Comparative metabolism study on chlorogenic acid, cryptochlorogenic acid and neochlorogenic acid using UHPLC-Q-TOF MS coupled with network pharmacology / 中国天然药物

Chlorogenic acid (5-CQA), neochlorogenic acid (3-CQA), and cryptochlorogenic acid (4-CQA), usually simultaneously exist in many traditional Chinese medicines (TCMs). However, insufficient attentions have been paid to the comparative metabolism study on these three isomeric constituents with similar effects on anti-inflammation until now. In this study, a novel strategy was established to perform comparative analysis of their metabolic fates in rats and elucidate the pharmacological mechanism of anti-inflammation. Firstly, diagnostic product ions (DPIs) deduced from the representative reference standards were adopted to rapidly screen and characterize the metabolites in rat plasma, urine and faeces using UHPLC-Q-TOF MS. Subsequently, Network pharmacology was utilized to elucidate their anti-inflammatory mechanism. Consequently, a total of 73 metabolites were detected and characterized, including 50, 47 and 43 metabolites for 5-CQA, 4-CQA and 3-CQA, orderly. Moreover, the network pharmacology study indicated that these three isomeric constituents and their major metabolites with similar in vivo metabolic pathways exerted anti-inflammatory effects through co-owned 20 biological processes, which involved 10 major signal pathways and 159 potential targets. Our study shed light on the similarities and differences of the metabolic profiling and anti-inflammatory activity among these three isomeric constituents and set an example for the further researches on the active mechanism of isomeric constituents existing in TCMs based on comparative metabolism study.

Research progress of Astragali Radix fermentation / 中国中药杂志

Astragali Radix is one of traditional Chinese medicines with effects in invigorating Qi for consolidating superficies, inducing diuresis to alleviate edema, promoting pus discharge and tissue regeneration. In recent years, the traditional Chinese medicine fermentation technology has received extensive attentions due to its high efficiency and safety. The pharmacological functions of traditional Chinese medicines could be further enhanced after microbial fermentation, which has a broad development prospects. In this paper, we summarized relevant literatures of Astragali Radix fermentation in such aspects as fermentation strains, fermentation forms, process optimization, active ingredients and pharmacological effects, in the expectation of providing a reference for development and utilization of Astragali Radix.

Effect of active peptides of Eupolyphaga on intestinal flora in rats with hyperlipemia / 中国药理学通报

Aim To investigate the effect of active peptide of Eupolyphaga (APE) on changes of intestinal flora and blood lipid in rats with hyperlipidemia. Methods SD rats fed with high-fat diet were induced to hyperlipemia model. Simvastatin being a positive drug, ELISA was used to investigate the effect of APE on blood lipids in hyperlipidemic rats. At the same time, the results of the microbial flora about APE model rats were measured using 16rS high-throughput assay technology (V4-V5). Results APE could significantly reduce the serum lipid index in model rats and improve the degree of liver pathological changes. Meanwhile, the intestinal flora results showed that when the relative abundance of hymenoscyphus, lactobacillus and bifidobacterium in firmicutes were enriched, the relative abundances of rumenococcus, plasmodium and prevotella in bacteroidetes and tenericutes were reduced. Conclusions APE could obviously reduce the level of blood lipid and repair the disordered intestinal flora of hyperlipidemia rats. It can be speculated that APE might play a role in lowering blood lipids through the intervention of lipid metabolism pathway by intestinal flora.

Study on lipid-lowering mechanism of active peptide DP17 from Eupolyphaga steleophaga in hyperlipidemia rats / 中国中药杂志

The aim of this paper was to investigate the mechanism of the active peptide DP17 of Eupolyphaga steleophaga in the treatment of hyperlipidemia rats. HPLC and MADIL-TOF/TOF-MS were used for the amino acid sequence analysis and solid-phase synthesis on the active peptide of E. steleophaga which were obtained by biomimetic enzymatic hydrolysis, separation and purification. The hyperlipidemia model was established by feeding with high-fat diet.Twenty days later, the rats in the blank group and the model group were given the saline and the rats in remaining groups were given the corresponding drugs by oral administration. After administration for 4 weeks, the levels of triglyceride(TG), total cholesterol(TC) and low density lipoprotein(LDL) in serum, the levels of TG, TC, adenosine monophosphate(AMP), adenosine triphosphate(ATP) in liver tissues and TG in feces were detected, respectively. Hematoxylin-eosin(HE) staining was used to observe the pathological changes of liver tissues. The Real-time fluorescence quantitative PCR method was used to detect the expression of acetyl coa carboxylase(ACC) and hydroxymethylglutaryl-coa reductase(HMGCR) mRNA in liver tissues. The expression of mammalian target of rapamycin(mTORC1) protein and adenosine 5'-monophosphate-activated protein kinase(AMPK) in liver tissues were detected by Western blot. The analysis showed that the amino acid sequence of active peptide from E. steleophaga was DAVPGAGPAGCHPGAGP(DP17). The results of pharmacological experiments showed that after oral administration of DP17 in rats, the levels of TG, TC and LDL in serum as well as TG and TC levels in liver tissues were significantly decreased(P<0.05), while the levels of AMP, ATP in liver tissues and TG content in feces were significantly increased(P<0.05); the liver steatosis of rats was significantly relieved; the expression of ACC, HMGCR mRNA and mTORC1 protein in liver tissues were significantly reduced, while the expression of AMPK phosphorylated protein was significantly increased(P<0.05). DP17, the active peptide of E. steleophag can significantly reduce lipid accumulation in liver tissues, and it may play a role in reducing blood lipids by regulating the energy metabolism balance in the body and activating AMPK/mTOR signaling pathway.

Change of Inflammatory Factors in Patients with Acute Coronary Syndrome / 中华医学杂志(英文版)

<p><b>Background</b>Acute coronary syndrome (ACS) is closely related to unstable plaques and secondary thrombosis. The inflammatory cells in plaques and their inflammatory products may be the cause for plaque instability and ruptures. The study aimed to disclose the changes of inflammatory factors including serum intracellular adhesion molecule-1 (ICAM-1), chitinase-3-like protein 1 (YKL-40), and lipoprotein-associated phospholipase A2 (Lp-PLA2) in patients with ACS and its clinical significance.</p><p><b>Methods</b>A total of 120 patients with coronary heart disease (CHD) were categorized into 2 groups: 69 with ACS and 51 with stable angina pectoris (SAP); 20 patients with chest pain and normal angiography served as a control group. The 120 patients with CHD were categorized into single-vessel disease group, double-vessel disease group, and three-vessel disease group based on the number of coronary artery stenosis. The severity of coronary artery stenosis was quantified based on coronary angiography using Gensini score. They were further divided into mild CHD group with its Gensini score <26 (n = 36), moderate CHD group with its Gensini score being 26-54 (n = 48) and severe CHD group with its Gensini score >54 (n = 36). Serum levels of ICAM-1, YKL-40, and Lp-PLA2 of different groups were determined by enzyme-linked immunosorbent assay. Correlation between ICAM-1, YKL-40, Lp-PLA2, and Gensini score was analyzed.</p><p><b>Results</b>The levels of serum inflammatory factors ICAM-1, YKL-40, and Lp-PLA2 were significantly higher in the ACS group than those in control group and SAP group (all P < 0.05); and compared with control group, no significant difference was observed in terms of the serum ICAM-1, YKL-40, and Lp-PLA2 levels in the SAP group (P > 0.05).The levels of serum ICAM-1, YKL-40, and Lp-PLA2 were not significantly different among control group, single-vessel disease group, double-vessel disease group, and three-vessel disease group (all P > 0.05). The levels of serum ICAM-1, YKL-40, and Lp-PLA2 were not significantly different among control group, mild CHD group (Gensini score <26), moderate CHD group (Gensini score 26-54), and severe CHD group (Gensini score >54) (all P > 0.05). Nonparametric Spearman correlation analysis showed that the levels of serum ICAM-1, YKL-40, and Lp-PLA2 were not correlated with the Gensini score in CHD patients (r = 0.093, r = -0.149, and r = -0.085, all P > 0.05; respectively).</p><p><b>Conclusions</b>The serum levels of ICAM-1, YKL-40, and Lp-PLA2 were correlated with different clinical types of CHD, but not well correlated the severity and extent of artery stenosis, suggesting that ICAM-1, YKL-40, and Lp-PLA2 might be involved in occurrence of instability of atherosclerotic plaque, and might reflect the severity of CHD mostly through reflecting the plaque stability.</p>

Evaluation of risk factors for sudden cardiac death after revascularization in patients with coronary heart disease and heart failure / 中国介入心脏病学杂志

Objective To explore the risk factors for sudden cardiac death(SCD)after revascularization in patients with coronary heart disease and heart failure.Methods This study was a retrospective analysis of 1683 patients with coronary heart disease whose left veatricalar ejection fraction(LVEF)≤40％within 30 days before revascularization.Patients were categorized into 2 groups according their clinical outcome as with or without SCD.Their clinical,angiographic and echocardiographic characteristics were reviewed and compared.The average follow-up time was 1803 days.Results There were total 59 SCD cases.The Cox regression analysis revealed that tricuspid regurgitation(HR 2.217,95％CI 1.285-3.827,P=0.004),lef t main with triple-vessel disease(HR 3.089,95％CI 1.310-7.283,P=0.010),uric acid levels(HR 1.003,95％CI 1.001-1.005,P=0.006)were independent risk factors of SCD.Conclusions The risk of sudden cardiac death after revascularization in coronary artery disease patients with heart failure were significantly higher in patients with tricuspid regurgitation,left main with triple-vessel disease and high uric acid levels.

Protection Effect of Exogenous Fibroblast Growth Factor 21 on the Kidney Injury in Vascular Calcification Rats / 中华医学杂志(英文版)

<p><b>Background</b>Chronic kidney disease (CKD) is closely related to the cardiovascular events in vascular calcification (VC). However, little has known about the characteristics of kidney injury caused by VC. Fibroblast growth factor 21 (FGF21) is an endocrine factor, which takes part in various metabolic actions with the potential to alleviate metabolic disorder diseases. Even FGF21 has been regarded as a biomarker in CKD, the role of FGF21 in CKD remains unclear. Therefore, in this study, we evaluate the FGF21 on the kidney injury in VC rats.</p><p><b>Methods</b>The male Sprague-Dawley rats were divided into three groups: (1) control group, (2) Vitamin D3 plus nicotine (VDN)-induced VC group, (3) FGF21-treated VDN group. After 4 weeks, the rats were killed and the blood was collected for serum creatinine, urea nitrogen, calcium, and phosphate measurement. Moreover, the renal tissues were homogenized for alkaline phosphatases (ALPs) activity and calcium content. The levels of FGF21 protein were measured by radioimmunoassay. The levels of β-Klotho and FGF receptor 1 (FGFR1) protein were measured by enzyme-linked immunosorbent assay (ELISA). The structural damage and calcifications in aortas were stained by Alizarin-red S. Moreover, the structure of kidney was observed by hematoxylin and eosin staining.</p><p><b>Results</b>The renal function impairment caused by VDN modeling was ameliorated by FGF21 treatment, inhibited the elevated serum creatinine and urea level by 20.5% (34.750 ± 4.334 μmol/L vs. 27.630 ± 2.387 μmol/L) and 4.0% (7.038 ± 0.590 mmol/L vs. 6.763 ± 0.374 mmol/L; P < 0.01), respectively, together with the structural damages of glomerular atrophy and renal interstitial fibrosis. FGF21 treatment downregulated the ALP activity, calcium content in the kidney of VC rats by 42.1% (P < 0.01) and 11.7% (P < 0.05) as well as ameliorated the aortic injury and calcification as compared with VDN treatment alone group, indicating an ameliorative effect on VC. ELISA assays showed that the expression of β-Klotho, a component of FGF21 receptor system, was increased in VDN-treated VC rats by 37.4% (6.588 ± 0.957 pg/mg vs. 9.054 ± 0.963 pg/mg; P < 0.01), indicating an FGF21-resistant state. Moreover, FGF21 treatment downregulated the level of β-Klotho in renal tissue by 16.7% (9.054 ± 0.963 pg/mg vs. 7.544 ± 1.362 pg/mg; P < 0.05). However, the level of FGFR1, the receptor of FGF21, kept unchanged under VDN and VDN plus FGF21 administration (0.191 ± 0.0376 ng/mg vs. 0.189 ± 0.032 ng/mg vs. 0.181 ± 0.034 ng/mg; P > 0.05).</p><p><b>Conclusions</b>In the present study, FGF21 was observed to ameliorate the kidney injury in VDN-induced VC rats. FGF21 might be a potential therapeutic factor in CKD by cutting off the vicious circle between VC and kidney injury.</p>

Relationship between two blood stasis syndromes and inflammatory factors in patients with acute coronary syndrome / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the relationship between inflammatory factors and two Chinese medicine (CM) syndrome types of qi stagnation and blood stasis (QSBS) and qi deficiency and blood stasis (QDBS) in patients with acute coronary syndrome (ACS).</p><p><b>METHODS</b>Sixty subjects with ACS, whose pathogenesis changes belongs to qi disturbance blood stasis syndrome, were divided into 2 groups: 30 in the QSBS group and 30 in the QDBS group. The comparative analysis on them was carried out through comparing general information, coronary angiography and inflammatory factors including intracellular adhesion molecule-1 (ICAM-1), chitinase-3-like protein 1 (YKL-40) and lipoprotein-associated phospholipase A2 (Lp-PLA2).</p><p><b>RESULTS</b>Compared with the QSBS group, Lp-PLA2 and YKL-40 levels in the QDBS group showed no-significant difference (P>0.05); ICAM-1 was significantly higher in the QDBS group than in the QSBS group in the pathological processes of qi disturbance and blood stasis syndrome of ACS (P<0.05).</p><p><b>CONCLUSIONS</b>Inflammatory factor ICAM-1 may be an objective basis for syndrome typing of QSBS and QDBS, which provides a research direction for standardization research of CM syndrome types.</p>

Nine-hole Peg Test and Ten-meter Walk Test for Evaluating Functional Loss in Chinese Charcot-Marie-Tooth Disease / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The 9-hole peg test (9-HPT) and 10-meter walk test (10-MWT) are commonly used to test finger motor function and walking ability. The aim of this present study was to investigate the efficacy of these tests for evaluating functional loss in Chinese Charcot-Marie-Tooth (CMT) disease.</p><p><b>METHODS</b>Thirty-four Chinese CMT patients (CMT group) from August 2015 to December 2016 were evaluated with 9-HPT, 10-MWT, CMT disease examination score, overall neuropathy limitation scale (ONLS), functional disability score, and Berg Balance Scale (BBS). Thirty-five age- and gender-matched healthy controls (control group) were also included in the study. Student's nonpaired or paired t-test were performed to compare data between two independent or related groups, respectively. The Pearson test was used to examine the correlations between recorded parameters.</p><p><b>RESULTS</b>The mean 9-HPT completion time in the dominant hand of CMT patients was significantly slower than that in the healthy controls (29.60 ± 11.89 s vs. 19.58 ± 3.45 s; t = -4.728, P < 0.001). Women with CMT completed the 9-HPT significantly faster than men with CMT (dominant hand: 24.74 ± 7.93 s vs. 33.01 ± 13.14 s, t = 2.097, P = 0.044). The gait speed of the average self-selected velocity and the average fast-velocity assessed using 10-MWT for CMT patients were significantly slower than those in the control group (1.03 ± 0.18 m/s vs. 1.44 ± 0.17 m/s, t = 9.333, P < 0.001; 1.31 ± 0.30 m/s vs. 1.91 ± 0.25 m/s, t = 8.853, P < 0.001, respectively). There was no difference in gait speed between men and women. Both 9-HPT and 10-MWT were significantly correlated with the ONLS, functional disability score, and BBS (P < 0.05 for all).</p><p><b>CONCLUSION</b>The 9-HPT and 10-MWT might be useful for functional assessment in Chinese patients with CMT.</p>

Surgical strategies of re-operation for non-anastomotic biliary duct stricture after liver transplantation / 解放军医学杂志

ObjectiveTo investigate the re-operation timing and surgical modality for non-anastomotic biliary stricture (NABS) after orthotopic liver transplantation (OLT). MethodsThe clinical data of 14 NABS patients hospitalized in our center from August 2003 to April 2014 were analyzed retrospectively. The patients were treated with different modalities of re-operation according to cholangiographic results, and the outcomes of re-operation were noted by postoperative follow-up. ResultsAmong 421 OLT patients, NABS was seen in 14 (3.3%, 14/421), and it was accompanied by stenosis of hepatic artery in 4. Their total bilirubin, ALP and r-GGT levels were significantly higher in NABS patients than in non-NABS patients (P<0.01). According to cholangiographic findings, NABS was divided into 3 types: hepatic bile duct strictures (4 patients, type Ⅰ), multiple extrahepatic and intrahepatic biliary strictures (8 patients, type Ⅱ), intrahepatic biliary stricture (2 patients, type Ⅲ). The cure rate of interventional treatment in this study was 57.1% (8/14), and 6 patients eventually required surgical treatment again. The type Ⅰ patient was treated with Roux-en-Y anastomosis, and re-transplantation for other 5 patients (type Ⅱ in 4 and type Ⅲ in 1). Among these 5 patients receiving liver re-transplantation, 1 patient died of perioperative fungal infection. The blood loss (2570±851ml) and operation time (492±173min) in those re-transplantation patients were almost the same as their previous-transplantation (P＞ 0.05). More than half of type Ⅱ and Ⅲ patients needed re-transplantation, but the probability of re-transplantation was especially higher for those with hepatic artery stenosis (75%, 3/4). Cholangitis disappeared and the total bilirubin significantly reduced from 123.4μmol/L to 31.6μmol/L after resurgery. ConclusionsFor those NABS patients who may fail to be improved after a minimally invasive treatment, especially when it was combined with hepatic arterial stenosis, resurgical treatment should be carried out timely to avoid the loss of a chance for re-operation. Based on the different types of stricture as shown by cholangiographic images, different modalities for re-operation should be adapted, and both Roux-en-Y anastomosis and re-transplantation are optional for the treatment of NABS.

Impact of primary percutaneous coronary intervention on blood perfusion in nonculprit artery in patients with anterior ST elevation myocardial infarction / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Recent studies have demonstrated that epicardial flow in nonculprit arteries, which has been assumed to be normal, was slowed in the setting of ST-elevation myocardial infarction (STEMI). However, the impact of primary percutaneous coronary intervention (PCI) on blood perfusion in nonculprit arteries in patients with STEMI has not been clarified. The purpose of this study was to investigate the impact of primary PCI on blood perfusion in nonculprit arteries in patients with STEMI and correlated clinical factors.</p><p><b>METHODS</b>A total of 117 patients with anterior wall STEMI, the culprit artery being the left anterior descending artery (LAD), undergoing primary PCI (the study group) and 100 patients with normal coronary angiography (the control group) were enrolled. To observe the differences of corrected TIMI frame count (cTFC) and myocardial blush grade (MBG) before and after primary PCI in both culprit and nonculprit arteries, the left circumflex coronary artery (LCX), cTFC and MBG in the LAD and LCX were measured in the study group and control group. The study group was divided into three groups; reflow in the culprit artery group (the R group), no reflow in culprit artery group (the NR group), and no reflow in both the culprit artery and nonculprit artery group (the NRB group) according to MBG grade. The level of serum C-reactive protein (CRP), catecholamine, and fibroblast growth factor-21 (FGF21) were assayed. The clinical and angiographic characteristics were also analyzed.</p><p><b>RESULTS</b>cTFC (28.1 ± 24.3 vs. 20.3 ± 19.3, P < 0.05) and MBG in the LCX were different in the study group compared to the control group before primary PCI. cTFC (25.2 ± 22.3 vs. 28.1 ± 24.3, P < 0.05) and the MBG level in the LCX were improved after successful primary PCI, but were not recovered to the normal level. Patients with no reflow in the culprit artery had a higher incidence of no-reflow in the nonculprit artery (78% vs. 19%, P < 0.0001), and the levels of CRP ((3.29 ± 1.31) mg/dl vs. (2.51 ± 1.14) mg/dl vs. (2.93 ± 1.07) mg/dl, P < 0.05, respectively), catecholamine ((epinephrine (693.48 ± 89.78) pg/ml vs. (398.12 ± 93.28) pg/ml vs. (562.54 ± 96.22) pg/ml, P < 0.0001, respectively), and norepinephrine ((7012.43 ± 932.47) pg/ml vs. (4012.34 ± 814.16) pg/ml vs. (5549.03 ± 912.65) pg/ml, P < 0.0001, respectively)) in the NRB group were higher than those in the R group and NR group. The level of FGF21 ((0.299 ± 0.093) ng/ml vs. (0.612 ± 0.071) ng/ml vs. (0.428 ± 0.074) ng/ml, P < 0.0001 respectively) in the NRB group was lower than that in the R group and NR group.</p><p><b>CONCLUSIONS</b>The blood perfusion in the nonculprit artery may be impaired in patients with STEMI. Although nonculprit artery perfusion may be improved after successful primary PCI, it is still lower than that in the control group, and may be involved in inflammation and spasms.</p>

Associated factors with repeat coronary angioplasty during the drug eluting stent era: a high volume center investigation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Repeat percutaneous coronary intervention (PCI) is associated with unfavorable prognosis in patients with coronary artery disease, but there is a current lack of related systematic cross-sectional studies in China. The survey was to investigate a real world of repeat PCIs and their associated factors during the drug eluting stent era in a Beijing high volume center.</p><p><b>METHODS</b>A comprehensive review of the institution's database between January 2006 and July 2009 was conducted. Demographic information, concomitant diseases, peri-procedure laboratory examinations and angiographic features were collected consecutively. Multivariate Logistic regression analysis was undertaken to explore the risk factors associated with repeat PCIs.</p><p><b>RESULTS</b>A total of 13 404 patients were included in the analysis. Of which, 1946 patients (14.5%) had prior PCI procedure. More males patients had previous PCI than the females (15.7% vs 10.9%, P < 0.001). After adjustment for age, gender, concomitant diseases, angiographic and procedural factors, a multivariate model showed that male, diabetes, hyperlipidemia and previous myocardial infarction, left main disease were identified as independent risk factors of repeat PCIs. Of which, previous myocardial infarction (odds ratio: 2.58, 95% confidence interval: 2.27 - 2.92) was highly related with repeat PCIs.</p><p><b>CONCLUSION</b>The frequency of repeat PCIs was 14.5% in this cross-sectional investigation, and their associated factors included male, diabetes, hyperlipidemia and previous MI and left main disease during drug eluting stent era.</p>

What is the optimal initiation timing of angiotensin converting enzyme inhibitor treatment for maximum benefits in acute myocardial infarction patients? / 中华医学杂志(英文版)

Randomized clinical trials led to the clinical recommendation that angiotensin-converting enzyme inhibitors (ACEI) should be used as standard therapy in most patients experiencing an acute myocardial infarction (AMI). However, the optimal initiation timing of treatment, as well as the exact mechanisms, have not been completely resolved, especially with the development of reperfusion strategy after AMI. Earlier initiation of ACEI might be associated with more prompt recovery of left ventricular ejection fraction due to more rapid attenuation of negative remodeling.

Biosynthesis and assay of crude T-2 toxin / 中国地方病学杂志

Objective To isolate Fusarium species from Kashin-Beck disease(KBD)area and biosynthesize cnlde T-2 toxin.Methods T-2 toxin.producing Fusarium was isolated from corns produced in KBD area and purifted.The purifted funsi were identified according to the traits of colony,appearance of thallus and characters of conidium and then weIe cultivated in sterile Corn culture media.After extraction with organic solvent and purification by silica gel chromatography column,the quality and quantity of the toxin in the extracts were estimated by thin,Layer chromatography and high-performance liquid chromatography.Results The toxin-producing strain was Fusarium tricinctum. The com cuIture media inoculated with this strain produced about 250 mg of crude T-2 toxin per kg. Conclusions This experiment has indirectly further confirmed pollution of T-2 toxin-producing Fmarium existed in

Clinical value of the model for end-stage liver disease score in predicting the prognosis of liver transplantation in patients with end-stage liver disease / 南方医科大学学报

<p><b>OBJECTIVE</b>To assess the value of the model for end-stage liver disease (MELD) in predicting the early-stage outcome of liver transplantation in patients with end-stage liver disease.</p><p><b>METHODS</b>The MELD scores of 87 liver transplantation recipients with end-stage liver disease were calculated, and their early-stage complications and mortality were analyzed.</p><p><b>RESULTS</b>The incidence of severe complications was 20.7%; in these recipients, with the 28-day and 3-month survival rates of 89.7%; and 88.5%;, respectively. The mean MELD scores showed significant differences between the complication-free group and survival group (14.6 vs 12.9, P<0.05), and also between the complication group and death group (21.6 vs 29.4, P<0.05). Compared to patients with MELD no greater than 15, patients with MELD between 16 and 24 showed significantly increased complication rate but had comparable survival rate (P>0.05); but in patients with MELD no less than 25, the survival rate was significantly decreased with also increased complication rate.</p><p><b>CONCLUSIONS</b>A higher MELD score before liver transplantation is associated with greater likeliness of early-stage complication rate and mortality. High MELD score (over 25) can be a useful index in predicting severe complications and death in patients undergoing liver transplantation.</p>

Postconditioning of sevoflurane and propofol is associated with mitochondrial permeability transition pore / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

<p><b>BACKGROUND</b>Sevoflurane and propofol are effective cardioprotective anaesthetic agents, though the cardioprotection of propofol has not been shown in humans. Their roles and underlying mechanisms in anesthetic postconditioning are unclear. Mitochondrial permeability transition pore (MPTP) opening is a major cause of ischemia-reperfusion injury. Here we investigated sevoflurane- and propofol-induced postconditioning and their relationship with MPTP.</p><p><b>METHODS</b>Isolated perfused rat hearts were exposed to 40 min of ischemia followed by 1 h of reperfusion. During the first 15 min of reperfusion, hearts were treated with either control buffer (CTRL group) or buffer containing 20 micromol/L atractyloside (ATR group), 3% (v/v) sevoflurane (SPC group), 50 micromol/L propofol (PPC group), or the combination of atractyloside with respective anesthetics (SPC+ATR and PPC+ATR groups). Infarct size was determined by dividing the total necrotic area of the left ventricle by the total left ventricular slice area (percent necrotic area).</p><p><b>RESULTS</b>Hearts treated with sevoflurane or propofol showed significantly better recovery of coronary flow, end-diastolic pressures, left ventricular developed pressure and derivatives compared with controls. Sevoflurane resulted in more protective alteration of hemodynamics at most time point of reperfusion than propofol. These improvements were paralleled with the reduction of lactate dehydrogenase release and the decrease of infarct size (SPC vs CTRL: (17.48+/-2.70)% vs (48.47+/-6.03)%, P<0.05; PPC vs CTRL: (35.60+/-2.10)% vs (48.47+/-6.03)%, P<0.05). SPC group had less infarct size than PPC group (SPC vs PPC: (17.48+/-2.70)% vs (35.60+/-2.10)%, P<0.05). Atractyloside coadministration attenuated or completely blocked the cardioprotective effect of postconditioning of sevoflurane and propofol.</p><p><b>CONCLUSION</b>Postconditioning of sevoflurane and propofol has cardioprotective effect against ischemia-reperfusion injury of heart, which is associated with inhibition of MPTP opening. Compared to propofol, sevoflurane provides superior protection of functional recovery and infarct size.</p>

Correlation between FDG PET /CT and the expression of glutl and ki-67 antigen in esophageal cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the correlation between standardized uptake valus (SUV) of 18F-fluorodeoxyglucose (18 F-FDG) of tumor at PET/CT examination and the expression of glucose transporter-1 (Glutl) and Ki-67 in esophageal cancer.</p><p><b>METHODS</b>56 patients with esophageal cancer were evaluated with 18 F-FDG PET/CT examination before operation. The expression of Glut1 and Ki-67 antigen in the tumor tissues was detected by immunohistochemistry after operation.</p><p><b>RESULTS</b>(1) Positive rate of Glutl and Ki-67 expression in esophageal cancer tissues was 100% , respectively. There was a positive correlation between the expression of Glutl and Ki-67 and the clinical stages and differentiation of the tumor. The more the tumor and the clinical stages were advanced and the lower was the tumor differentiation, the more Glutl and Ki-67 were expressed. (2) There were abnormal radioactive high uptake regions on PET/CT imaging of esophagus in the 56 patients, which were confirmed by pathology as the primary carcinoma. The SUV was higher than 2. 5. There was a gradually increasing tendency in SUV along with the lowering of the tumor differentiation and the advance of clinical stages. (3)There was a correlation between the expression of Glutl, Ki-67 and the SUV, the more Glutl and Ki-67 were expressed, the higher the SUV of tumor 18F-FDG at PET/CT examination was in esophageal tumor tissues.</p><p><b>CONCLUSION</b>There is a widespread expression of Glutl in esophageal cancer tissues, and the SUV may be used to indirectly evaluate the proliferative capacity of esophageal cancer.</p>

Study of gastric function after esophagectomy and cardiectomy with vagus nerve preserved and reconstruction of gastric funds in patients with esophageal and cardiac cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To study the gastric function after esophagectomy and cardiectomy with vagus nerve preserved and reconstruction of gastric funds (VPRG)in patients with esophageal cancer (EC) and cardiac cancer (CC).</p><p><b>METHODS</b>Sixty-eight patients with early or middle staged EC or CC received esophagectomy and cardiectomy with vagus nerve preserved and reconstruction of gastric funds (VPRG),while other 68 patients esophagectomy and cardiectomy with vagus nerve severed and no reconstruction of gastric funds (VSNG) as control. The symptoms,the pressure of the residual esophagus and thoracic stomach, 24-hour pH monitoring, mean basic gastric acid output, gastric emptying time of the intrathoracic stomach,fasting serum gastrin level, fibreoptic endoscopic results were compared before and after operation between the two groups.</p><p><b>RESULTS</b>The patients with VPRG had less symptoms after operation than those with VSNG such as anorexia, belch, reflux, heartburn, nausea, diarrhea, postcibal satiety (P< 0.01). In VPRG group,compared with the results before operation,there were no significant differences in 24-hour pH monitoring,the mean basic gastric acid output, the fasting serum gastrin level,the gastric emptying time of intrathoracic stomach one month and one year after operation (both P > 0.05). The pressure of the residual esophagus above the anastomosis in VPRG group was significantly higher than that in VSNG group (both P< 0.05). Fibreoptic endoscopic examination revealed higher incidences of postoperative atrophic gastritis and reflux esophagitis in VPRG group one month and one year after operation than those in VSNG group (P< 0.01).</p><p><b>CONCLUSION</b>Preservation of the vagus nerve and reconstruction of gastric funds after esophagectomy and cardiectomy for esophageal and cardiac cancer can prevent digestive disorder and improve the life quality of the patients.</p>

Analysis of the unsuccessful cases of the porcelain-fused-to-metal-crowns and bridges / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To discuss the unsuccessful reasons and the preventive methods of the unsuccessful clinic cases.</p><p><b>METHODS</b>The retrospective analysis was carried on the 80 prosthesis in 70 patients from 1994 to 2001 which were suffered with unsuccessful results after the restoration of the metal crowns and bridges.</p><p><b>RESULTS</b>There were 68 teeth which had collapsed or broken. 20 teeth had the post loosing or shedding. Root breaking, food impaction, unharmony colors of porcelain and the changing color of gingival were 3, 3, 6 and 2 teeth.</p><p><b>CONCLUSION</b>It is necessary to select suitable repairing materials and operate correctly for preventing the occurring of the unsuccessful results in the porcelain-fused-to-metal-crowns and bridges.</p>

A candidate tumor suppressor gene mutated in primary hepatocellular carcinoma: kruppel-like factor 6 / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the relationship between kruppel-like factor (KLF)6 gene and the development or progression of hepatocellular carcinoma (HCC).</p><p><b>METHODS</b>Reverse-transcription polymerase chain reaction (RT-PCR) was used to examine the expression of KLF6 mRNA in normal liver tissue and primary hepatocellular carcinoma, and single strand conformation polymorphism (SSCP), DNA sequencing were used to detect the point mutation of KLF6 in primary hepatocellular carcinoma.</p><p><b>RESULTS</b>An amplified fragment of 427 bp DNA was detected in 31 (97%) of 32 adjacent noncancerous tissue and normal liver tissue, and in 23 (85%) of 27 HCCs. There was no significant difference in the levels of KLF6 mRNA between normal liver and liver tumors (chi(2) = 2.58, P > 0.05). For the 27 HCCs, six SSCP-positive bands (22%) were detected. Among them, three of 5 (3/5) tumor samples showing loss of heterozygosity (LOH) of KLF6 had mutations in the retained KLF6 allele.</p><p><b>CONCLUSION</b>We showed that LOH was detected in 5 (36%) HCCs obtained from 14 informative cases, and three of 5 tumor samples showing LOH of KLF6 had mutations in the retained KLF6 allele. Two inactivating events had occurred; thus, as defined by Knudson's "two-hit model", 16 KLF6 appears to be a tumor suppressor gene.</p>