Laparoscopic proximal gastrectomy and lymph node resection in adenocarcinoma of the esophagogastric junction / 中华胃肠外科杂志

The proportion of adenocarcinoma of the esophagogastric junction (AEG) in gastric cancer is gradually increasing. Due to the unique anatomical structure and biological characteristics of the tumor at this site, AEG has a certain degree of complexity in many aspects of diagnosis and treatment, which brings difficulties to the operation method, the selection of the resection range, the lymph node dissection and the treatment decision-making. Therefore, AEG has always been the focus of academic debate. With the development of minimally invasive surgery in recent years, laparoscopic technology has been increasingly mature and widely used in the treatment of gastrointestinal tumors. Compared with distal gastric cancer, the minimally invasive treatment of AEG is in a lagging state, and there are also a series of problems that have not yet reached a consensus. This article reviews and summarizes the recent research progress in two aspects: proximal gastrectomy for AEG and lymph node dissection. Laparoscopic-assisted proximal gastrectomy is safe for early proximal gastric cancer and has a long-term survival outcome not inferior to total gastrectomy, but the surgical indications must be strictly selected. Abdominal lymph node metastasis of AEG is mainly in group 1, 2, 3, and 7, and mediastinal lymph node metastasis is closely related to the length of the infiltrated esophagus. The abdominal transhiatal (TH) approach can obtain a sufficient number of harvested lymph node, and has good safety and efficacy, which is the first-choice of surgical approach for early AEG. The results of the CLASS-10 clinical trial can provide a higher level of evidence for laparoscopic mediastinal lymph node dissection. Laparoscopic surgery for AEG should be carried out in experienced medical center based on clinical research.

Clinical Effect of Peiyuan Tongnao Capsule Combined with “Zhisanzhen” for Post-stroke Dementia / 中国实验方剂学杂志

Objective: To observe the clinical efficacy of Peiyuan Tongnao capsule combined with "Zhisanzhen" for post-stroke dementia (PSD) and investigate its mechanism.Method: Ninety-eight eligible patients were randomly divided into control group (49 cases) and observation group (49 cases) by random number table.Both groups received donepezil tablet,10 mg/time,qd,and nimodipine tablet,30 mg/time,qd.Patients in control group additionally took "Zhisanzhen" ,qd,5 times/week.Based on the treatment in control group,patients in observation group additionally took Peiyuan Tongnao capsule,3 capsules/time,tid.The treatment course was 12 weeks.Before and at the 4th,8th and 12th week after treatment,mini-mental state examination (MMSE),montreal cognitive assessment (MoCA),activity of daily living scale (ADL),neuropsychiatric inventory (NPI) and symptoms of traditional Chinese medicine (TCM) were evaluated.Before and after treatment,levels of serum hyperhomocysteinemia (Hcy),hepatocyte growth factor (HGF),oxidized low density lipoprotein (Ox-LDL) and acetylcholinesterase (AchE) were detected.Result: The total clinical effective rate was 93.88% in observation group,better than 77.55% in control group (χ2=5.333,PFcontrol=3.947,Fobservation=5.833,PFcontrol=3.876,Fobservation=6.011,Pth and 12th after treatment,scores of MMSE in the observation group were all higher than those in control group (Pth week after treatment,score of MoCA in observation group was higher than that in control group (PPPPPConclusion: Peiyuan Tongnao capsule combined with "Zhisanzhen" can improve cognitive and behavioral abilities,improve clinical efficacy,ameliorate abnormal mental behavior,relieve clinical symptoms,and regulate levels of Hcy,Ox-LDL,AchE and HGF in the treatment of post-stroke dementia.

Leucine-rich Glioma-inactivated Protein 1 Antibody-associated Encephalitis:Report of Two Cases / 中国医学科学院学报

Leucine-rich glioma-inactivated protein 1(LGI1)antibody-associated encephalitis is an autoimmune brain disease mainly seen in mid-aged and elderly people.Its main clinical manifestations include abnormal mental behaviors,facial-arm dystonia,hyponatremia,and hypokalemia.Immunotherapy with gamma globulin and/or hormone is effective.Two patients with LGT1 antibody-associated encephalitis were diagnosed in our center between January 2018 and October 2018,with typical clinical findings.The disease was cursed after immunoglobulin and hormone treatments.

The protective effect of astrocyte inhibitor fluorocitrate on subarachnoid hemorrhage in rats / 西安交通大学学报(医学版)

Objective To study the effects of fluorocitrate (FC),astrocytic metabolic inhibitor,on early brain injury after subarachnoid hemorrhage (SAH)in rats so as to explore the mechanism of early brain injury mediated by astrocyte after SAH.Methods Thirty six SD male rats were randomly divided into sham group,SAH 3 d group and SAH 3 d+FC group,with 12 rats in each group.The model of SAH was established by an endovascular perforation technique. FC was injected into the lateral ventricle. Three days after SAH, the expressions of GFAP,Iba-1 and TNF-α were detected using immunohistochemistry in all rats.The expression and phosphorylation of NF-κB in the nucleus were detected by Western blot.The expressions of TNF-α,IL-1βand IL-6 were detected by ELISA.Cell apoptosis was detected by TUNEL.Results Neuronal swelling,nuclear anomalies, disorganization of micrangium,abnormality of endothelial cells appeared in SAH 3 d group,but not in sham group. The expressions of NSE,GFAP and Iba-1 were significantly increased in SAH 3 d group compared with those in sham group (all P＜0.05).The number of apoptotic cells was increased.The expression and phosphorylation of NF-κB were significantly increased.The expressions of TNF-α,IL-1β and IL-6 were significantly increased.However, neuronal injuries were alleviated by injecting FC.The expressions of NSE,GFAP and Iba-1 in SAH 3 d+FC group were inhibited.The number of apoptotic cells in SAH 3 d+FC group was decreased compared with that in SAH 3 d group.The expression and phosphorylation of NF-κB were decreased by FC.The expressions of TNF-α,IL-1β and IL-6 were significantly decreased by FC (P＜0.05).Conclusion Astrocytes may play an important role in early brain injury after SAH,underlying the mechanism that they released TNF-α,IL-1βand IL-6 and activate microglia by activating NF-κB signal.The inhibition of excess activation of astrocytes may plays a protective role in early brain injury after SAH.

Bladder neoplasms in patients aged between 20 and 30 years old: An analysis of clinical characteristics / 第二军医大学学报

Objective To evaluate the clinicopathological features and prognosis of patients with bladder neoplasm aged between 20 and 30 years old. Methods The clinical data of the patients with bladder tumors aged 20-30 years old, who were treated from Jan. 2009 to March 2014, were retrospectively analyzed. The general information, clinical manifestations, diagnostic essentials, pathological outcomes, treatment strategies and prognoses were analyzed. Results A total of 20 patients were included in this study, which accounted for 1.22%(20/1 645) of all the bladder neoplasm cases in our hospital during the same period. The mean age of the 20 patients was (25.8±3.1) years old, including 13 males and 7 females. Gross hematuria as the main clinical symptoms were found in 10 patients, 6 patients were detected accidently due to non-hematuria symptoms, and 4 patients were diagnosed during the health checkup. There were 2 multifocal and 18 solitary tumors, with the total number of tumors being 24, including 15 in the lateral bladder wall, 3 in the posterior wall, 1 in the anterior wall, 3 in the trigone and 2 in the bladder neck. Two tumors in patients with hematuria were missed by ultrasound. The maximum diameters of tumors measured by ultrasound ranged from 0.4 cm to 2.7 cm (mean [1.1±0.7] cm). The detection rate of cystoscopy for tumors was 100%. The pathological results found 1 paraganglioma and 19 urothelial neoplasms, including 2 urothelial flat lesions and 17 papillary urothelial neoplasms. Of the 20 patients, 19 received transurethral resection of bladder tumor, 1 underwent exploratory laparotomy after four-cycles of neoadjuvant chemotherapy with gemcitabine and cisplatin. Sixteen patients were followed-up for 3 months to 5 years (mean [28±16] months). Three patients had recurrence, with one progressed to muscle invasive carcinoma. Conclusion Bladder neoplasms in patients aged 20-30 years old are usually solitary, of low grade and low stage; meanwhile, there is a possibility of highly aggressive disease. It is noteworthy that a good few of patients are asymptomatic. The long-term follow-up is crucial for all these patients.

The change of thioredoxin system in myocardial tissue of type 2 diabetic rats undergoing myocardial injury / 生理学报

The aim of the present study is to investigate the change of thioredoxin (Trx) system in myocardial tissue of type 2 diabetic rats after myocardial injury and the underlying mechanism. Adult Sprague Dawley rats were randomly divided into two groups: normal control (NC) group and diabetes (DM) group. Rats in DM group were subjected to high-sugar, high-fat diet and streptozotocin (STZ) injection. Rats in NC group were only given normal diet and equal amount of citric acid buffer injection. At week 1, 2, 4, 12, 21 after STZ injection, plasma glucose concentration and the concentrations of insulin, creatine kinase MB (CK-MB), cardiac troponin I (cTnI) in serum were measured. Myocardial Trx and thioredoxin reductase (TR) activities, as well as caspase-3 activity, were determined by respective assay methods. Protein and mRNA levels of Trx, TR, Trx interacting protein (TXNIP) were determined by Western blot and real time PCR, respectively. The results showed that type 2 diabetic rat model was successfully established at week 1 after STZ injection, and myocardial injury was induced from week 2. Moreover, caspase-3 activity was significantly increased at week 4, 12 in diabetic rats. The activities of myocardial Trx and TR in diabetic rats was decreased from week 2, and continually aggravated as the disease developed. Compared with those in NC group, the mRNA levels of Trx1, Trx2, TR1, TR2 in DM group decreased at week 4, and then increased in week 12. In DM group, the protein levels of Trx1, Trx2, TR1 and TR2 increased significantly at week 12. The mRNA expressions of myocardial TXNIP in diabetic rats were significantly increased at week 4, 12, 24 and protein expression was increased at week 12. These results suggest diabetes can decrease myocardial Trx, TR activity, inducing myocardial cell apoptosis and heart injury. The inhibitory effect of diabetes is mainly associated with TXNIP up-regulation and Trx nitration.

Organic gallium improves tretinoin-induced osteoporosis in rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of organic gallium and gallium chloride on bone metabolism and their therapeutic effect against tretinoin-induced osteoporosis in rats.</p><p><b>METHODS</b>Rat models of osteoporosis was established with intragastric administration of tretinoin at the daily dose of 85 mg/kg for 15 days and randomized into control, organic gallium and gallium chloride groups. After administration of the corresponding treatments (none for the control group) for 4 weeks, the changes of the indices for osteoporosis were evaluated through biochemical and pathological approaches.</p><p><b>RESULTS</b>Tretinoin induced obvious changes in bone structure and contents of bone calcium and other elements, causing also significantly increased tartrate-resistant acid phosphatase (TRAP) and alkaline phosphatase (AKP), which suggested the development of osteoporosis. Administration of organic gallium and gallium chloride treatments increased the bone density, bone cortex thickness and the percentage of bone trabecula, and Ga, Ca, P contents in the femur and teeth, but lowered the activity of TRAP and AKP, suggesting decreased bone conversion rate. Compared with gallium chloride, organic gallium required smaller dose with better safety to produce better therapeutic effect.</p><p><b>CONCLUSION</b>Organic gallium can be safe and effective for treatment of tretinoin-induced osteoporosis in rats.</p>