Effect of small interfering RNA-mediated BIRC6 silencing on apoptosis and autophagy of renal cancer 786-O cells / 南方医科大学学报

OBJECTIVE@#To study the expression of BIRC6 in renal cancer tissues and investigate the effect of BIRC6 silencing on apoptosis and autophagy of 786-O cells.@*METHODS@#Twenty surgical specimens of renal cancer tissues and adjacent renal tissues were collected from Meizhou People's Hospital between February, 2016 and December, 2018 for detection of BIRC6 protein expression using immunohistochemistry. Renal cancer 786-O cells were transfected with a control small interfering RNA (siRNA) or BIRC6 siRNA @*RESULTS@#The expression of BIRC6 protein was significantly higher in renal cancer tissues than in the adjacent renal tissues. Western blotting showed that siRNA-mediated silencing of BIRC6 significantly lowered the expression of BIRC6 in 786-O cells. In the cells with BIRC6 silencing, treatment with 12.5, 25, 50, 100 and 200 μg/mL 5-FU resulted in significantly higher proliferation inhibition rates than in the cells transfected with the control siRNA (@*CONCLUSIONS@#Interference of BIRC6 mediated by siRNA can inhibit autophagy and promote 5-FU-induced apoptosis to enhance the sensitivity of 786-O cells to 5-FU.

Switch from prednisone to dexamethasone in metastatic castration-resistant prostate cancer patients progressing on abiraterone plus prednisone / 中华泌尿外科杂志

Objective:To evaluate the efficacy and safety of switch from prednisone (AA+ P) to dexamethasone (AA+ D) in metastatic castration-resistant prostate cancer patients (mCRPC) progressing on abiraterone plus prednisone.Methods:Between November 2016 and December 2019, 46 mCRPC patients were switched to AA+ D after progression on AA+ P at Sun Yet-sen University Cancer center. Median age was 72 years(50 to 89 years), with median androgen deprivation therapy (ADT) duration 14.6 months(2.1 to 168.5 months). PSA level at the time of diagnosis, the initiation of AA+ P treatment, the time of switch were 258.9 ng/ml, 56.6 ng/ml, 25.1 ng/ml, respectively. 42 (91.3%), 12(26.1%), 7(15.2%) patients had bone metastasis, lymph node metastasis, visceral metastasis, respectively. 28 patients had Gleason score ≥8, and 11 patients had Gleason score<8. The primary endpoint was progression free-survival (PFS). Secondary endpoints included PSA response rate of PSA decline ≥50% and ≥30% and safety. Patients were divided into different risk level groups according to PSA level at the time of switch and PFS on AA+ P.Results:The median follow-up of 46 patients was 4.9 months, 40 patients progressed at the last follow-up, the treatment was terminated in 1 patient because of cerebral infarction, 5 patients were still on the treatment of AA+ D. Median PFS on AA+ D of 46 patients was 3.7 (1.6-24.1) months. A total of 12 (26.1%) patients showed a PSA decline≥50% after treatment with AA+ D, and 21 (45.7%) patients showed a PSA decline ≥30%. The median PFS was 8.5 (2.7-24.1) and 3.0 (1.6-17.8) months for patients with PSA decline≥50% and PSA didn’t decline ≥50%, respectively. Four factors below were significantly associated with a longer PFS on AA+ D after steroid switch in univariate analysis: lower PSA level at the time of switch (<30 ng/ml, HR=0.30, 95% CI 0.14-0.64, P=0.002), longer ADT sensitivity duration (≥18 months, HR=0.55, 95% CI 0.28-1.06, P=0.045), longer AA+ P treatment PFS (≥8 months, HR=0.36, 95% CI 0.18-0.72, P=0.004), and greater PSA decline on AA+ D (≥50%, HR=0.30, 95% CI 0.17-0.75, P=0.007). The above mentioned factors were also independent prognostic factors associated with better PFS on AA+ D after steroid switch in multivariate analysis. Treatment with AA+ D was well tolerated in all patients, with no grade 3/4 toxicity reported. Conclusions:Switching from prednisone to dexamethasone is effective and safe in mCRPC patients progressing on abiraterone plus prednisone. Patients with lower PSA level at the time of switch, longer ADT sensitivity duration, longer AA+ P treatment PFS and greater PSA decline on AA+ D might gain better efficacy.

Factors predicting 2014 ISUP pathology grade upgrading from prostate biopsy to radical prostatectomy pathology / 中华泌尿外科杂志

Objective To investigate the risk factors predicting pathology grade upgrading after radical prostatectomy using the 2014 International Society of Urologic Pathology (ISUP) grading system.Methods A total of 205 patients who underwent biopsy and radical prostatectomy from January 2017 to December 2018 were reviewed retrospectively.The median and range of the patients' age,PSA level,prostate volume,number of biopsy core examined,Gleason score and ISUP grade were 66 (45-81) years old,17.16(0.89-1254.00)ng/ml,36.4(4.1-152.1) rnl,10(1-15),7(6-10),and 3(1-5) respectively.The patients were divided into group of upgrading ISUP grade and group without upgrading ISUP grade.Multivariate Logistic regression analysis and receiving operating characteristic curve analysis were performed to identify predictors of ISUP upgrading and determine the optimal cut off value respectively.Result The median and range of Gleason score and ISUP grade after radical prostatectomy were 7 (6-10),and 3 (1-5) respectively.The radical prostatectomy ISUP grade upgraded in 73 (35.6％) out of 205 cases when compared with biopsy ISUP grade.Radical prostatectomy ISUP grades were concordant in 91 cases (44.4％) and downgraded in 41 cases(20.0％).Of 101 with biopsy ISUP grades less than or equal to 2,the ISUP grade of radical prostatectomy upgraded in 58 cases (57.4％),while radical prostatectomy ISUP grade upgraded in only 18 (26.9％) of 67 patients with biopsy ISUP grades of 3 or 4.Biopsy ISUP grades represent an independent predictor for ISUP grade upgrading after radical prostatectomy (OR =0.496,P ＜ 0.001).Conclusion Patients with biopsy ISUP grades less than or equal to 2 are at great risk of ISUP grade upgrading after radical prostatectomy.

Characteristics of acute myocardial infarction caused by spontaneous coronary artery dissection in young female patients / 中华心血管病杂志

Objective@#To investigate the characteristics of acute myocardial infarction caused by spontaneous coronary artery dissection(SCAD) in young female patients. @*Methods@#In this casecontrolstudy,127 young(≤55 years) female patients with acute myocardial infarction onset within 1 week in Nanjing first hospital, Xuzhou central hospital, affiliated hospital of Xuzhou medical university, and Lianyungang first people's hospital were enrolled between January 2013 and February 2017,and the clinical data were retrospectively analyzed. According to their clinical manifestations and coronary angiography(CAG) results,the patients were divided into coronary atherosclerosis disease(CAD) group(CAG evidenced atherosclerosis, n=83) and SCAD group(CAG detected coronary artery dissection,n=44).The SCAD patients were subdivided into definite group (the results affirmed from intravenous ultrasound or optical coherence tomography, n=21) and probable group (the CAG results highly confirmed to characteristics of SCAD,but no intravenous ultrasound or optical coherence tomography image affirmation,n=23). Then, according to the different treatment strategies, the SCAD patients were subdivided into conservative treatment group(treated with drugs,n=19) and interventional therapy group(treated with percutaneous coronary intervention,n=25). @*Results@#(1)Compared to CAD group, patients in the SCAD group had less risk factors, such as hypertension history (25.0% (11/44) vs. 45.8% (38/83) , P=0.022) and diabetes history (6.8% (3/44) vs. 21.7% (18/83) , P=0.043),and had lower levels of fasting blood glucose (5.34(4.59,5.87) mmol/L vs. 7.12(5.18,8.60)mmol/L, P=0.001),total cholesterol((3.94±1.14) mmol/L vs. (4.91±1.50) mmol/L, P=0.001),triglyceride(1.42 (0.91,1.64) mmol/L vs. 1.89 (1.23,2.45) mmol/L, P=0.005),and low density lipoprotein cholesterol ((2.24±0.91) mmol/L vs. (2.94±1.16) mmol/L, P=0.001),CAG results showed that patients in the SCAD group had more single vessel lesion (88.6% (39/44) vs. 39.8% (33/83) , P=0.001), and their target lesion stenosis was less severe ( (79.2±22.4) % vs. (91.5±12.1) %, P=0.001). (2) The clinical risk factors such as hypertension history, diabetes history, smoking history, family history of cardiology disease, fasting blood glucose,total cholesterol,triglyceride and low density lipoprotein cholesterol were similar between definite group and probable group (all P>0.05). CAG results showed that prevalence of single vessel lesion (100% (21/21) vs. 78.3% (18/23) , P=0.050) and percent of target lesion stenosis ( (76.9±20.6) % vs. (81.2±24.1) %, P=0.529) were similar between definite group and probable group.(3)There were no significant difference in single vessel(84.0% (21/25) vs. 94.7% (18/19) , P=0.370), target lesion stenosis(85.0(70.0,100.0)% vs. 75.0(50.0,90.0)%, P=0.186),and survival rates in hospital(96.0% (24/25) vs. 100% (19/19) , P=1.000) between interventional therapy group and conservative treatment group.@*Conclusions@#Prevalence of SCAD is highin young female patients with acute myocardial infarction. Acute myocardial infarction patients with less risk factors of CAD and with CAG showing smooth lesion of narrowing segment and normal finding in the other vessels, are more likely to be diagnosed with SCAD.Acute myocardial infarction patients caused by SCAD have high survival rate either receiving percutaneous coronary intervention or drug treatment.

Laparoscopic ultrasonography in difficult place right laparoscopic hepatectomy / 中华普通外科杂志

Objective To evaluate the role of laparoscopic ultrasonography (LUS) in difficult place laparoscopic hepatectomy of the right liver.Methods The data of 7 patients undergoing laparoscopic hepatectomy with tumor in the difficult location of the right liver in our hospital between Jun 2015 and Aug 2017 were retrospectively analyzed.LUS was used during all the operations in order to investigate the anatomy of the operations,determine the tumor stage and guide the incision margin of tumor.It was conventionally used to detect the relationship between the lesions and peripheral intrahepatic vessels and ducts.Results Seven cases underwent successful laparoscopic hepatectomy.The mean operative time was (121 ± 50) min,average intraoperative blood loss was (301 ± 122) ml,and there was no operative mortality.Mean hospital stay was (7.1 ± 1.2) d.One suffered biliary leakage and was cured by conservative treatment.Conclusions Laparoscopic ultrasound can determine tumor location and guide the operative route,increasing safety of laparoscopic hepatectomy.

Surgical site infection following abdominal surgery in China: a multicenter cross-sectional study / 中华胃肠外科杂志

OBJECTIVE@#To determine the incidence of surgical site infection (SSI) after abdominal surgery and to further evaluate the related risk factors of SSI in China.@*METHODS@#The multicenter cross-sectional study collected clinical data of all adult patients who underwent abdominal surgery from May 1, 2018 to May 31, 2018 in 30 domestic hospitals, including basic information, perioperative parameters, and incisional microbial culture results. The primary outcome was the incidence of SSI within postoperative 30 days. SSI was classified into superficial incision infection, deep incision infection, and organ/gap infection according to the US Centers for Disease Control and Prevention (CDC) criteria. The secondary outcome variables were ICU stay, postoperative hospital stay, total hospital stay, 30-day mortality and treatment costs. Multivariate logistic regression was used to analyze the risk factors of SSI.@*RESULTS@#A total of 1666 patients were enrolled in the study, including 263 cases of East War Zone Hospital of PLA, 140 cases of Affiliated Hospital of Qingdao University, 108 cases of The First Affiliated Hospital of Nanchang University, 87 cases of Central War Zone Hospital of PLA, 77 cases of West China Hospital, 74 cases of Guangdong General Hospital, 71 cases of Chenzhou First People's Hospital, 71 cases of Zigong First People's Hospital, 64 cases of Zhangjiagang First People's Hospital, 56 cases of Nanyang City Central Hospital, 56 cases of Lanzhou General Hospital of Lanzhou Military Command, 56 cases of Shandong Provincial Hospital, 52 cases of Shangqiu First People's Hospital, 52 cases of People's Hospital of Xinjiang Uygur Autonomous Region, 48 cases of The Second Xiangya Hospital of Central South University, 48 cases of Chinese PLA General Hospital, 44 cases of Affiliated Hospital of Xuzhou Medical University, 38 cases of Hunan Province People's Hospital, 36 cases of Dongguan Kanghua Hospital, 30 cases of Shaoxing Central Hospital, 30 cases of Northern Jiangsu People's Hospital, 29 vases of The First Affiliated Hospital of Zhengzhou University, 27 cases of General Hospital of Tianjin Medical University, 22 cases of Zigong Fourth People's Hospital, 21 cases of The Second Hospital of University of South China, 18 cases of Tongji Hospital, 15 cases of Nanchong Central Hospital, 12 cases of The 901th Hospital of PLA, 11 cases of Hunan Cancer Hospital, 10 cases of Lanzhou University Second Hospital. There were 1019 males and 647 females with mean age of (56.5±15.3) years old. SSI occurred in 80 patients (4.8%) after operation, including 39 cases of superficial incision infection, 16 cases of deep incision infection, and 25 cases of organ/interstitial infection. Escherichia coli was the main pathogen of SSI, and the positive rate was 32.5% (26/80). Compared with patients without SSI, those with SSI had significantly higher ICU occupancy rate [38.8%(31/80) vs. 13.9%(220/1586), P<0.001], postoperative hospital stay (median 17 days vs. 7 days, P<0.001) and total hospital stay (median 22 days vs. 13 days, P<0.001), and significantly higher cost of treatment (median 75 000 yuan vs. 44 000 yuan, P<0.001). Multivariate analysis showed that male rise(OR=2.110, 95%CI:1.175-3.791, P=0.012), preoperative blood glucose level rise(OR=1.100, 95%CI: 1.012-1.197, P=0.026), operative time (OR=1.006, 95%CI:1.003-1.009, P<0.001) and surgical incision grade (clean-contaminated incision:OR=10.207, 95%CI:1.369-76.120, P=0.023; contaminated incision: OR=10.617, 95%CI:1.298-86.865, P=0.028; infection incision: OR=20.173, 95%CI:1.768-230.121, P=0.016) were risk factors for SSI; and laparoscopic surgery (OR=0.348, 95%CI:0.192-0.631, P=0.001) and mechanical bowel preparation(OR=0.441,95%CI:0.221-0.879, P=0.020) were protective factors for SSI.@*CONCLUSIONS@#The incidence of postoperative SSI in patients with abdominal surgery in China is 4.8%. SSI can significantly increase the medical burden of patients. Preoperative control of blood glucose and mechanical bowel preparation are important measures to prevent SSI.

Association of vitamin D receptor polymorphisms with susceptibility to psoriasis vulgaris and clinical response to calcipotriol in patients with psoriasis vulgaris / 中华皮肤科杂志

Objective To investigate association of vitamin D receptor (VDR) polymorphisms with susceptibility to psoriasis vulgaris and clinical response to calcipotriol in patients with psoriasis vulgaris.Methods A total of 110 patients with psoriasis vulgaris and 183 healthy controls were enrolled into this study,and they were all of Han nationality from Hainan province.Ligase detection reaction (LDR) was conducted to determine the genotypes of VDR gene polymorphisms rs2228570,rs731236,rs1544410 and rs7975232.Single nucleotide polymorphism (SNP)-based association analysis in genotypic and allelic models,and haplotype-based association analysis were then performed.Then,75 patients with psoriasis area and severity index (PASI) scores less than 10 were topically treated with calcipotriol ointment alone.After 6-week treatment,the efficacy of calcipotriol ointment was evaluated,and the correlation between the efficacy and individual genotypes was analyzed.Results The frequency of A allele of rs7975232 in the psoriasis group and control group was 39.09％ and 27.05％ respectively,and the risk of developing psoriasis in rs7975232 A allele carriers was significantly higher than that in non-carriers (OR =1.731,95％ CI:1.213-2.471,P ＜ 0.05).Additionally,the risk of developing psoriasis in individuals with AA genotype (OR =2.404,95％ CI:1.085-5.328,P ＜ 0.05),as well as in individuals with AC genotype (OR =2.143,95％ CI:1.283-3.579,P ＜ 0.05),was significantly higher than that in patients with CC genotype.CTGA haplotype carriers (rs2228570,rs731236,rs1544410,rs7975232,respectively) had significantly higher risk of developing psoriasis compared with non-carriers (OR =1.907,95％ CI:1.132-3.214,P ＜ 0.05).Among 72 patients with mild-to-moderate psoriasis whose PASI scores were less than 10,patients with CC genotype of rs7975232 showed better response to calcipotriol ointment compared with those with AC genotype (OR =3.798,95％ CI:1.061-13.590,P ＜ 0.05) and those with AA genotype (OR =9.667,95％CI:1.556-60.040,P ＜ 0.05).Conclusion VDR polymorphisms are associated with psoriasis susceptibility and clinical response to calcipotriol in patients with psoriasis individuals.

Correlation between serum inflammatory cytokine levels and fibrous cap thickness of fibrofatty plaque in coronary culprit lesions / 中华心血管病杂志

Objective@#To identify the correlation between serum inflammatory cytokine levels including high sensitive C reactive protein (hs-CRP) and lipoprotein associated phospholipase (Lp-PLA2) and the fibrous cap thickness of fibrofatty plaque in coronary culprit lesions.@*Methods@#Clinical data of 117 patients with selective coronary artery angiography diagnosed coronary artery disease admitted to our hospital from January 2015 to January 2016 were retrospective analyzed. According to type of coronary disease, patients were divided into 3 subgroups: SAP group (containing 47 stable angina patients), UAP group (containing 52 unstable angina patients), and NSTEMI group(containing 18 acute non ST segment elevation myocardial infarction patients). Serum hs-CRP and Lp-PLA2 levels were measured before subsequent procedures. The characteristics of the culprit lesions were detected by optical coherence tomogarpgy(OCT) before interventional treatment, and the correlation between hs-CRP and Lp-PLA2 and the fibrous cap thickness of fibrofatty plaque in coronary culprit lesions were analyzed.@*Results@#(1) The serum levels of hs-CRP (2.13(1.04, 4.75)μg/L vs. 1.02(0.60, 1.29)μg/L and 1.30(1.03, 1.96)μg/L, all P<0.05) and Lp-PLA2 ((394.8±61.4)mg/L vs. (140.1±40.4)mg/L and (284.5±93.6)mg/L, all P<0.05) were significantly higher in NSTEMI group than in SAP group and UAP group, and serum levels of hs-CRP and Lp-PLA2 were significantly higher in UAP group than in SAP group (all P<0.05). (2)The fibrous cap thickness of fibrofatty plaque in coronary culprit lesions were smaller in NSTEMI group and UAP group than in SAP group(50(50, 60)μm and 60(50, 90)μm vs. 130(80, 190)μm, all P<0.05), and there was no significantly difference between NSTEMI group and UAP group(P>0.05). Proportion of thin-cap fibroatheroma plaque(82.35%(14/18) vs. 19.15%(9/47) and 63.46%(33/52), all P<0.05), plaque rupture(55.56%(10/18)vs. 6.38%(3/47) and 28.85%(15/52), all P<0.05) and thrombosis(33.33%(6/18) vs. 4.26%(2/47) and 9.26%(5/52), all P<0.05) were significantly higher in NSTEMI group than in SAP group and UAP group. Proportion of calcifiacation in plaque was lower in NSTEMI group than in SAP group (11.11%(2/18)vs. 42.55%(20/47), P<0.05), and there was no significantly difference between NSTEMI group and UAP group(P>0.05). (3) Pearson correlation analysis showed that serum levels of hs-CRP(r=-0.233, P<0.05) and Lp-PLA2(r=-0.465, P<0.01)were negatively correlated with fibrous cap thickness of fibrofatty plaques. Spearman correlation analysis showed that serum levels of hs-CRP were positively correlated with plaque rupture(r=0.409, P<0.01) and thrombosis (r=0.227, P<0.05), and serum levels of Lp-PLA2 were also positively correlated with plaque rupture(r=0.499, P<0.01) and thrombosis(r=0.263, P<0.01). (4)Multiple logistic regression analysis showed that serum levels of Lp-PLA2 at baseline was independently related to thin-cap fibroatheroma plaque(OR=1.017, P<0.01).@*Conclusions@#The serum levels of hs-CRP and Lp-PLA2 in NSTEMI patients are much higher than that in SAP and UAP patients, higher in UAP patients than in SAP patients. Prevalence of thin-cap fibroatheroma plaque, plaque rupture and thrombosis was significantly higher in the NSTEMI patients, while the prevalence of calcification in plaque is more often in SAP patients. Increased serum levels of Lp-PLA2 are independent risk factor of thin-cap fibroatheroma plaque formation.

Preoperative evaluation of multi-slice spiral computed tomography angiography in laparoscopic radical operation for colorectal carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical application of 256 multi-slice spiral computed tomography angiography (MSCTA) technique in the preoperative evaluation of mesenteric angiography in order to provide a reference to vessel anatomy and dissociation in laparoscopic radical operation for colorectal carcinoma.</p><p><b>METHODS</b>Clinical data of 50 patients with colorectal cancer who underwent preoperative MSCTA+FDCT and laparoscopic curative operation at our hospital from October 2013 to March 2015 were collected (MSCTA group). The evaluation item was visualization of mesenteric artery, which was compared with the findings under laparoscopic surgery. Meanwhile, another 50 colorectal cancer patients undergoing laparoscopic radical operation by the same surgeon team without preoperative MSCTA examination were used as control(control group). Clinical data were compared between the two groups.</p><p><b>RESULTS</b>MSCTA precisely and correctly demonstrated anatomy and variations of the mesenteric artery and relative nutrient vessel in carcinoma. The angiography reconstruction images were consistent with the visual anatomy and variation from laparoscopic findings, whose diagnostic conformity rate of 100%. As compared to control group, operative time was shorter [(195.0±23.2) minutes vs.(218.0±19.6) minutes, t=8.326, P=0.015], and blood loss was less[(168.1±18.8) ml vs. (206.5±14.3) ml, t=-19.369, P=0.002] in MSCTA group. Differences of number of harvested lymph node, postoperative complication morbidity, postoperative hospital stay and hospitalization cost were not significant between two groups(all P>0.05).</p><p><b>CONCLUSION</b>Preoperative MSCTA can demonstrate anatomy and variations of the mesenteric artery precisely and correctly, thus it is beneficial to shorten the operation time and to reduce blood loss.</p>

Study of relationship between myocardial infarction size and left ventricular torsion by speckle tracking imaging / 中华超声影像学杂志

Objective To investigate the most sensitive markers of left ventricular(LV) torsion which can reflect infarct size by assessing the relationship between routine markers of LV torsion and infarct size using speckle tracking imaging (STI).Methods Fifteen open-chest pigs underwent 120 minutes of left anterior descending (LAD) ligation followed by 12 hours of reperfusion.Rotation and torsion of LV were obtained by STI before LAD occlusion,LAD occlusion immediately,and 30,60,90 minutes and 12 hours after reperfusion.Infarct size was measured by nitrotetrazolium blue chloride staining.Results LAD ligation resulted in a dramatic decrease in both subepicardial and subendocardial peak apical rotation or peak LV torsion.Twelve hours after reperfusion,all of the peak rotation and torsion remained significantly reduced (P ＜ 0.01 versus AMI).At AMI,peak bulk LV torsion and peak bulk apical rotation inversely correlated with infarct size (r = - 0.81,P ＜0.01; r = - 0.69,P ＜0.01).There existed the good relationship at 12-hour follow-up after reperfusion.The relationship was superior to that of other torsion markers.Conclusions Peak bulk LV torsion and peak bulk apical rotation are the most sensitive markers of LV torsion which can reflect infarct size.

Alternations of left ventricular torsion of myocardial ischemia before and after reperfusion assessed by speckletracking imaging / 中华超声影像学杂志

ObjectiveTo evaluate the alternations of left ventricular (LV) torsion of myocardial ischemia before and after reperfusion using speckle tracking imaging (STI).MethodsFourteen open-chest pigs underwent randomizedly 1 minute (group A) or 15 minutes (group B) of left anterior descending (LAD) ligation and followed up for 1 week.Torsion of LV in both groups were quantified by STI before LAD occlusion,LAD occlusion immediately,and 1-,5-,30-,60-,90-minute and 1-week after reperfusion.ResultsOne minute after reflow,decreased peak apical rotation and peak LV torsion fully recovered in the inner layer in group A.In contrast,there was a brief resumption in group B during 30min after reflow from (6.5 ± 0.8)° to (3.4 ± 1.2)°( P ＜0.01 ) and from (7.8 ± 1.0)° to (6.1 ± 1.1 ) ° ( P ＜0.01 ),respectively.Peak LV subepicardial torsion increased gradually after reperfusion.Conclusions As a result of various durations of ischemia,peak torsion in subendocardium and subepicardium change differently before and after reflow.STI may be suitable for evaluation of the extent of ischemia by noninvasive quantification of torsion in subendocardium and subepicardium.Therefore,duration of assessment of myocardial ischemia can be prolonged.

Assessment of endocardial and epicardial rotation of left ventricle in patients with acute myocardial infarction before and after revascularization by speckle tracking imaging / 中华超声影像学杂志

Objective To evaluate peak rotation in the endocardium(endo)and epicardium(epi)and peak mural torsion in patients with anterior wall acute myocardial infarction(AMI)before and after revascularization by speckle tracking imaging(STI).Methods The study comprised 20 normal controls and 21 consecutive xpatients with a first-episode anterior wall AMI with stenosis of the left anterior descending artery.All patients underwent Successful percutaneous coronary intervention within 12h onset of AMI.During one month, two patients were ruled OUt because one died of heart failure and the other suffered from persistent atrial fibrillation.Conventional echocardiography and STI were performed in normal controls and AMI patients before and one month after revascularization.Results In the left ventricle(LV)apical and basal level,peak endo-and epi-rotation and peak mural torsion in AMI patients were significantly reduced relative to those of normal control group(all P<0.01).One month after revascularization,there were significant changes in these three variables,especially in peak endorotation(P<0.01).Peak apical endo-rotation positively correlated with LV ejection fraction(LVEF)(r=0.717,P<0.01)and inversely correlated with LV end-diastolic volume(EDV)(r=-0.694,P<0.05).However,tight relations were not found among other variables at the two planes.Conclusions Peak endo-and epi-rotation and peak mural torsion can make the sensitive assessment of abnormal myocardial contractile performancein AMI patients using STI.

Establishment of an in vitro system for testing cytomegalovirus-specific immune response / 中华微生物学和免疫学杂志

Ohiective To establish an in vitro test system for testing CMV specific immune response. Methods Human embryonic lung fibroblasts(HELF)infected with CMV-AD169 and a mutant strain RV-TB40E-4, respectively, were stained with anti-HLA-A * 0201-PE and then measured for the expression of HLA-A * 0201. The infected HELF were incubated with individual pp65 peptide NLVPMVATV and cultured together with PBMC,then intracellular IFN-γ was tested by flow cytometry(FCM). Results The expression of HLA-A * 0201 was markedly suppressed on AD169-infected fibroblasts, while it was not affected on RV-TB40E-4-infected cells. PBMC showing no response to AD169-infected cells responded significantly to RV-TB40E-4-infected cells. The HELF infected with AD169 and loaded with external peptides induced a significantly stronger response which was the sum of the induced response ratios of the infected HELF and the uninfected HELF loaded with peptides. Conclusion CMV-AD169 downregulates the expression of MHC Ⅰ, while it does not decrease the capacity of cells to present external peptides. RV-TB40E-4,a CMV mutant in which the gene of US2-6/US11 has been deleted, does not affect MHC Ⅰ expression, and therefore represents a more suitable tool to explore CMV-specific immune response.

Study on the Effect of Aldehydes and Tannic Acid on the Stability of Soft Capsules / 中国中医药信息杂志

Objective To study the influence of aldehydes and tannic acid on soft capsules, approach how to prevent soft capsules from delayed disintegration. Methods Add aldehydes and tannic acid to soft capsules material ingredient, to proceed accelerating stability trial and test the disintegration time. Result Little increase of aldehydes amount had great effect on the disintegration time of soft capsules, different aldehydes and tannic acid had different effect on the disintegration time, adding some organic acid such as fumaric acid to the material would improve disintegrating property. Conclusion The amount of aldehydes and tannic acid contained in the material and ingredient should be controlled strictly when prepare soft capsules so that the disintegration time of capsules could be complying with the Pharmacopeia.

Clinical application of laparoscopy in acute abdominal emergency / 中国微创外科杂志

Objective To evaluate the laparoscopy in the diagnosis and treatment for acute abdominal emergency. Methods A retrospective analysis was conducted on clinical data of 35 patients with an acute abdomen of unknown causes diagnosed and treated under laparoscope from December 1999 to April 2003 in this hospital. Results Diagnosis was confirmed by laparoscopy in all the 35 cases. Laparoscopic operation was successfully completed in 28 cases, whereas a conversion to open surgery was required in 7 cases, in which the site of incision was under the guidance of laparoscopic observations. No surgery-related deaths or wound-related complications occurred. The mean operative time was 48 min (range, 30~72 min), and the mean hospital stay was 5.8 days (range, 3~9 days). Conclusions Laparoscopy is not only a safe and accurate diagnostic method, but also a good procedure for treatment.

The reason and treatment of severe encephalocele / 临床外科杂志

Objective To study and find the reason and treatment way of severe encephalocele after operation on the brain. Me thods 15 cases who have severe encephalocele were reviewed retrospec tively.Results Among 15 cases, 12 cases have been cured,3 c ases died with severe pulmonary infection.Conclusion The re asons of severe encephalocele are hydrocephalus?cerebral edema and intracranial infection and it is useful to utilize medicine and other ways to lighten hydroc ephalus?cerebral edema and intracranial infection for the patients who have sev ere encephalocele.

Laparoscopic enterodialysis versus open enterodialysis: A comparison study / 中国微创外科杂志

Objective To compare the clinical efficiency between laparoscopic enterodialysis and open enterodialysis. Methods Clinical data of 25 cases of adhesive intestinal obstruction treated by laparoscopic enterodialysis (Laparoscopic Group) from December 1999 to December 2002 were retrospectively reviewed and compared with clinical records of 23 cases receiving open enterodialysis (Open Group) in the same period. The operating time, intra-operative blood loss, incidence of complications, postoperative recovery time of bowel movement and length of hospital stay of the two groups were compared, respectively. Results In the Laparoscopic Group operation was successfully accomplished in 23 cases while a conversion to open surgery was required in 2 cases. Of the Laparoscopic Group and the Open Group, the operation time was (58.3?8.1) min and (84.0?7.5) min (t=11.383, P=0.000), respectively; the intra-operative blood loss was (31.4?5.1) ml and (192.6?26.4) ml (t=29.995, P=0.000), respectively; the postoperative hospital stay was (4.1?1.4) days and (9.7?2.0) days (t=11.413, P=0.000), respectively; the postoperative recovery time of bowel function was (19.6?2.2) hours and (49.0?8.8) hours (t=16.207, P=0.000), respectively and the postoperative complications were seen in 1 case and 9 cases (?2=6.960, P=0.008), respectively. Conclusions Compared with open enterodialysis, laparoscopic enterodialysis has advantages of short operation time, less blood loss, rapid recovery and fewer complications.

Venous hemodynamic changes during laparoscopic cholecystectomy / 中国微创外科杂志

Objective To evaluate changes of venous hemodynamics during laparoscopic cholecystectomy(LC).Methods A total of 25 cases of LC was included in the study.A Doppler ultrasonography of the lower limb veins was performed in all the patients to exclude those with abnormal veins or thrombosis.During the LC,the diameter and venous flow volume of the femoral vein were measured under Doppler ultrasonography.Measurements were obtained at three different times:after the induction of anesthesia but prior to the creation of the pneumoperitoneum,during the pneumoperitoneum,and after abdominal deflation but prior to the reversal of anesthesia.Results All the operations were successfully completed.The mean operation time was 45 min(range,30～70 min).No intraoperative hemorrhage or bile duct complications occurred.No conversion to open surgery was required.All the patients were dismissed from hospital on the first postoperative day.After the establishment of the pneumoperitoneum,the cross-sectional area of the femoral vein was increased from 0.94?0.18 cm2 to 1.12?0.23 cm2(q=3.919,P0.05).The venous flow was significantly increased from 7.62?0.72 cm3/s to 9.65?0.63 cm3/s(q=12.971,P