hg in kidney in HgCl2 and MeHg groups was observed (P <0.05), but these changes were not found in other groups. Compared with normal control group, mRNA expressions of Oat1 and Oat2 were evidently lower in HgCl2 and MeHg groups, but mRNA expressions of Mrp2 were apparently higher in HgCl2 group (P <0.05), mRNA expression of Mrp4 was significant higher in HgCl2 and MeHg groups, and mRNA expression of Urat1 was apparently lower in MeHg group.</p><p><b>CONCLUSION</b>HgCl2 and MeHg groups show significant difference from the normal group in mercury accumulation in kidneys and gene expression of kidney transporters, but with no difference between other groups and the normal group. Compared with HgCl2 and MeHg, cinnabar and its compounds could cause lower renal toxicity to mice.</p>

Clinical analysis of the application of hand-assistant laparoscopy or total laparoscopy in radical right colectomy / 中国综合临床

Objective To investigate the clinical application value of hand-assistant laparoscopy and total laparoscopy in radical right colectomy.Methods Five hundred and twenty-four patients were selected as our subjects who performed by hand-assistant laparoscopic radical right colectomy (213 cases) or total laparoscopic radical right colectomy (293 cases) in colon cancer therapy.The operation durations,bleeding volumes,postoperative pain scores,postoperative draining volumes,recovery time of gastrointestinal function,hospitalization times,hospitalization expenses,postoperative complications and cosmetic satisfactory scores were recorded and compared.Results The operation durations,bleeding volumes,postoperative draining volumes in hand-assistant laparoscopic group were (112.4±52.9) min,(105.6 ± 49.5) ml,(28.6± 15.7) ml,lower than those in total laparoscopic group((148.5±61.7) min,(171.5±72.4) ml,(28.6±15.7) ml;P=0.032,0.041,0.039).The recovery time of gastrointestinal function of hand-assistant laparoscopic group were (69.4±21.8) h,longer than total laparoscopic group ((53.4 ± 21.7) h;P =0.008).The hospitalization times,hospitalization expenses,postoperative complications of hand-assistant laparoscopic group were as same as total laparoscopic group(P＞0.05).Hand-assisted laparoscopic group mild pain in 35 cases,121 cases of moderate and severe 75 cases;Total 96 cases of mild pain in laparoscopic group,146 cases of moderate and severe in 51 cases,the difference was statistically significant(P=0.027).Beauty score incision of laparoscopic group was higher than in the whole hand-assisted laparoscopic group,the difference was statistically significant ((4.3 ± 0.9) score vs.(2.4±0.6) score;P=0.002).Conclusion Hand-assistant laparoscopic radical right colectomy is convenient and more quickly for operation.Total laparoscopic radical right colectomy has advantage in terms of less injury and the patients are more satisfactory.For practiced operators,total laparoscopic radical right colectomy is recommended cosmetic satisfactory score.

G-protein coupled receptor 34 knockdown impairs the proliferation and migration of HGC-27 gastric cancer cells in vitro / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Overexpression of G-protein coupled receptor 34 (GPR34) affects the progression and prognosis of human gastric adenocarcinoma, however, the role of GPR34 in gastric cancer development and progression has not been well-determined. The current study aimed to investigate the effect of GPR34 knockdown on the proliferation, migration, and apoptosis of HGC-27 gastric cancer cells and the underlying mechanisms.</p><p><b>METHODS</b>The expression of GPR34 in gastric cancer cell line HGC-27 was detected by quantitative real-time reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting. HGC-27 cells were employed to construct the stable GPR34 knockdown cell model in this study. Real-time RT-PCR and Western blotting were applied to validate the effect of short hairpin RNA (ShRNA) on the expression of GPR34 in HGC-27 gastric cells. The proliferation, migration of these cells were examined by Cell Counting Kit-8 and transwell. We also measured expression profile of PI3K/PDK1/AKT and ERK using Western blotting.</p><p><b>RESULTS</b>The ShRNA directed against GPR34 effectively inhibited both endogenous mRNA and protein expression levels of GPR34, and significantly down-regulated the expression of PIK3CB (P < 0.01), PIK3CD (P < 0.01), PDK1 (P < 0.01), phosphorylation of PDK1 (P < 0.01), Akt (P < 0.01), and ERK (P < 0.01). Furthermore, GPR34 knockdown resulted in an obvious reduction in HGC-27 cancer cell proliferation and migration activity (P < 0.01).</p><p><b>CONCLUSIONS</b>GPR34 knockdown impairs the proliferation and migration of HGC-27 gastric cancer cells in vitro and provides a potential implication for therapy of gastric cancer.</p>

Clinical characteristics and prognostic factors of primary duodenal carcinoma / 中华消化外科杂志

Objective To summarize the clinical characteristics and investigate the prognostic factors of primary duodenal carcinoma.Methods The clinical data of 122 patients with primary duodenal carcinoma who were admitted to the Shengjing Hospital Affiliated to China Medical University from November 2007 to May 2013 were retrospectively analyzed.All the patients received different operations according to the characteristics of tumors.Primary duodenal carcinomas of patients were confirmed by the postoperative pathological diagnosis.All the patients were followed up by outpatient examination, telephone interview and correspondence till November 30,2014.The treatment process, results of imaging examination and laboratory examination and postoperative survival were recorded.The clinical features, diagnostic criteria, therapeutic regimens and prognostic factors were analyzed.The survival rate and survival curve were analyzed and drawn by the Kaplan-Meier method.The univariate analysis was done using the Log-rank test, and multivariate analysis was done using the COX regression model.Results Among the 122 patients with primary duodenal carcinoma, jaundice as the first symptom was detected in 57 patients, abdominal pain and upper abdomen discomfort in 37 patients, gastrointestinal obstruction in 14 patients,anorexia and reduction of body weight in 4 patients, gastrointestinal hemorrhage in 3 patients, diarrhea in 3 patients, pyrexia in 3 patients and abdominal mass in 1 patient.The positive rates of CT examinations, endoscopic examinations, magnetic resonanced cholangio-pancreatography (MRCP), B-ultrasound examinations and upper gastrointestinal contrast examinations were 69.67％ (85/122), 85.56％ (77/90), 79.76％ (67/84), 12.73％ (7/55) and 75.00％ (36/48), respectively.Among the 122 patients, anemia was detected in 48 patients,positive fecal occult blood test in 94 patients, increasing level of CA19-9 in 71 patients, increasing level of CEA in 22 patients and increasing level of AFP in 9 patients.The tumors located at the descending part of duodenum,duodenal bulb and horizontal part of duodenum were detected in patients of 86.07％ (105/122), 7.37 ％ (9/122) and 6.56％ (8/122), respectively.The mean diameter of tumors was 2.3 cm (range, 1.0-15.0cm).All the 122 patients received operation.Pancreaticoduo-denectomy was performed in 100 patients, including combined with jejunostomy in 17 patients, pylorus-preserving pancreatoduodenectomy in 7 patients, segmental resection of duodenum and gastrojejunostomy in 5 patients, local resection of duodenal papilla in 6 patients and palliative gastrojejunostomy in 11 patients.Nineteen patients with complications were cured by symptomatic treatment.Of the 122 patients, adenocarcinoma, carcinoid tumor, lymphoma, small cell carcinoma, intraepithelial neoplasm combined with differentiated rhabdomyoma and with undifferentiated rhabdomyoma were detected in 116, 2, 1, 1,1 and 1 patients, respectively.The Ⅰ , Ⅱ , Ⅲ and Ⅳ stage of tumors were detected in 10, 4, 74 and 34 patients.There were 100 patients without lymph node metastasis, 13 patients with 0 ＜ metastatic lymph node ratio (MLR) ≤0.2, 4 patients with 0.2 ＜ MLR≤0.4 and 5 patients with MLR ＞ 0.4.One-hundred and twelve of 122 patients were followed up for 1-70 months with a median follow-up time of 20 months.The postoperative survival time, a median of survival time, postoperative 3-and 5-year survival rates were 1-70 months, 18 months, 36.6％ and 13.5％ , respectively.The results of univariate analysis showed that the lymph node metastasis, differentiated grade of tumor, MLR and with invasion of pancreas were risk factors affecting the prognosis of patients (x2 =8.465, 57.355, 16.232, 20.112, P ＜ 0.05).The multivariate analysis showed that the low-differentiation of tumor, invasion of pancreas, lymph node metastasis and MLR ＞ 0.4 were independent risk factors affecting the prognosis of patients (RR =3.330, 3.718, 2.623, 95％ confidence interval: 1.861-5.956, 1.292-10.696,1.624-4.236, P ＜ 0.05).Conclusions Most of the primary duodenal carcinomas are located at the descending part of duodenum without specific clinical symptoms in the early stage.The joint usage of assistant examinations can improve the diagnostic rate of primary duodenal carcinoma, and surgery is mainly therapeutic method.The low-differentiation of tumor, MLR ＞ 0.4 and invasion of pancreas are independent risk factors affecting the prognosis of patients.

Comparison of percutaneous versus open pedicle screw fixation for thoracolumbar fractures:a Meta analysis / 重庆医学

Objective To compare the feasibility and efficacy of PPSF with OPSF for thoracolumbar fractures.Methods We searched the PUBMED,OVID and Cochrane CENTRAL databases through Jan 2014.All of the clinical trials included were extrac-ted and evaluated by two reviewers independently.Data were analyzed using RevMan 5.2.6 software by the Cochrane Collabora-tion.Results Seven studies including 353 patients met the inclusion criteria.The Meta analysis found there were significant differ-ences between the two procedures in intraoperation blood loss (RR = 1.89,95%CI :1.55 - 2.29,P 0.05).Conclusion Both PPSF and OPSF are safe and efficacious internal fixation methods for treating thoracolumbar fractures,while,PPSF may cause less blood loss and cost less time.

Dynamic distribution of the avian infectious bronchitis virus isolate strain Jin-13 in SPF chickens / 病毒学报

This study aimed to understand the dynamic distribution of infectious bronchitis virus (IBV) Jin-13 strain in SPF chickens. Ninety-day-old SPF chickens were inoculated with Jin-13, a virulent strain, and dissected at day 1, 4, 7, 10, 14, 21, 28 or 35 post-inoculation (dpi). Samples of heart, liver, spleen, lung, trachea, kidney and duodenum were collected and the N gene was detected by Sybr Green I real-time quantitative RT-PCR assays. The established method had a good linear correlation from 7.77 x 10(8) to 10(0) copies/microL. SPF chickens developed typical clinical signs of IBV at the 4th dpi, and the IBV viral concentration of tissues and organs gradually increased with a peak of up to 7.13 x 10(4) copies/microL. The viral concentration of most organs decreased by the 10th dpi, but those of the kidney, trachea and lung remained positive for IBV at 28 dpi and the heart was still positive for IBV at > 35 dpi. The results of this study, showed that the Jin-13 strain can cause prolonged virus excertion in chickens with severe renal damage.

Application of multiple-locus variable-number tandem-repeat analysis in Brucellosis surveillance / 中国地方病学杂志

Objective To establish the standard operating procedures on multiple locus variable number tandem repeat analysis and to evaluate the values in identification of Brucella(B.) melitensis and epidemiological trace-back.Methods Sixteen B.melitensis,22 B.abortus,21 B.suis and 10 B.cnais were investigated by Brucella MLVA-16 genotyping scheme.All data were analyzed using BioNumerics version 5.1 software (AppliedMaths,Belgium).Clustering analysis was based on the categorical coefficient and unweighted pair group method using arithmetic averages(UPGMA) method.Polymorphism at each locus was quantified using Nei's diversity index.Resultant genotypes were compared using the web-based Brucella 2010 MLVA database.Results MLVA methods were successfully established and some strains can be clustered.Bruce06,bruce08,bruce11,bruce12,bruce42,bruce43,bruce45 and bruce55 were useful for species identification of Brucella isolates.Bruce04,bruce07,bruce09,bruce16 and bruce 30 afforded a higher discriminatory power for investigation of strain relatedness in regions of endemicity.Conclusions TheMLVAmethod has proved to be highly discriminatory and epidemiological concordance and is easy for Brucellosis surveillance in province-level lab.

Rapid detection of Haemophilus influenzae and Haemophilus parainfluenzae in nasopharyngeal swabs by multiplex PCR / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To establish multiplex PCR-based assays for detecting H.influenzae and H.parainfluenzae. And the PCR-based assays were applied to detect the carriage rates of H.influenzae and H.parainfluenzae in nasopharyngeal swab specimens which were collected from healthy children.</p><p><b>METHODS</b>Multiplex primers for species-specific PCR were designed by using DNAstar soft based on the sequences of 16S rRNA genes from genus Haemophilus to detect H.influenzae and H.parainfluenzae.</p><p><b>RESULTS</b>The sensitivity of the 16S rRNA PCR assay for detecting H.influenzae and H.parainfluenzae was 97.53% and 100% respectively, and the specificity was 95.89% and 96.63% respectively. Youden's Index on the ability to detect H.influenzae and H.parainfluenzae was 0.9342 and 0.9663 respectively. 666 nasopharyngeal swab specimens were collected from healthy children. The detection rates of H.influenzae and H.parainfluenzae were 14.11% and 16.07% respectively by using isolation and culture methods. The detection rates of H.influenzae and H.parainfluenzae were 43.54% and 57.96% respectively by 16S rRNA PCR assays. The carriage rates of serotypes a, b, c, d, e, f and non-typeable isolates were 0% (0/666), 0.15% (1/666), 1.20% (8/666), 0.15% (1/666), 1.20% (8/666), 1.80% (12/666), 95.50% (636/666) respectively.</p><p><b>CONCLUSION</b>The multiplex PCR assays were very rapid, reliable and feasible methods for detection of H.influenzae and H.parainfluenzae in pharyngeal swab specimens which were compared to conventional isolation and culture methods. 95.5% of H.influenzae strains in healthy children were nontypeable. The encapsulated or typable strains were mainly three serotypes which was c, e, and f serotype.</p>