Efficacy and anatomical factors of Endurant stent graft in endovascular aortic repair of abdominal aortic aneurysm with hostile neck / 中国实用外科杂志

OBJECTIVE: To observe the safety and efficacy of Endurant stent-graft in abdominal aortic aneurysm with hostile neck,and detect the anatomic factors of hostile neck-related adverse events.METHODS: The clinical data of 144 consecutive patients of abdominal aortic aneurysm with hostile proximal neck who underwent endovascular aortic repair with Endurant stentgraft from January 2010 to January 2016 in Department of Vascular Surgery,Zhongshan Hospital,Fudan University were analyzed retrospectively.The perioperative clinical and the technical success rate as well as adverse event during follow up were observed.The anatomical factors correlated with proximal neck related adverse events were analyzed.RESULTS: The median length of follow-up was 36(1-73) months,and there were 26 cases of adverse events,with 18.1% incidence rate of adverse events.The clinical success rate was 98.6% and technical success rate 96.5%.Nineteen patients experienced proximal neck related adverse events.Univariate analysis demonstrated proximal neck length,neck angle,short neck,twist neck were anatomical factors that influenced the proximal neck related adverse events(All P<0,05).Multifactor logistic regression analysis identified that proximal neck length,neck angle,taper neck were anatomical factors significantly correlated with proximal neck related adverse events(All P<0.05).CONCLUSION: The Endurant stent graft generally presents safe and effective for the treatment of abdominal aortic aneurysm with hostile proximal neck,while patients with short,angulated and taper proximal neck warranted enhanced follow up.

Vitamin D level in patients with menstrually related migraine / 上海交通大学学报（医学版）

Objective · To compare vitamin D levels in the patients with menstrually related migraine and those with non-menstrual migraine.Methods · A total of 100 patients with menstrually related migraine were enrolled as case group, and 100 patients with non-menstrual migraine were matched as control group in Renji Hospital, Shanghai Jiao Tong University School of Medicine, from June 2017 to June 2018. The patients' information was collected and serum vitamin D levels were measured. Univariate analysis was performed to analyze the differences between the groups, and Logistic regression model was performed to analyze the relationship between menstrually related migraine and vitamin D levels. Results · Vitamin D levels were lower in case group than those in control group [ (13.48±5.02) ng/mL vs (14.93±4.94) ng/mL, P=0.042]. There were no statistically significant differences in other indexes between the groups (P＞0.05). Logistic regression analysis showed that the patients with vitamin D less than 10 ng/mL were more likely to have menstrually related migraine than those with vitamin D more than 20 ng/ml (OR=3.656, 95％ CI 1.382-9.672, P=0.009). In addition, there were no statistically significant differences in clinical characteristics and vitamin D levels between the patients with migraine occurring in premenstrual period and menstrual period (P＞0.05). Conclusion · Low vitamin D levels may be associated with menstrually related migraine, but not with its occurrence in premenstrual or menstrual period.

Antibacterial mechanisms of endophytic fungi Alternaria alternata of ethyl acetate extract on Escherichia coli / 中草药

Objective To study the antibacterial mechanisms of ethyl acetate extract (B06e) from the fermentation liquid of an endophytic fungus Alternaria spp. Alternaria spp isolated from the medicinal plant Humata tyermanni. Methods Double dilution method was adopted to measure the minimum inhibitory concentration (MIC) of B06e against Escherchia coli. Then, the changes of electric conductivity of bacterial culture, nucleic acid and protein concentration before and after treated by B06e were analysed, respectively. Besides, flow cytometry, scanning electron microscopy, gel retardation experiments, circular dichroism spectrum and Real-time quantitative PCR were introduced to study the antimicrobial mechanisms of B06e against E. coli. Results The results showed that MIC value of B06e against E. coli was 25 μg/mL. The electric conductivity of 3 × MIC treatment group was 1.01 times the value of the control group. The β-galactosidase activity of 3 × MIC treatment group was 11.6 times more than the value of the control group. Flow cytometry analysis showed that PI positive cells ratio of 3 × MIC treatment group was 286.5 times the value of the control group. Scanning electron microscopy showed that cell surface becomes rough after the treatment of B06e, a large number of cell membrane collapse. These results suggested that B06e can increase the permeability of cell membrane, destroy the integrity of cell membrane. The results of gel retardation experiments and circular dichroism spectrum applied that B06e can be inserted into DNA structure at particular position, however, can not cause DNA degradation. Real-time quantitative PCR results showed that the expressions of recA and recN genes were both up-regulated with the values of 2.9 and 3.7 times the value of the control group, respectively. This result suggested that B06e can destroy the DNA structure, which force E. coli to initiate SOS repair. Conclusion B06e can kill E. coli cell by destroying the cell membrane and damaging DNA structure.

Antibacterial mechanisms of ethyl acetate extract from endophytic fungi Alternaria alternata against Staphylococcus aureus / 中草药

Objective To investigate the effect of ethyl acetate extract (B06e) from fermentation liquid of an endophytic fungus Alternaria spp. on the cell membrane integrity and the permeability of Staphylococcus aureus. Methods The minimum inhibitory concentration (MIC) of B06e against S. aureus was measured by double dilution method; The changes of electric conductivity of bacterial culture, A260 and A280 before and after treated by B06e were analyzed, respectively. Besides, the changes of cell membrane permeability before and after by B06e was measured by flow cytometry. The effect of B06e on the cell membrane structure was investigated by scanning electron microscopy (SEM) and Fourier transform infrared spectroscopy (FT-IR). Results The results showed that MIC value of B06e against S. aureus was 50 μg/mL. The conductivity of 3 × MIC treatment group was 1.06 times of the value of the control group; after treatment of B06e, the values of A260 and A280 were significantly higher than those of the control group: The beta-galactosidase activity of 3 × MIC treatment group was 9.43 times more than the value of the control group; Flow cytometry analysis showed that 3 × MIC treatment group by propidium iodide (PI) staining of positive cells was 47.63 times more than the control group; SEM and FT-IR analysis showed that the structure of bacterial cell changed after B06e treatment. Conclusion B06e can kill S. aureus cell by increasing the permeability of its cell membrane and destroy cell membrane integrity.

Curative effect of the rivaroxaban and the low-molecular weight heparin anticoagulation in patients with active malignant tumors combined with venous thromboembolism / 复旦学报（医学版）

Objective To investigate the efficacy and safety of rivaroxaban in contrast with lowmolecular weight heparin (LMWH) in patients with active malignant tumor combined with venous thromboembolism (VTE).Methods This study was a prospective case-control study.All cases were from Zhongshan Hospital,Fudan University between Jan.,2015 and Aug.,2016.They were treated with either rivaroxaban or LMWH for anticoagulation.Patients were followed up for 90 days to observe the treatment efficacy,recurrence and bleeding events.The total efficiency,recurrence events,bleeding events and adverse events were statistically analyzed.Results A total of 67 patients were enrolled in this study.Among them,37 cases aged 38-84 years old were assigned to LMWH group,of which 16 cases (43.2％) were male.Another 30 cases aged 45-88 years old were assigned to rivaroxaban group and 12 cases (40.0％) were male.There was no statistically significant difference between the two groups.The total effective rate (P =0.699),recurrence events (P =0.774),bleeding events (P =0.490) and adverse events (P =0.448) between the LMWH group and the rivaroxaban group had no significant difference.Conclusions Rivaroxaban and LMWH anticoagulation had similar safety and efficacy in patients with active malignant tumor combined with VTE.

Clinical observation of modified Da Chaihu decoction in treating essential hypertension with anxiety / 中国中药杂志

To observe the clinical efficacy of modified Da Chaihu decoction in treating essential hypertension with anxiety, the randomized, controlled, clinical trial was performed in this study. One hundred and twenty-six hypertensive patients with anxiety meeting the inclusive criteria were randomized into the treatment group and the control group. All of the included patients in the above 2 groups were treated by amlodipine besylate tablets. Patients in the treatment group were given Chinese herbal medicine modified Da Chaihu decoction every day. And patients in the control group were given flupentixol and melitracen tablets. The treatment course was 4 weeks. Blood pressure, the score of traditional Chinese medicine syndrome, blood lipids, C reactive protein, the Hamilton anxiety scale score and adverse effects were observed. It has been identified that, both systolic and diastolic blood pressure were significantly reduced (P<0.05). However, no significant difference between the treatment group and the control group was identified. For traditional Chinese medicine syndrome, it was significantly improved in the treatment group (P<0.05). For blood lipids, TC, TG, HDL-C, and LDL-C were significantly improved in the treatment group (P<0.05). After treatment, only TC was significantly reduced in the treatment group when compared to the control group (P<0.05). For C reactive protein, it was significantly reduced in the treatment group after treatment (P<0.05). For anxiety, no significant difference between the treatment group and the control group on the Hamilton anxiety scale score was identified. For adverse effect, no severe adverse effect was identified in this study. The modified Da Chaihu decoction maybe effective in the treatment of essential hypertension with anxiety. In addition to a certain role in lowering blood pressure, the modified Da Chaihu decoction was also effective in improving traditional Chinese medicine syndrome and blood lipids, reducing the level of C reactive protein, relieving anxiety with little adverse effect.

Analysis on biomechanical properties and hemodynamics of the vena cava filters with different numbers of support bars / 医用生物力学

Objective To investigate the interaction between vessel and vena cava filter (VCF) with different numbers of support poles and the influence on blood flow during its implantation by using finite element method and computational fluid dynamics method, so as to provide more scientific guidance for intervention treatment and design & development of the filter. Methods Three kinds of VCF models with 4, 6, 8 support poles were established by using Solidworks, respectively. The stress distribution and radial support stiffness of the vessel and filter under working condition were then simulated and analyzed by using ABAQUS. The distributions of blood flow velocity, pressure and shear stress after VCF implantation were simulated by using Fluent. Results All the mechanical and fluid properties of the three kinds of VCFs were within the scope of security. The comprehensive mechanical performance of the 6-pole filter was better, while for the 8 pole-filter, it showed larger stress under working condition, larger support intensity, higher exit velocity, larger shear stress on the filter mesh, and the trail of the flow was changed from laminar to transition flow, which might cause some damage to the vessel wall. The 4 pole-filter under working condition had a larger stress on the vessel, while its exit velocity was lower, which could be likely to cause local damage on the vessel wall, and disadvantageous to accurately positioning the filter in diseased region of the vessel. Conclusions The 6 pole-filter has a superior hemodynamic effect and comprehensive mechanical properties, which reduces the potential possibility of damage to the vessel wall caused by implantation of the filter. The simulation analysis on VCF provides a good reference for design of the filter and its intervention treatment in clinic.

An open-labeled, randomized, multicenter phase IIa study of gambogic acid injection for advanced malignant tumors / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Gambogic acid is a pure active compound isolated from the traditional Chinese medicinal plant gamboge (Garcinia morella Desv.). Based on the preliminary results of a phase I study, this phase IIa study compared the efficacy and safety of different dosage schedules of gambogic acid in patients with advanced malignant tumors.</p><p><b>METHODS</b>Patients with advanced or metastases cancer who had not received any effective routine conventional treatment or who had failed to respond to the existing conventional treatment were randomly assigned to receive either 45 mg/m(2) gambogic acid intravenously from Days 1 to 5 of a 2-week cycle (Group A), or 45 mg/m(2) every other day for a total of five times during a 2-week cycle (Group B). The primary endpoint was objective response rate (ORR).</p><p><b>RESULTS</b>Twenty-one patients assigned to Group A and 26 to Group B were included in the final analysis. The ORRs were 14.3% in Group A and 0% in Group B. It was not possible to analyze the significant difference because one of the values was zero. The disease control rates (DCRs) were 76.2% in Group A and 61.5% in Group B (P = 0.0456). The observed adverse reactions were mostly Grades I and II, and occurred in most patients after administration of the trial drug. There was no significant difference in the incidence of adverse reactions between the two arms.</p><p><b>CONCLUSIONS</b>The preliminary results of this phase IIa exploratory study suggest that gambogic acid has a favorable safety profile when administered at 45 mg/m(2). The DCR was greater in patients receiving gambogic acid on Days 1 - 5 of a 2-week cycle, but the incidence of adverse reactions was similar irrespective of the administration schedule.</p>

Clinical efficacy evaluation of shuangshen tongguan capsule on acute myocardial infarction patients after direct percutaneous coronary intervention / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To evaluate the therapeutic efficacy of Shuangshen Tongguan Capsule (STC) on acute myocardial infarction (AMI) patients after direct percutaneous coronary intervention (PCI).</p><p><b>METHODS</b>Using a randomized controlled method, AMI patients with elevated ST segment after successful direct PCI were randomly assigned to the control group (62 cases) and the treatment group (67 cases). On the basis of the standard Western medical treatment, patients in the treatment group took STC, while those in the control group took STC placebos, 4 pills each time, three times daily. The Chinese medicine syndrome integrals, the cardiac function in the resting and loading states, the microcirculation perfusion rate, and the changes of Seattle Angina Scale score were evaluated after 6 months of treatment.</p><p><b>RESULTS</b>Five cases were lost, accounting for 3.88%. Six months later the Chinese medicine syndrome integrals obviously decreased, the efficacy of Chinese medicine syndrome was enhanced, the LVEF in the loading state and the percentage of normal myocardium obviously increased, anterior myocardial infarction segments with increased k value of the microcirculation perfusion increased, the total score of Seattle Angina score, the satisfactory degree of the treatment, and the integrals for the disease recognition degree were significantly enhanced (all P<0.05).</p><p><b>CONCLUSIONS</b>STC could improve the angina symptoms of AMI patients after direct PCI and elevate their heart functions. It has certain roles in improving microcirculation perfusion of myocardium, thus elevating patients' quality of life.</p>

Role of conventional pulmonary function tests and cardiopulmonary exercise test in the prediction of postoperative cardiopulmonary complications in high risk thoracic cancer patients / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate and compare the value of cardiopulmonary exercise test and conventional pulmonary function tests in the prediction of postoperative cardiopulmonary complications in high risk patients with chest malignant tumors.</p><p><b>METHODS</b>From January 2006 to January 2009, 216 consecutive patients with thoracic malignant tumors underwent conventional pulmonary function tests (PFT, spirometry + DLCOsb for diffusion capacity) and cardiopulmonary exercise test (CPET) preoperatively. The correlation of postoperative cardiopulmonary complications with the parameters of PFT and CPET were retrospectively analyzed using Chi-square test, independent sample t-test and logistic regression analysis. The P value < 0.05 was considered as statistically significant.</p><p><b>RESULTS</b>Of the 216 patients, 57 did not receive operation due to advanced stage diseases or poor cardiopulmonary function in most of them. The remaining 159 underwent different modes of operations. Thirty-six patients (22.6%) in this operated group had postoperative cardiopulmonary complications and 10 patients (6.3%) developed operation-related complications. Three patients (1.9%) died of the complications within 30 days postoperatively. The patients were stratified into groups based on V(O(2)) max/pred (≥ 65.0%, < 65.0%); V(O(2)) max×kg(-1)×min(-1) (≥ 20 ml, 15 - 19.9 ml, < 15 ml) and FEV1 (≥ 2.0 L, 1.2 - 1.99 L, < 1.2 L) according to the criteria in reported papers. There was statistically significant difference among these groups in the parameters (P < 0.05), the rates of postoperative cardiopulmonary complications were much higher in the groups with poor cardiopulmonary function (V(O(2)) max/pred < 65.0%; V(O(2)) max×kg(-1)×min(-1) < 15 ml or FEV1 < 1.2 L). It was shown by logistic regression analysis that postoperative cardiopulmonary complications were significantly correlated with age, associated diseases, poor results of PFT or CPET, operation modes and operation-related complications.</p><p><b>CONCLUSIONS</b>FEV1 in spirometry, V(O(2)) max×kg(-1)×min(-1) and V(O(2)) max/pred in cardiopulmonary exercise test can be used to stratify the patients' cardiopulmonary function status and is correlated well with FEV1. V(O(2)) max×kg(-1)×min(-1) is the best parameter among these three parameters to predict the risk of postoperative cardiopulmonary complications in patients with chest malignant tumors and borderline cardiopulmonary function.</p>

Comparison of the results of lymph node dissection via left versus right thoracotomy / 中华肿瘤杂志

<p><b>OBJECTIVE</b>Up to now surgical treatment has been still the most effective treatment for esophageal cancer. However, postoperative lymph node recurrence is still a frequent event and affects long term survival considerably. The aim of this study is to compare the results of lymph node dissection via left vs. right thoracotomies and to verify whether there is any essential difference in lymphadenectomy between these two approaches.</p><p><b>METHODS</b>Five hundred and fifty-nine cases with thoracic esophageal cancer were randomly selected from the database of esophageal cancer patients who underwent surgical treatment in our hospital between May 2005 and January 2011, including 282 cases through left thoracotomy and 277 cases through right thoracotomy. This series consisted of 449 males and 110 females with a mean age of 58.8 years (age range: 36 - 78 years). The pathological types were mainly squamous cell carcinoma (548 cases) and other rare types (11 cases). The data were analyzed and compared using Chi-square test. The P-value < 0.05 was considered as statistically significant. The actual 5-year survival rate was calculated based on the recent follow-up data of the patients who underwent surgery at least 5 years ago.</p><p><b>RESULTS</b>The average number of dissected lymph nodes was 23.4 via left versus 24.6 via right thoracotomies. The overall lymph node metastasis rate was 48.9% via left thoracotomy and 53.8% via right thoracotomy, and 34.8% vs. 50.5% in the chest (P < 0.001), 29.1% vs. 17.7% in the abdomen (P = 0.001). The pathologically confirmed lymph node metastasis rate was 45.9%, 44.0% and 34.9% in the upper, middle and lower segments of thoracic esophagus, respectively. The lymph node metastasis rates detected via left and right thoracotomy in the stage T1 cases were 14.7% (5/34) vs. 42.9% (12/28) (P < 0.001), and in the stage T2 cases were 35.4% (17/48) vs. 52.8% (28/53) (P = 0.007); in the station of para-thoracic esophagus were 9.6% vs. 13.4%, in the left upper mediastinum were 2.1% vs. 7.6%, and in the right upper mediastinum were 1.4% vs. 26.0%, respectively. The preliminary actual 5-year survival rate was 38.2% in the cases via left thoracotomy vs. 42.1% in those via right thoracotomy.</p><p><b>CONCLUSIONS</b>The results of this study demonstrate that lymph node dissection is more complete via right thoracotomy than via left thoracotomy, especially for the tracheoesophageal groove and para-recurrent laryngeal nerve nodes, which may eventually improve the survival of patients with esophageal cancer. Therefore, surgical treatment via right thoracotomy by Ivor-Lewis (two incisions) mode or Levis-Tanner (three incisions) mode with two-field or three-field complete lymph node dissection may become prevalent in the future.</p>

Surgical treatment and prognostic analysis of 109 patients with primary esophageal small cell carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>Since the principles of treatment of primary esophageal small cell carcinoma (PESCC) remain still in controversy, the aim of this study was to investigate the clinical characteristics, treatment modalities and prognostic factors of this malignancy.</p><p><b>METHODS</b>The clinical data of 109 patients treated by surgery in our hospital between October 1989 and April 2009 were retrospectively reviewed and analyzed. According to the most recently published TNM staging system for esophageal cancer (AJCC 2009), there were 17 patients in stage Ib, 31 patients in stage II, 59 patients in stage III, and 2 patients in stage IV. All the data were analyzed using SPSS 15.0 software. The median survival time (MST) and overall survival rate (OS) were calculated and compared by the Kaplan-Meier method and log-rank test. The prognostic factors were calculated by Cox hazard regression model.</p><p><b>RESULTS</b>Among all the 109 patients included, 93 patients were treated by radical esophagectomy, and 11 patients by palliative resection, while 5 patients by exploration. The median survival time (MST) of the whole group was 14.4 months and the 1-, 3- and 5-year overall survival rates (OS) were 56.9%, 17.6%, and 12.0%, respectively. The median survival time (MST) and 5-year overall survival rates (OS) were 18.5 months and 21.4% for pathological N0 cases, 23.5 months and 24.0% for N1 cases, 8.5 months and 0% for N2 cases, and 10.5 months and 0% for N3 cases, respectively (P < 0.001). The MST and 1-, 3- and 5-year OS of patients treated with postoperative chemotherapy were 17.0 months, 60.7%, 19.8%, and 13.0%, respectively, statistically significantly longer than the 7.0 months, 28.5%, 8.9% and 8.9%, respectively, of the patients without chemotherapy (P = 0.005). The pathological N stage and postoperative chemotherapy were independent prognostic factors by Cox multivariate analysis.</p><p><b>CONCLUSIONS</b>Primary esophageal small cell carcinoma is an aggressive systemic disease, characterized by early and wide dissemination of lymph nodes and poor prognosis while treated with surgery or chemotherapy alone. Multimodality treatment based on radical esophagectomy should be recommended for patients in pathological stage I and II.</p>

Clinical manifestation and prognosis of the surgical treatment of esophageal carcinosarcoma / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical characteristics and prognostic factors of esophageal carcinosarcoma.</p><p><b>METHODS</b>The clinical data of patients treated by surgery and pathologically diagnosed as esophageal carcinosarcoma between January 1967 and December 2008 were retrospectively reviewed. There were 28 male and 4 female patients aged from 39 to 76 years with a median age of 58 years. All the data were analyzed using SPSS 15.0 software. The overall survival rates were calculated and compared with the Kaplan-Meier method and the Log-rank test. The prognostic factors were identified by Cox hazard regression model.</p><p><b>RESULTS</b>Among all the 32 patients included, 29 patients were polypoid type, 2 patients were fungoid type and 1 patient were medullary type. With regard to the depth of tumor infiltration, 17 patients involved the mucosa or submucosa (pT1), 13 patients involved the muscularis propria (pT2), 2 patients involved the adventitia (pT3). The involvement of local lymph nodes was present in 10 patients, with an incidence of 31.3%, including metastatic carcinoma alone in 7 patients and both carcinomatous and sarcomatous components in 3 patients. According to the most recently published international TNM staging system for esophageal carcinoma (AJCC 2009), 15 patients were in stage I, 13 patients in stage II, 4 patients in stage III. The 1-, 3- and 5-year overall survival rates of the whole group were 90.0%, 72.1% and 57.0%, respectively. Both in single-factor prognostic analysis and in Cox multivariate analysis, pathological N stage was the only prognostic factor (RR = 2.531, 95%CI: 1.055 - 6.070).</p><p><b>CONCLUSIONS</b>Esophageal carcinosarcoma is consisted of both sarcomatous component and carcinomatous component, while the latter one appears more frequently in local lymph node metastasis. In multivariate prognostic analysis, pathological N stage is the only independent prognostic factor. Curative resection of this tumor may achieve good prognosis because of its' lower incidence of lymph node metastasis and less invasive tendency.</p>

Cardiopulmonary exercise testing in the evaluation of high risk patients with lung cancer / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>It is still unclear whether pulmonary function tests (PFTs) are sufficient for predicting perioperative risk, and whether all patients or only a subset of them need a cardiopulmonary exercise test (CPET) for further assessment. Thus, this study was designed to evaluate the CPET and compare the results of CPET and conventional PFTs to identify which parameters are more reliable and valuable in predicting perioperative risks for high risk patients with lung cancer.</p><p><b>METHODS</b>From January 2005 to August 2008, 297 consecutive lung cancer patients underwent conventional PFTs (spirometry + single-breath carbon monoxide diffusing capacity of the lungs (DLCOsb) for diffusion capacity) and CPET preoperatively. The correlation of postoperative cardiopulmonary complications with the parameters of PFT and CPET was retrospectively analyzed using the chi-square test, independent sample t test and binary Logistic regression analysis.</p><p><b>RESULTS</b>Of the 297 patients, 78 did not receive operation due to advanced disease stage or poor cardiopulmonary function. The remaining 219 underwent different modes of operations. Twenty-one cases were excluded from this study due to exploration alone (15 cases) and operation-related complications (6 cases). Thus, 198 cases were eligible for evaluation. Fifty of the 198 patients (25.2%) had postoperative cardiopulmonary complications. Three patients (1.5%) died of complications within 30 postoperative days. The patients were stratified into groups based on VO(2)max/pred (≥ 70.0%, < 70.0%); VO(2)max×kg(-1)×min(-1) (≥ 20.0 ml, 15.0 - 19.9 ml, < 15.0 ml) and FEV1 (≥ 2.0 L, 1.2 - 1.99 L, < 1.2 L), respectively. The rate of postoperative cardiopulmonary complications was significantly higher in the group with VO(2)max/pred< 70.0% or VO(2)max×kg(-1)×min(-1) < 15.0 ml or FEV1 < 1.2 L than that in the group with VO(2)max/pred ≥ 70.0% or VO(2)max×kg(-1)×min(-1) ≥ 15.0 ml or FEV1 ≥ 1.2 L, respectively. Logistic regression analysis revealed that postoperative cardiopulmonary complications were significantly correlated with age, comorbidities, and poor PFT and CPET results.</p><p><b>CONCLUSIONS</b>FEV1 in spirometry, VO(2)max×kg(-1)×min(-1) and VO(2)max/pred in cardiopulmonary exercise tests can all be used to stratify the patients' cardiopulmonary function status and to predict the risk of postoperative cardiopulmonary complications for the high risk patients with lung cancer. FEV1 and VO(2)max×kg(-1)×min(-1) are better than VO(2)max/pred in predicting perioperative risk. If available, cardiopulmonary exercise testing is strongly suggested for high-risk lung cancer patients in addition to conventional pulmonary function tests, and both should be combined to assess cardiopulmonary function status.</p>

Effects of phytoestrogens on testosterone production of rat Leydig cells / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the effects of phytoestrogens (daidzein and genistein) on the testosterone production of rat Leydig cells and the possible mechanisms.</p><p><b>METHODS</b>Primary Leydig cells were obtained from 3-month old male SD rats using discontinuous Percoll density gradient centrifugation. The effects of phytoestrogens at various concentrations were evaluated by ELISA, with hCG as the positive control. The mRNA expression of P450 side-chain cleavage enzyme (P450scc) was analyzed by semi-quantitative RT-PCR.</p><p><b>RESULTS</b>Genistein at 0.1 micromol/L obviously promoted the secretion of testosterone and upregulated the mRNA level of P450scc. At a higher concentration of 5 micromol/L, however, both daidzein and genistein significantly inhibited the testosterone production of Leydig cells (P > 0.05).</p><p><b>CONCLUSION</b>Genistein can promote the testosterone production of Leydig cells at a low concentration (0.1 micromol/L), but both daidzein and genistein can inhibit it at a higher concentration ( >5 micromol/L).</p>

High-performance capillary electrophoresis for determining the chemical compositions of Gegen and Fenge extracts / 南方医科大学学报

<p><b>OBJECTIVE</b>To develop a method for analyzing the chemical compositions of Gegen and Fenge extracts using high-performance capillary electrophoresis (HPCE).</p><p><b>METHODS</b>Using HPCE/DAD, the chemical composition of the extracts was analyzed with the buffer solution of 40 mmol/L borax containing 16.7% methanol, with injection pressure at 137.9 kPa for 5 s, separation voltage at 25 kV in 0-5 min time range and at 22 kV in 5-25 min time range, and the temperature of the capillary of 20 degrees celsius.</p><p><b>RESULTS AND CONCLUSION</b>The method for analysis of Gegen and Fenge extracts was established, which identified puerarin and daidzein as the two major components. This simple and rapid analysis method can be used for Gegen and Fenge extract fingerprinting.</p>

Experimental studies on antitussive, expectorant and antiasthmatic effects of extract from Citrus grandis var. tomentosa / 中国中药杂志

<p><b>OBJECTIVE</b>To observe the antitussive, expectorant and antiashmatic effects of the extract from Citrus grandist var. tomentosa.</p><p><b>METHOD</b>The cough models induced by ammonia liquor in mice and citric acid in guines pigs were used to observe the antitussive effects. The methods of phenel red execretion in mice and phlegm displacement of rats were used to investigate the expectorant effects. Bronchial asthma model induced by histamine-acetylcholine in guinea pigs was used to observe the antiasthmatic effects.</p><p><b>RESULT</b>The extract from the title plant could inhibit the cough induced by ammonia in mice, decrease the frequency of cough induced by citric acid in guineas pig and prolong the latent period of cough. The extract also could obviously increase phenol red output of trachea in mice, promote expectoration in rats and prolong the latent period of asthma induced by histamine-acetylcholine in guinea pigs.</p><p><b>CONCLUSION</b>The extract from C. grandis var. tomenfosa has significant antitussive, expectorant and antiasthmatic effects.</p>

TME or TSD with pelvic autonomic nerve preserving operation for 247 patients with advanced rectal cancer / 肿瘤研究与临床

Objective To investigate effects of rectal cancer to undergo total mesorectal excision (TME)or three space dissection(TSD)with pelvic autonomic nerve preservation(PANP).Methods TME or/ and TSD was applied in 247 Patients with advanced rectal cancer in which 185 cases (74.9 %) underwent PANP(Group P)including TME-PANP(Group Pro)139 cases and TSD-PANP(Group Ps)46 cases.The other 62 cases underwent none-PANP(Group P-)due to tumor invasion.Results There were no death cases for operation inall patients.Group Pm was better than Group Ps in the operation time and the difficulty of proce- dure(P0.05).Conclusion The procedure with TME to preserve pelvic autonomic nerves adapts to the majority of rectal cancer patients.TSD procedure is more complex than TME.Statistically,the survival differ- ence between Patients with TSD and with TME is no defective.The survival time is determined to the tumor's earlier diagnosis and therapy.

Comparison of clinical and surgico-pathological TNM stage of 2007 lung cancer patients / 中华肿瘤杂志

<p><b>OBJECTIVE</b>An accurate clinical TNM staging of lung cancer is essential for the precise determination of the extent of the disease in order that an optimal therapeutic strategy can be planned. This is especially true in patients with marginally resectable tumors. Clinical over-staging of the disease may deny a patient the benefit of surgery, whereas under-staging may oblige a patient to accept a fruitless or even harmful surgery. We aimed to analyze preoperative clinical (c-TNM) and postoperative surgico-pathologic staging (p-TNM) of lung cancer patients in order to evaluate the accuracy of our clinical staging and its implications on the surgical strategy for lung cancer.</p><p><b>METHODS</b>We did a retrospective comparison of c-TNM and p-TNM staging of 2007 patients with lung cancer surgically treated from January 1999 to May 2003. Preoperative evaluation and c-TNM staging of all patients were based on physical examination, laboratory studies, routine chest X-ray and CT scan of the chest and upper abdomen. Other examinations included sputum cytology, bronchoscopy, abdominal ultrasonography, bone scintiscan, brain CT/MRI, and mediastinoscopy whenever indicated.</p><p><b>RESULTS</b>In the present study the comparison of c-TNM and p-TNM staging of 2007 patients with lung cancer revealed an overall concurrence rate of only 39.0%. In the entire series the extent of disease was clinically underestimated in 45.2% and overestimated in 15.8% of the patients. Among all c-TNM stages the c-IA/B stage of 1105 patients gave the highest rate (55.2%) of underestimating the extent of disease. Clinical staging of T subsets was relatively easy with an overall accuracy rate of 72.9%, while that of N subsets was relatively more difficult with an overall accuracy rate of 53.5%. Analysis also showed that c-IV stage may not be an absolute contraindication to surgery, because in half of the patients, c-M1 turned out to be p-M0, providing the possibility of resectional surgery depending on the status of T and N.</p><p><b>CONCLUSION</b>For reasons to be further determined, the present preoperative clinical TNM staging of lung cancer remains a crude evaluation. Further efforts to improve its accuracy are needed.</p>

Diagnosis and surgical treatment of metachronous second primary lung cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To review the experience of the diagnosis, surgical treatment and prognosis of metachronous second primary lung cancers.</p><p><b>METHODS</b>Between January 1983 and April 2004, 32 patients with metachronous second primary lung cancers were operated in our department. Clinical data of all these patients were reviewed retrospectively.</p><p><b>RESULTS</b>The initial procedures for their first primary lung cancers were lobectomy or pneumonectomy. Lobectomy or completion pneumonectomy for the second primary lung cancers were performed in 17 cases, limited pulmonary resection was done in 14 cases and exploration was in 1 case. The postoperative morbidity and mortality were 12% (4/32) and 3% (1/32), respectively. The 1-, 3-, and 5-year survival rate after second operation were 66% (19/29), 32% (9/28) and 19% (4/21), respectively.</p><p><b>CONCLUSIONS</b>The incidence of metachronous second primary lung cancers has been increasing gradually during recent years. The closely follow-up for patients undergoing resection for their first primary lung cancers is most important factor for improvement of the diagnosis of metachronous second primary lung cancers. Limited resection and incomplete lymph node dissection might be the factors contributing to the poor prognosis.</p>