Induction of robust senescence-associated secretory phenotype in mouse NIH-3T3 cells by mitomycin C / 生理学报

Senescence-associated secretory phenotype (SASP) is often a concomitant result of cell senescence, embodied by the enhanced function of secretion. The SASP factors secreted by senescent cells include cytokines, proteases and chemokines, etc, which can exert great influence on local as well as systemic environment and participate in the process of cell senescence, immunoregulation, angiogenesis, cell proliferation and tumor invasion, etc. Relative to the abundance of SASP models in human cells, the in vitro SASP model derived from mouse cells is scarce at present. Therefore, the study aimed to establish a mouse SASP model to facilitate the research in the field. With this objective, we treated the INK4a-deficient mouse NIH-3T3 cells and the wildtype mouse embryonic fibroblasts (MEF) respectively with mitomycin C (MMC), an anticarcinoma drug which could induce DNA damage. The occurring of cell senescence was evaluated by cell morphology, β-gal staining, integration ratio of EdU and Western blot. Quantitative RT-PCR and ELISA were used to detect the expression and secretion of SASP factors, respectively. The results showed that, 8 days after the treatment of NIH-3T3 cells with MMC (1 μg/mL) for 12 h or 24 h, the cells became enlarged and the ratios of β-gal-positive (blue-stained) cells significantly increased, up to 77.4% and 90.4%, respectively. Meanwhile, the expression of P21 protein increased and the integration ratios of EdU significantly decreased (P < 0.01). Quantitative RT-PCR detection showed that the mRNA levels of several SASP genes, including IL-6, TNF-α, IL-1α and IL-1β increased evidently. ELISA detection further observed an enhanced secretion of IL-6 (P < 0.01). On the contrary, although wildtype MEF could also be induced into senescence by MMC treatment for 12 h or 24 h, embodied by the enlarged cell volume, increased ratios of β-gal-positive cells (up to 71.7% and 80.2%, respectively) and enhanced expression of P21 protein, the secretion of IL-6 displayed no significant change. Our study indicated that, although MMC could induce senescence in both mouse NIH-3T3 cells and wildtype MEF, only senescent NIH-3T3 cells displayed the canonical SASP phenomena. Current study suggested that senescent NIH-3T3 cells might be an appropriate in vitro SASP model of mouse cells.

Comparison of Ultrasound Features of Primary Metastatic Papillary Thyroid Carcinoma and Recurrent/Persistent Metastatic Cervical Lymph Nodes / 中国医学科学院学报

Objective To explore the ultrasound features and levels of cervical lymph node metastases in primary and recurrent/persistent papillary thyroid cancer (PTC).Methods We retrospectively analyzed the clinical data of 2181 patients who underwent cervical lymph nodes dissection for PTC from January 12015 to January 12016.Totally 418 PTC patients (with 622 lymph nodes) who met the inclusion criteria entered the final analysis.Patients who had not received any prior thyroid treatment (surgery with or without radioactive iodine) were categorized as the primary group (352 patients with 527 metastatic lymph nodes),and patients who had received prior treatment (thyroidectomy with or without radioactive iodine) for PTC were categorized as recurrent/persistent group (66 patients with 95 metastatic lymph nodes).Pathological results from lymph node dissections were used as the gold standards by means of level-to-level analysis.Results The mean of the minimum axis diameter of the lymph nodes in the primary group was (6.7±3.6)mm,and that of the recurrent/persistent group was (6.6±3.1)mm (U=0.180,P=0.857).The proportion of metastasis in the central area of primary group was 40.0%,which was significantly higher than that in the recurrent/persistent group (12.6%);the proportion of metastasis in the lateral area was 60.6% in the primary group,which was significantly lower than that in the recurrent/persistent group (87.4%)(χ=26.288,P<0.001).In lateral metastatic lymph nodes,Ⅲ level was the most common place in both groups.Level Ⅴ metastatic lymph was rare in both primary group and recurrent/persistent group.Calcifications (63.1% vs. 48.2%;χ=7.207,P=0.007) and peripheral vascularity (81.1% vs. 59.4%;χ= 16.147, P<0.001) were more common in the recurrent/persistent group.The round shape,absence of an echogenic hilum,hyperechogenicity,and cystic aspects were not significantly different between these two groups (all P>0.05).Conclusions Primary metastatic lymph nodes often occur in the central area of lymph nodes,while lateral metastatic lymph nodes are more common in recurrent/persistent PTC.For metastatic lymph nodes,calcifications and peripheral vascularity are more common in recurrent/persistent PTC.

Risk Factors of Lymphnode Metastasis in Patients with Thyroid Papillary Carcinoma Associated with Graves Disease / 中国医学科学院学报

Objective To summarize the characteristics of lymph node metastasis in patients with papillary thyroid carcinoma accompanied with Graves disease,and to provide evidence for clinical treatment. Methods Totally 98 patients with papillary thyroid carcinoma and Graves disease who had been treated in Peking Union Medical College Hospital from January 2004 to December 2013 were divided into the lymph node metastasis positive group (n=34) and lymph node metastasis negative group (n=64). The general information,blood biochemical results,pathological results,and prognoses were compared between these two groups. Results These two groups showed no significant differences in gender (χ=0.2113,P=0.6458),age (t=1.7000,P=0.0922),tumor diameter (t=1.2559,P=0.2122),and multifocal tumors (χ=1.9170,P=0.1661). The median level of thyrotropin receptor antibody (TR-Ab) value in the lymph node metastasis positive group was 4.84 U/L,which was significantly higher than that in the negative group which was 2.99 U/L (t=2.0169,P=0.0465). There were no significant differences in serum thyroid stimulating hormone (t=0.0257,P=0.9800),free triiodothyronine (t=1.3610,P=0.1770),free thyroxine (t=0.0082,P=0.9930),thyroid peroxidase antibody (t=0.0177,P=0.9860),and thyroglobulin antibody levels (t=1.1450,P=0.2550) between two groups. The postoperative pathological results showed that tumor capsular invasion rate (26.5% vs. 9.38%;χ=5.006,P=0.0253) and lymph node recurrence rate (14.7% vs. 1.56%;χ=4.583,P=0.0323) were significantly higher in the positive group than in the negative group. The distal metastasis rate in the positive group and negative group were 5.88% and 0,respectively. Conclusions There is no definite association between lymph node metastasis and tumor size in patients with thyroid papillary carcinoma associated with Graves disease. The risk factors for lymph node metastasis include TR-Ab and tumor capsular invasion,with a higher incidence of lymph nodes recurrence.

Clinicopathologic features of familial nonmedullary thyroid carcinoma / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Familial nonmedullary thyroid carcinoma (FNMTC) is a variant of nonmedullary thyroid carcinoma(NMTC) with particular clinicopathologic features. In recent years, a number of studies have shown that FNMTC is more invasive than sporadic NMTC(SNMTC). The purpose of this study was to explore the differences in clinicopathologic features of FNMTC between different types of families and to determine in which of these families more invasive FNMTC occurred.</p><p><b>METHODS</b>We retrospectively reviewed all patients with thyroid carcinoma admitted to Peking Union Medical College Hospital from January 2009 to July 2013 in the database. Of all 2000 cases, 55 met the inclusive criteria for FNMTC and were studied. There are two different grouping methods. The first is that all samples were allocated to families with three or more first-degree relatives affected (FNMTC-3 group) and families with only two affected first-degree relatives (FNMTC-2 group). The second is that all patients were divided into families with three or more affected first-degree relatives over two generations (FNMTC-3-2 group) and the other families. We compared the clinicopathologic features such as sex, age, tumor size, multifocality, location, complications by thyroiditis, complications by benign thyroid nodules, surgical procedure, capsule invasion, histological type, lymph node metastases, tumor node metastasis stage, and BRAF mutation between FNMTC-2 group and FNMTC-3 group. We also made the same comparison between FNMTC-3-2 group and other families.</p><p><b>RESULTS</b>No pronounced differences in clinicopathological features were present between FNMTC-2 group and FNMTC-3 group. The proportion of FNMTC-3-2 group aged <45 years was significantly higher than that in the other families (58.8% vs. 26.3%, P = 0.021). A similar difference was found in the proportion of lymph node metastasis (64.7% vs. 34.2%, P = 0.035).</p><p><b>CONCLUSIONS</b>FNMTC-3-2 is more invasive than the other families. Early screening and positive treatment for members of these families are recommended.</p>

Correlations between cellular immunity and invasiveness in differentiated thyroid cancer / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the relationship between the immunity and invasiveness in differentiated thyroid cancer (DTC).</p><p><b>METHODS</b>Totally 74 DTC who were treated in Peking Union Medical College Hospital from September 2012 to December 2012 were enrolled in this study. These 74 patients were divided into membrane invasion group (n=36) and without membrane invasion group (n=38); also, they were divided into distant metastasis group (n=18) and without distant metastasis group (n=56). Natural killer (NK) cells and T-cell subsets were chosen as indicators for cellular immunity to investigate the correlation between cellular immunity and invasiveness in DTC.</p><p><b>RESULTS</b>Univariate analysis showed that the membrane invasion (Χ(2)=12.175, P=0.000) and distant metastasis (Χ(2)=8.139, P=0.006) correlated with cell immunity, whereas distant metastasis correlated with lymphocytic thyroiditis (Χ(2)=7.094, P=0.008). Further investigation shows that distant metastasis was associated with the percentage of CD8+T cell subgroup (Χ(2)=5.429, P=0.020), and membrane invasion was significantly associated with NK cells (Χ(2)=2.445, P=0.018) and CD4/CD8 disorder subgroup (Χ(2)=8.079, P=0.002). Multivariate analysis showed that cell immunity disorder was a risk factor for membrane invasion [OR=5.701,95%CI(2.075~15.666), P=0.001] and distant metastasis [OR=5.063,95%CI (1.571~16.320), P=0.008]. Further analysis showed that CD8+T cell was a risk factor for metastasis [OR=2.236,95%CI( 1.084~4.613), P=0.029], and CD4/CD8 disorders were the risk factors for membrane invasion [OR=2.802,95%CI(1.257~6.244), P=0.012].</p><p><b>CONCLUSION</b>Cell immunity in thyroid cancer has close relationship with membrane invasion and distant metastasis, especially when the percentage of CD8+T cells decreases and when the NK cells and CD4/CD8 are abnormal, which may lead to membrane invasion and distant metastasis.</p>

BRAF(V600E) mutation is not a positive predictor for distant metastasis in sporadic papillary thyroid carcinoma / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>BRAF(V600E) mutation is correlated with local aggressive clinicopathological features in papillary thyroid carcinoma; yet the relationship between this genetic variation and distant papillary thyroid carcinoma metastasis was unclear. This study aimed to investigate whether BRAF(V600E) is predictive for distant metastasis in the Chinese population.</p><p><b>METHODS</b>One hundred and seven patients with papillary thyroid carcinoma were enrolled in this study, including 43 patients with distant metastasis and 64 patients without. Quantitative real-time polymerase chain reaction was used to detect BRAF(V600E) mutation, while immunohistochemistry was performed to detect vascular endothelial growth factor (VEGF) expression. The associations between distant metastasis and BRAF(V600E) mutation, and VEGF expression as well as local clinicopathological factors were determined.</p><p><b>RESULTS</b>A total of 28.6% of the patients in the distant metastasis group harbored BRAF(V600E) mutation, which was significantly lower than in the without distant metastasis group (68.8%, P < 0.001). BRAF(V600E) mutation was negatively correlated with positive VEGF expression (P = 0.001). Furthermore, 52.2% of the patients with distant metastasis exhibited VEGF expression, compared with 25.0% of those without. Higher levels of VEGF expression were also observed in the distant metastasis group. Tumor size, extra-thyroid invasion, and BRAF(V600E) mutation were independent predictors for distant metastasis according to multivariate analysis (odds ratios were 2.8, 12.4, and 0.3; 95% CI 1.483-5.334, and 2.950-52.407, 0.100-0.890; P = 0.002, 0.001, and 0.030, respectively). BRAF(V600E) mutation was negatively correlated with distant metastasis in adult subgroup analysis (P = 0.005) but was not an independent parameter.</p><p><b>CONCLUSIONS</b>BRAF(V600E) mutation is predictive for distant metastasis in papillary thyroid carcinoma but not positively. VEGF may be involved in the pathogenesis of distant metastasis.</p>

Influence of haemoxygenase 1 (HO-1) gene expression on intestinal mucosa injury induced by intra-abdominal hypertension in rats / 中华烧伤杂志

<p><b>OBJECTIVE</b>To observe the effects of up- or down-regulation of haemoxygenase 1 (HO-1) gene expression on intestinal mucosa injury induced by intra-abdominal hypertension (IAH).</p><p><b>METHODS</b>(1) Reproduction of rat model of up- or down-regulation of HO-1 gene expression. Twenty-four healthy adult Wistar rats were divided into Co-PP (HO-1 specific revulsive) 2.5 mg, Co-PP 5.0 mg, Sn-PP (HO-1 specific inhibitor) 2.5 mg, and control groups according to the random number table, with six rats in each group. Rats in groups Co-PP 2.5 mg and Sn-PP 2.5 mg were respectively given Co-PP 2.5 mg/kg and Sn-PP 2.5 mg/kg by intraperitoneal injection, once every 12 hours for 3 days. The rats in group Co-PP 5.0 mg were intraperitoneally injected with Co-PP 5.0 mg/kg, once a day for 3 days. The rats in control group were treated with equal volume of normal saline by intraperitoneal injection. All rats were sacrificed on post injection day (PID) 4, and intestinal mucosa tissues were collected for determination of HO-1 mRNA expression. Optimal dose of Co-PP was chosen for the following experiment. (2) The influence of up- or down-regulation of HO-1 gene expression on intestinal mucosa injury under IAH condition. Another 24 healthy adult Wistar rats were divided into control, IAH, Co-PP+IAH, and Sn-PP+IAH groups according to the random number table, with six rats in each group. The rats in groups Co-PP+IAH and Sn-PP+IAH were intraperitoneally injected with 2.5 mg/kg Co-PP and 2.5 mg/kg Sn-PP, once every 12 hours for 3 days. Equal volume of normal saline was intraperitoneally injected into the rats in control group, once every 12 hours for 3 days. Then, nitrogen gas pneumoperitoneum was used to establish the model of IAH in rats of the latter three groups on PID 4, with IAP at 20 mm Hg (1 mm Hg = 0.133 kPa) , and it was maintained for 2 hours. Puncture and intubation were performed in rats of control group without inflating nitrogen gas. Jejunal segment in the length of 10-15 cm was harvested for collecting intestinal mucosa tissues to determine the HO-1 mRNA expression and diamine oxidase (DAO) content. Serum obtained from portal vein blood was collected to determine the D-lactate, TNF-α, and IL-6 contents. Another jejunal segment in the length of 1-2 cm was harvested for histopathological examination. Data were processed with one-way analysis of variance and t test.</p><p><b>RESULTS</b>(1) The HO-1 mRNA expression in group Co-PP 2.5 mg was significantly higher than that in control and Co-PP 5.0 mg groups (with t values respectively 4.756, 3.175, P < 0.05 or P < 0.01). The HO-1 mRNA expression in group Sn-PP 2.5 mg was significantly lower than that in control group (t = 4.880, P < 0.01). The optimal dose of Co-PP for the following experiment was 2.5 mg/kg. (2) HO-1 mRNA expression in group Co-PP+IAH was 60 ± 5, and it was obviously higher than that of group IAH (49 ± 5, t = 3.811, P < 0.01) and control group (39 ± 4, t = 8.034, P < .001) . HO-1 mRNA expression was higher in group IAH than in control group (t = 3.826, P < 0.01). HO-1 mRNA expression in group Sn-PP+IAH was 29 ± 4, which was obviously lower than that of control group (t = 4.330, P < 0.01). The contents of DAO and D-lactate in group Co-PP+IAH were (0.52 ± 0.05) U/mL and (1.9 ± 0.6) mg/L, which were significantly lower than those in group IAH [(0.88 ± 0.06) U/mL and (4.3 ± 0.7) mg/L, with t values respectively 11.291, 6.376, P values all below 0.01], but still higher than those in control group [(0.34 ± 0.04) U/mL, (1.2 ± 0.5) mg/L, with t values respectively 6.886, 2.295, P < 0.05 or P < 0.01]. The contents of TNF-α and IL-6 were much lower in group Co-PP+IAH than in group IAH, but still higher than in control group (with t values from 3.781 to 18.557, P values all below 0.01). The contents of DAO, D-lactate, TNF-α, and IL-6 in group Sn-PP+IAH were all higher than those in the other 3 groups (with t values from 4.181 to 32.938, P values all below 0.01). Structure of epithelial cells from intestinal mucosa was intact and regularly arranged in rats of control group. Intestinal mucosal tissue was edematous, and the top of villi was anabrotic and necrotic in rats of group IAH. Compared with that of group IAH, the degree of intestinal mucosa injury was alleviated in rats of group Co-PP+IAH, while the pathology was aggravated in rats of group Sn-PP+IAH.</p><p><b>CONCLUSIONS</b>Up-regulation of HO-1 gene expression can ameliorate intestinal mucosa injury caused by IAH, thus protecting intestinal mucosa tissues.</p>

Investigation of attention via the counting Stroop task in patients with functional constipation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The etiology and pathology of functional constipation (FC) is unclear. Some researches suggest that psychological factors may be related to this common problem. This study aimed to investigate the relationship between attention processing and emotional status in FC patients compared with healthy controls.</p><p><b>METHODS</b>We investigated selective attention and emotional status in patients with FC using the counting Stroop task. Thirty-five FC patients (FCP group) and 24 healthy controls (HCs) underwent an event-related potential (ERP) study while performing the task. Response time, latency and amplitude of P300 were collected and compared between the two groups. The Hamilton Depression Rating Scale (HAMD-17), Hamilton Anxiety Scale (HAMA), Symptom Checklist-90 (SCL-90) and Eysenck Personality Questionnaire (EPQ) were administered prior to the counting Stroop task.</p><p><b>RESULTS</b>Scores for the FCP group differed significantly from those for the HCs on the HAMD-17, HAMA, SCL-90 (Global Severity Index, Positive Symptoms Total, dimensions of somatization, obsessive-compulsive, depression, anxiety, and psychosis), as well as extraversion and neurosis dimensions of the EPQ (P < 0.05). There was no significant difference in response time or accuracy rate between the two groups (P > 0.05). ERP results showed prolonged latency at F4, additionally found enhanced activation at F3, FC1 and T8, and decreased activation at sites FC6 and P7 in the patients with FC. Statistically, significant differences of P300 latency at site F4 (P < 0.05) and P300 amplitude at F3, F4, T8, P7, FC1 and FC6 (P < 0.05) between the patients with FC and the HC were revealed.</p><p><b>CONCLUSIONS</b>The findings suggest that patients with FC are more susceptible to depression and anxiety, as well as somatization, obsessive-compulsive tendencies and other neurotic personality characteristics. Patients may employ psychological defense mechanisms to avoid the pain of depression and anxiety. ERP results imply there may be some brain dysfunction and attention deficits in patients with FC.</p>

An improved technique for repairing hand defects with abdominal pedicled flaps / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the feasibility a modified method for repairing hand soft tissue defects using abdominal pedicle flaps.</p><p><b>METHODS</b>Between January 1997 and October 2010, abdominal pedicle flaps were used to repair hand soft tissue defects in 108 cases. A strategy of segmented skin-flap ligations was adopted for early pedicle cut-off with early separation of the combined fingers, donor site closure with auxiliary flaps and application of thin flap and full-thickness skin graft.</p><p><b>RESULTS</b>Ligation of the pedicle site only was performed in 68 cases with an average time of pedicle cut-off of 10 days. Pedicle cut-off and separation of the combined fingers were simultaneously performed in 40 cases without flap necrosis. The healing rate of the donor sites reached 96.8%.</p><p><b>CONCLUSION</b>The method is simple, safe and reliable and allows simultaneous pedicle cut-off and separation of the combined fingers to ensure good functional and appearance recovery of the hand with soft tissue defect.</p>

Diagnosis and treatment of 166 patients with early gastric cancer / 中国医学科学院学报

<p><b>OBJECTIVE</b>To summarize our experiences in the diagnosis and treatment of early gastric cancer (EGC).</p><p><b>METHODS</b>The clinicopathological data of the 166 EGC inpatients who were treated in our hospital from January 1999 to January 2009 were retrospectively analyzed and their treatment outcomes were followed up.</p><p><b>RESULTS</b>Surgical treatment for ECG accounted for 9.04% (176/1946) among all the surgeries performed for gastric cancers. Among the analyzed 166 cases, 9 asymptomatic patients were diagnosed by routine examination, 29 (17.47%) had a history of gastric ulcer or chronic gastritis, and 20 (12.05%) had a family history of esophageal or gastric cancer. Of 64 patients who received double-contrast gastric X-ray examination, 57 patients (89.06%) were found to be with abnormalities. Endoscopy revealed lesions in lower third, middle third, and upper third of the stomach in 115 patients (69.28%), 26 patients (15.66%), and 25 patients (15.06%), respectively. A total of 126 patients received D(0) or D1 operations and 40 patients received operations more than D+1 operation. As shown by post-operative pathological examinations, the mean diameter of the lesions was (2.52±1.62) cm; 75 patients (45.18%) had mucosal gastric cancer, 91 (54.82%) had submucosal gastric cancer, 20 patients with submucosal gastric cancer had lymph node metastasis, and 8 patients had lymphatic vessel involvement. The overall 5-year survival rate was 70.0% and 89.7% among patients with or without lymph node metastasis (P=0.002). Univariate analysis revealed that depth of tumor invasion (submucosa) and lymphatic vessel involvement were significantly correlated with lymph node metastasis (P=0.000, P=0.001). Multivariate analysis showed that lymphatic vessel involvement was significantly correlated with lymph node metastasis (odds ratio: 15.67; 95% confidence interval, 3.40-72.14).</p><p><b>CONCLUSIONS</b>The proportion of EGC patients undergoing gastrectomy is relatively low among all gastric cancer patients. Lymph node metastasis is a key prognostic factor for EGC. A proper staging of gastric cancer, a precise evaluation of the depth of infiltration, and appropriate and standardized treatment are important to improve the outcomes.</p>

Investigation of selective neck dissection for differentiated thyroid cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the indication, operative method and results of selective neck dissection (SND) for differentiated thyroid cancer.</p><p><b>METHODS</b>According to the level system and the operative guideline of the American Head and Neck Society, 40 cases of thyroid cancer (phase I: 35 cases, phase II: 2 cases, phase III: 3 cases) were collected prospectively. Thyroidectomy plus SND was performed on all the cases. And the indication, operative methods and results were investigated.</p><p><b>RESULTS</b>Nine of the 40 cases received level VI dissection only. Twenty-four of the 40 cases received SND with levels </= 3 by a simple transverse incision on the neck. The overall lymph nodes positive rate was 67% (28/42). The positive rates of VI, IV, III, II and V levels were 58% (23/40), 48% (16/33), 48% (14/29), 50% (7/14) and 27% (4/15) respectively. The positive rate of level VI was not significantly higher than those of the level IV, III and II (P > 0.05). One parathyroid was found in 20% (8/40) of the specimen and 27% (11/40) of the patients had transient hypocalcemia, but no permanent hypocalcemia. Three (7.5%) of the patients had vocal cord paralysis for a short period of time and no permanent case was detected. Nineteen patients were followed up for more than 6 months after the operation and no enlarged neck lymph node was found by ultrasound at the 6th month postoperatively.</p><p><b>CONCLUSION</b>It is reasonable to give SND to the early thyroid cancer patients.</p>

Therapeutic effect of excision of hypomere esophagus and proximal stomach on portal hypertension and upper gastrointestinal bleeding / 中华外科杂志

<p><b>OBJECTIVE</b>To analyze the therapeutic effect of excision of hypomere esophagus and proximal stomach (Phemister operation) on portal hypertension and upper gastrointestinal bleeding.</p><p><b>METHODS</b>Retrospectively analyze the clinical data of 136 cases treated with the Phemister operation for portal hypertension and upper gastrointestinal bleeding from August 1999 to May 2005.</p><p><b>RESULTS</b>Varication of the patients improved markedly, 50.8% of the varication disappeared completely, incidence of complications was 5.0%, rebleeding rate was 4.4%, mortality rate was 0.7%.</p><p><b>CONCLUSIONS</b>The Phemister operation could treat the upper gastrointestinal bleeding and prevent rebleeding effectively in portal hypertension, it is a radical, precise and secure disconnection for portal hypertension with varication in fundus of stomach and esophagus.</p>

Experimental study and clinical application of early pedicle division of skin flap by ligation / 中华外科杂志

<p><b>OBJECTIVE</b>To establish a new method of early cut-off skin flap by ligating to stegnosis pedicle and assess its feasibility and clinical application.</p><p><b>METHODS</b>Twenty New Zealand rabbits were used to make skin flaps with the size of 8.0 cm x 4.0 cm on both sides of the back respectively. And one side was experimental group with the pedicles of skin flaps horizontally oversewn by several pairs of silk thread, the other side was control group. Two pairs of silk thread in the two sides of the pedicle of skin flap of experimental group were ligated on the 3rd day. On the 5th day the pedicle was wholly ligated. All pedicles were divided on the 6th day and the survival area of skin flaps were measured after 3 days. The tissue samples from the skin flaps were collected for histology test on the 4th and 6th day respectively. The pedicles of 78 random flaps from 48 patients were cut off after narrowing them by ligating.</p><p><b>RESULTS</b>The mean flap survival rate of the experimental group was statistically higher than the control group. Histological examination results showed the density and diameter of blood vessel were increased in the skin flaps of the experimental group. The mean time for removal pedicles was shortened to 10 days, and no necrosis was found after resecting.</p><p><b>CONCLUSIONS</b>This method is secure and convenient and the time of pedicle division can be shortened.</p>

Endoscopic thyroid surgery: a comparison of the trans-subclavian and the trans-areolar approach / 中华外科杂志

<p><b>OBJECTIVE</b>To compare the advantages and shortcomings of the endoscopic thyroid surgery by trans-subclavian approach and trans-areolar approach.</p><p><b>METHODS</b>Twelve patients received the trans-areolar approach and 10 patients were given the trans-subclavian approach procedure.</p><p><b>RESULTS</b>With the trans-areolar approach: the mean size of tumor was 1.8 cm, the mean operating time was 115 min, the mean blood loss during operation was 63 ml. Two patients converted to the conventional operation. With the trans-subclavian procedure: the mean size of tumor was 4.2 cm, the mean operating time was 85 min, the mean blood loss during operation was 66 ml. No complications were found in all of the patients and they were satisfied with the cosmetic effects of the procedures. There were significant differences in tumor size and operating time between the two operation types.</p><p><b>CONCLUSIONS</b>Compared with the trans-areolar approach, the trans-subclavian approach comes with less trauma, higher success rate and it fits for bigger tumor.</p>

Diagnosis and treatment of chronic lymphocytic thyroiditis coexistent with thyroid malignancy / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the principles of diagnosis and treatment of chronic lymphocytic thyroiditis (CLT) coexistent with thyroid malignancy.</p><p><b>METHODS</b>The clinical data of 52 patients with CLT, including clinicopathologic features, treatment, and prognosis were retrospectively analyzed. Among these 52 patients, 40 patients had coexisting thyroid carcinoma (TC group) and 12 had coexisting thyroid lymphoma (TL group).</p><p><b>RESULTS</b>These two thyroid malignancies accounted for 13.87% of all the CLT inpatients during this period, in which 10.67% were CLT with carcinoma and 3.20% were CLT with lymphoma. Significant differences existed between TC group and TL group in sex (P = 0.008) , age (P = 0.000), and B-mode ultrasound findings (P = 0.000). Most patients in TC group received total lobectomy of one lobe and subtotal lobectomy of the other side, of which some received elective lymphadenectomy. The operations varied among patients in TL group, and most of them received chemotherapy after surgery. The median follow-up was (35.51 +/- 39.84) months for 37 patients in TC group, and 36 patients survived with a median period of (34.50 +/- 39.91) months; the median follow-up was (39.50 +/- 29.00) months for 12 patients in TL group, and 10 patients survived with a median period of (44.70 +/- 28.78) months.</p><p><b>CONCLUSIONS</b>CLT with thyroid malignancies are not uncommon in clinical practice. While thyroid carcinoma accounts for majority of these malignancies, its clinicopathologic features, treatment, and prognosis differs with thyroid lymphoma. Surgery may be appropriate for CLT patients with rapid thyroid enlargement or nodule, and for patients with solitary solid nodule or nodules with calcification revealed by B ultrasound.</p>

The use of local flap in repairing deeply burned wound of extremities / 中华外科杂志

<p><b>OBJECTIVE</b>To discuss a method for reconstruction of deeply burned of extremities' functional regions with local skin flaps.</p><p><b>METHODS</b>Ninety-eight cases (with 126 place) of deeply burned wound of extremities were reconstructed with fasciocutaneous flaps.</p><p><b>RESULTS</b>The survival rate of 162 flaps was 93.2%. The movement of 112 joints (88.9%) was restored to normal, and the movement of 14 joints was mild limitation, none of the cases was severe obstacle.</p><p><b>CONCLUSIONS</b>The method is simple and with satisfactory results, which can decrease the rate of disability suffered from burn.</p>

Diagnosis and treatment of polypoid lesion of the gallbladder / 中国医学科学院学报

<p><b>OBJECTIVE</b>To discuss the principles of diagnosis and treatment of the polypoid lesion of gallbladder.</p><p><b>METHODS</b>Clinical and pathological features of 342 cases were analysed.</p><p><b>RESULTS</b>Totally 328 patients with benign polypoid lesions (including 234 cholesterol polyps, and 74 adenomas), and 14 patients with malignant polypoid lesions (including 10 adenocarcinomas and 4 adenomas with malignant changes) were included. Two hundred and forty-seven cases (72.2%) had symptoms. Seventy-eight point six percent of patients with malignant polyps were over 50 years of age, and while 29.9 percent of patients with non-malignant polyps were over 50 years. The lesions were more than 1 cm in 91.7% of the malignant polyps and in only 13.2% of the benign polyps. One hundred percent of malignant polyps, and 46 percent of benign polyps were single polyp.</p><p><b>CONCLUSIONS</b>Cholesterol polyps, adenomas, and adenocarcinomas are the most common lesions in polypoid lesion of the gallbladder. Cholecystectomy should be done in patients with symptoms. The risk factors for malignancy are the age of the patient (> 50), the size (> 1 cm), and number (single) of the polypoid lesions. In asymptomatic patients, cholecystectomy can be justified after integrated analysis.</p>

Excitatory postsynaptic potential evoked by stimulation of the ventrolateral region of the cerebellum in crucian carp Mauthner cell / 生理学报

In the present experiments, the characteristics of the electrical responses to stimulation of the cerebellum in crucian carp Mauthner cell were explored with microeletrode intracellular recording technique. A composite excitatory postsynaptic potential (cerebellum-evoked EPSP) could be induced from the soma, the ventral dendrite and the proximal end of the lateral dendrite in crucian carp Mauthner cell (M-cell) on either side by stimulation of the ventrolateral region of the cerebellum. The cerebellum-evoked EPSP presented characteristics of relatively short latency (0.63+/-0.09 ms), longer duration (5.49+/-1.13 ms), graded amplitude and dependence on stimulation frequency. Stimulation of the cerebellum with higher intensity always activated the M-cell orthodromically. Multiple intracellular recordings showed that the cerebellum-evoked EPSP originated in the distal end of the ventral dendrite. The results suggest that the cerebellum-M-cell pathway is probably composed of a group of neuron chains with different numbers of synaptic relays projecting to the distal end of the ventral dendrite in order of length of the chains.