A prospective cohort study on the clinical value of pelvic peritoneal reconstruction in laparoscopic anterior resection for middle and low rectal cancer / 中华胃肠外科杂志

Objective: To investigate the safety and efficacy of pelvic peritoneal reconstruction and its effect on anal function in laparoscopy-assisted anterior resection of low and middle rectal cancer. Methods: A prospective cohort study was conducted. Consecutive patients with low and middle rectal cancer who underwent laparoscopy-assisted transabdominal anterior resection at Naval Military Medical University Changhai Hospital from February 2020 to February 2021 were enrolled. Inclusion criteria: (1) the distance from tumor to the anal verge ≤10 cm; (2) laparoscopy-assisted transabdominal anterior resection of rectal cancer; (3) complete clinical data; (4) rectal adenocarcinoma diagnosed by postoperative pathology. Exclusion criteria: (1) emergency surgery; (2) patients with a history of anal dysfunction or anal surgery; (3) preoperative diagnosis of distant (liver, lung) metastasis; (4) intestinal obstruction; (5) conversion to open surgery for various reasons. The pelvic floor was reconstructed using SXMD1B405 (Stratafix helical PGA-PCL, Ethicon). The first needle was sutured from the left anterior wall of the neorectum to the right. Insertion of the needle was continued to suture the root of the sigmoid mesentery while the Hemo-lok was used to fix the suture. The second needle was started from the beginning of the first needle, after 3-4 needles, a drainage tube was inserted through the left lower abdominal trocar to the presacral space. Then, the left peritoneal incision of the descending colon was sutured, after which Hemo-lok fixation was performed. The operative time, perioperative complications, postoperative Wexner anal function score and low anterior resection syndrome (LARS) score were compared between the study group and the control group. Three to six months after the operation, pelvic MRI was performed to observe and compare the pelvic floor anatomical structure of the two groups. Results: A total of 230 patients were enrolled, including 58 who underwent pelvic floor peritoneum reconstruction as the study group and 172 who did not undergo pelvic floor peritoneum reconstruction as the control group. There were no significant differences in general data between the two groups (all P>0.05). The operation time of the study group was longer than that of control group [(177.5±33.0) minutes vs. (148.7±45.5) minutes, P<0.001]. There was no significant difference in the incidence of perioperative complications (including anastomotic leakage, anastomotic bleeding, postoperative pneumonia, urinary tract infection, deep vein thrombosis, and intestinal obstruction) between the two groups (all P>0.05). Eight cases had anastomotic leakage, of whom 2 cases (3.4%) in the study group were discharged after conservative treatment, 5 cases (2.9%) of other 6 cases (3.5%) in the control group were discharged after the secondary surgical treatment. The Wexner score and LARS score were 3.1±2.8 and 23.0 (16.0-28.0) in the study group, which were lower than those in the control group [4.7±3.4 and 27.0 (18.0-32.0)], and the differences were statistically significant (t=-3.018, P=0.003 and Z=-2.257, P=0.024). Severe LARS was 16.5% (7/45) in study group and 35.5% (50/141) in control group, and the difference was no significant differences (Z=4.373, P=0.373). Pelvic MRI examination 3 to 6 months after surgery showed that the incidence of intestinal accumulation in the pelvic floor was 9.1% (3/33) in study group and 46.4% (64/138) in control group (χ(2)=15.537, P<0.001). Conclusion: Pelvic peritoneal reconstruction using stratafix in laparoscopic anterior resection of middle and low rectal cancer is safe and feasible, which may reduce the probability of the secondary operation in patients with anastomotic leakage and significantly improve postoperative anal function.

Etiological analysis and surgical method selection of adult megacolon / 中华胃肠外科杂志

Adult megacolon is a rare disease with heterogeneneous etiology. The treatment schemes of megacolon caused by different causes are also different, but surgery is the final and the most effective method. Due to the lack of early understanding of the disease, many patients have not been clearly diagnosed as adult megacolon and have not been properly treated. This article classifies adult megacolon according to the etiology and summarizes its surgical options. For adult Hirschsprung's disease, modified Duhamel, the Jinling procedure, low anterior resection, or pull-through low anterior resection can be used. For patients with idiopathic megacolon, one-stage subtotal colorectal resection can be selected with adequate preoperative preparations. Some patients admitted to the hospital with emergency intestinal obstruction can be treated with conservative treatment or decompression under colonoscopy followed by selective surgery. For patients with aganglionosis, the procedure is subtotal colorectal resection, the same as that of idiopathic megacolon. The procedure is to remove both the dilated proximal intestine and the stenotic distal intestine, then an ileorectal anastomosis or ascending colon rectal anastomosis is performed. For toxic megacolon, colostomy can be done for mild cases, and for severe infections, subtotal colorectal resection is required. Latrogenic megacolon is mostly caused by segmental stenosis or lack of peristalsis, resulting in chronic dilatation of the proximal end and the formation of megacolon. It is necessary to choose a reasonable surgical procedure according to the specific conditions of the patient. The first choice for the treatment of acute colonic pseudo-obstruction syndrome is decompression under colonoscopy. For those with the secondary changes in the intestine, ostomy is still the most effective surgical procedure, but should be performed with caution.

PSA density in the diagnosis of prostate cancer in the Chinese population: results from the Chinese Prostate Cancer Consortium / 亚洲男科学杂志(英文版)

We performed this study to investigate the diagnostic performance of prostate-specific antigen density (PSAD) in a multicenter cohort of the Chinese Prostate Cancer Consortium. Outpatients with prostate-specific antigen (PSA) levels ≥4.0 ng ml

Microwave ablation combined with percutaneous fixation and open decompression treat oppressive spinal metastasis / 中华骨科杂志

Objective:To evaluate the safety and efficacy of the treatment for oppressive spinal by microwave ablation combined with percutaneous fixation and open decompression.Methods:From January 2015 to September 2018, 20 patients with 26 spinal metastatic were treated with microwave ablation combined with percutaneous fixation and open decompression, including 13 males and 7 females with an average age of 43.85±18.67 years (range, 16-79 years). The locations of the lesions included: 9 in the thoracic, 11 in the lumbar. The tumors' type: myeloma 2 cases, leukemia 1 case, liver cancer 4 cases, osteosarcoma 2 cases, lung cancer 5 cases, kidney cancer 1 case, esophagus cancer 1case, cervical cancer 1 case, intestinal cancer 1 case, prostate cancer 1 case, adenoid cystic cancer 1case. Preoperatively all the patients suffered with the local pain and the spinal cord or nerve root compression symptoms. All 20 cases were examined with CT or MRI to determine the lesions and the sizes of metastasis, as well as to evaluate the ablation zone. The entry of the pedicle screws were performed by Wiltse method through paravertebral muscles. After that the lesions were treated with partial resection for decompression of spinal cord or nerve root, and followed with microwave ablation at the metastasis site. Thermometer was used to monitor the temperature at the central and posterior edges of the vertebral body. The surrounding important tissue were cooled by ice saline. 13 patients were performed with vertebroplasty for enhancement the intensity of the vertebral body. The visual analogue scale (VAS) score was used to evaluate the effect of pain relief after surgery. The postoperative neurological function and performance status were evaluated using Frankel grading and Eastern Cooperative Oncology Group (ECOG).Results:Each lesion was heated for 5.43±2.07 min (range, 3-10 min). The power of microwave ablation was 40-60 W. The mean blood loss during operation was 852.50±514.40 ml (range, 100-1 700 ml). The mean operating time was 4.11±0.99 h (range, 2.5-6.0 h). The temperature inside the lesion was 70-85 ℃. The temperature of the surrounding tissue was maintained at<43 ℃ by repeated frozen saline flush. All cases were followed up for 8.45±2.01 months (range, 6-14 months) without any recurrence. The VAS score of the 20 patients at 48 h, 1 month, 3 months and 6 months after operation were 1.55±1.23, 2.70±0.87, 2.40±1.14 and 3.05±1.00 points, which were all statistically lowerthan the preoperative score 5.95±1.18 ( P<0.05). The Frankel grading of 14 patients had at least one grade improvement 6 months after operation. There were 8 patients shown markedly improved ECOG score 6 months after surgery. Only one case suffered from reduced myodynamiaof lower limb and covered in one month after system treatment. Conclusion:The microwave ablation combined with percutaneous fixation and open decompression could resolve the spinal and nerve compression, relieve the pain in metastatic spinal oppression, reconstruct the stability, and improve the quality of lives, which is a safe and effective palliative surgical method.

Indication and operation skills of colonoscopy for bowel obstruction / 中国实用外科杂志

As one of the major acute abdomen in general surgery,the treatment of bowel obstruction has made great progress at present,but it is still a difficult problem for doctors to deal with.The key question is to make clear the cause of obstruction,the choice of treatment method and operation time. With the progress of technology and equipment,colonoscopy has been applied more and more to the diagnosis and treatment of intestinal obstruction from the contraindications of bowel obstruction to the present,and become an important means to judge the state of illness,guide and implement treatment. However, the emergency colonoscopy for patients with bowel obstruction has its own particularity,which is different from the selective colonoscopy.From the preparation of tract before examination,such as not taking cathartic,and trying to be as simple and effective as possible, to the colonoscopy for patients with bowel obstruction,surgeons should take different schemes and skills according to the different causes and positions of obstruction.

Application of septoplasty and primary cheiloplasty for complete unilateral cleft lip / 中华整形外科杂志

Objective@#To explore the application of septoplasty and cheiloplasty in complete unilateral cleft lip repairment, and evaluate the effect on nasal shape correction.@*Methods@#Twenty-four infants with complete unilateral cleft lip were divided into two groups: the correction group and the control group. Both groups underwent cheiloplasty by Mohler′s technique, septoplasty was performed in the correction group during the primary cheiloplasty. Six-month follow-up was taken to evaluate the nasal shape with the three dimensional images. Independent-samples t Test was performed using SPSS 21.0, to compare the nasal morphology between two groups.@*Results@#All patients healed in the first stage, and were followed for 6 months after operations. There were no complication, including nasal septum perforation, occurred in either group.There were statistically significant differences in nasal parameters between the correction group and controls (P<0.05). The columellar width, nostril width on the affected side, and columella deviation of the correction group were smaller, than those of controls. The nose tip height, columellar height and nostril height on the affected side of the correction group were greater than those of the control group.@*Conclusions@#Septoplasty associated with the primary cheiloplasty in complete unilateral cleft lip repairment, shows better results in the elongation of the nasal columella, and the correction of septum deviation, and provides a stable nasal structure.

Efficacy of repair of bilateral complete cleft lip and nasal deformity by 3dMD face system / 中华医学美学美容杂志

Objective To assess the effectiveness of the Mulliken's method in bilateral complete cleft lip patients with 3dMD system and anthropometric landmarks.Methods Thirty-one infants with bilateral complete cleft lip received treatment in Hospital of Stomatology,Wuhan University between January 2014 and December 2016.Patients underwent primary cheiloplasty and nasoplasty by the same senior surgeon.Periodic review was taken to measure and record the 7 items in the nasolabial area with three-dimensional (3D) images.Results The labial and nasal deformities were restored after primary surgery.The upper lip and nose were corrected and obtained the symmetric shape.The columella was elongated to acquire favorable nasal tip.The arc of nasal fornix was upward.The ridge of the white lipwas continuous and integrated with full vermilion tubercle.Total length of upper lip (Sn-Sto),thickness of the vermilion tubercle (Ls-Sto),protrusion of the nasal tip (Nh) and columellar height (Ch) were markedly improved and there were no significant difference between the observation group and the control group.The significant differences between two groups occurred in values of the nostril width (Nw),which was greater than control group and white lip height (Sn-Ls) and lower than that of control group.Conclusions Mulliken's method during the primary cheiloplasty of the bilateral complete cleft lip shows better results in correction the nasal deformity and the ideal effects are achieved during follow-up.

Ubiquitin-like modification (SUMOylation) and genomic stability / 上海交通大学学报（医学版）

The mechanism of protein post-translational modifications in regulation of cell mitosis and genomic stability is always a hot issue in biological researches. The present review introduced the functional activity of de-SUMOylase SENP3 in sister chromatin dissociation at mitosis, and demonstrated a new molecular mechanism of cross-talk regulation between protein SUMOylation and phosphorylation in maintaining genomic stability.

Preparation,Characterization and Biocompatibility Evaluation in vitro of DiR-PEG-PLGA Fluorescent Nanocapsules / 中国药房

OBJECTIVE:To prepare and characterize Fluorescent dye 1,1′-octacosyl-3,3,3′,3′-tetramethylindocarbocyanine iodide(DiR)-loading polyethylene glycol-poly lactic-co-glycolic acid(DiR-PEG-PLGA)nanocapsules,and to evaluate its biocompatibility in vitro. METHODS:Using PLGA and PEG-PLGA as carrier,DiR-PEG-PLGA nanocapsules were prepared by modified ultrasonic emulsification method. The particle size,Zeta potential,morphology,stability and fluorescence in vitro of nanocapsules were detected respectively. MTT assay was used to evaluate cytotoxicity in vitro of nanocapsules to human-derived HL7702 hepatocytes,and hemolysis test was carried out to investigate its hemolysis effects. RESULTS:Prepared DiR-PEG-PLGA nanocapsules were spherical with a clear core-shell structure. The average particle size was(507.53 ± 7.87)nm,polydispersity coetficient of particle size was 0.306 1±0.001 5 and Zeta potential was(-35.20±0.92)mV with good stability within 6 months under 4℃. Fluorescence signal intensity(y)of nanocapsules was increased linearly with DiR mass concentration(x)in vitro. The linear eguation was y=0.345 2x+0.433 4(R2=0.997 3).The toxicity of nanocapsules to HL7702 cells was between 0-1 degree,and no hemolytic effect was observed. CONCLUSIONS:The study successfully prepare fluorescent DiR-PEG-PLGA nanocapsules with high biocompatibility in vitro,which is further expected to become a safe optical drug carrier.

Effects of bacterial lipopolysaccharide on the mineralization and differentiation of periodontal ligament stem cells / 医学研究生学报

Objective Periodontal tissue engineering has shown a highlight prospect in the treatment of periodontitis,but the related clinical experiments have not achieved the predetermined goal. In this study,we analyzed the reasons for the limited clinical efficacy of periodontal tissue engineering. Methods We primarily cultured the periodontal tissue from the young permanent teeth extracted for or-thodontic treatment,isolated periodontal ligament stem cells (PDLSCs),and transplanted the well-grown third-generation PDLSCs onto the fluorapatite-polycaprolactone (FA-PCL) nanofiber scaffolds and PCL nanofiber scaffolds. We randomly divided the cells into groups A (cultured with 10 ng/mL porphyromonas gingivalis lipopo-lysaccharide (Pg-LPS)+FA-PCL),B (cultured with 10 ng/mL PG-LPS+PCL),C (cultured with 10 μg/mL PG-LPS+FA-PCL),D (cultured with 10 μg/mL PG-LPS+PCL),E (cultured with FA-PCL),and F (cultured with PCL),and observed their proliferation,differentiation and mineralization. Results The PDLSCs adhered and grew well after transplanted onto the nanofiber scaffolds and their proliferation significantly increased in groups A and B but decreased in C and D as compared with E and F. At 7 days,the expres-sions of ALP and mineralization-related genes runx2 and SPP1 in the PDLSCs were significantly higher in group E than in the other five groups (P<0.05),but higher groups A and C than in B and D as well as in A than in C. At 28 days,alizarin red and Von Kossa stai-ning showed a higher positivity in group E than in the other five groups,but higher groups A and C than in B and D as well as in A than in C. Conclusion The inflammatory environment not only affects the proliferation of PDLSCs,but also inhibits their differentiation and mineralization. The FA-PCL scaffold can reduce the cytotoxic effect of PG-LPS.

Research on Preparation and in Vitro Release of pH Sensitive Gel for Eye Cornea of Salvianolic Acid B / 昆明医科大学学报

Objective To prepare pH sensitive gel for eye cornea of salvianolic acid B and accomplish in vitro release study. Me thods We used corneal permeability, eye irritation in rabbits, hydration of the cornea, viscosity, gel capacity, transparency, liquidity as index, to select pH sensitive gel matrix composition. Re s ults The gel composition was: 0.5％ of salvianolic acid B, 0.14％ Carbomer, 0.3％ HPMC, 0.05％ Azone, 0.1％ ethylparaben and 0.2％ Vc. The corneal hydration level was 77.32±1.88.The gel released 27.21％ drug in 15 min, and released 97.44％ drug in 6 h. By research of corneal permeability, the cumulative release of gel was bigger than the one of saline (P＜0.05). Conclus ions The selection of the gel matrix prescription is reasonable in design, simple in process, not harsh to eyes, and can prolong the retention time of drug in corneas and improve the corneal penetration.

Manipulative reduction and percutaneous Kirschner wire internal fixation for grade IV supination-external rotation ankle fractures / 中国骨伤

<p><b>OBJECTIVE</b>To investigate surgical skills and clinical effects of manipulative reduction and percutaneous Kirschner wire internal fixation in treating grade IV supination-external rotation ankle fractures.</p><p><b>METHODS</b>From May 2013 to October 2016, 35 patients with grade IV supination-external rotation ankle fractures were treated with percutaneous Kirschner wire internal fixation, involving 22 males and 13 females with an average age of 38.2 years ranged from 18 to 65 years old. The time from injury to operation ranged from 2 h to 10 d with an average of 5 d. Reduction quality was assessed by Burwell-Charnley radiological criteria. Baird-Jackson ankle scoring system was used to assess clinical effects.</p><p><b>RESULTS</b>Thirty-three patients were followed up from 10 to 28 months with an average of 14 months. Fracture healing time ranged from 10 to 18 weeks with an average of 12 weeks. According to Burwell-Charnley radiological criteria, 30 cases were obtained anatomic reduction, 3 cases moderate. According to Baird-Jackson ankle scoring system, total score was 93.8±5.4, 17 cases got excellent result, 12 good, 2 fair and 2 poor.</p><p><b>CONCLUSIONS</b>Manipulative reduction and percutaneous Kirschner wire internal fixation in treating grade IV supination-external rotation ankle fractures has advantages of reliable efficacy, less complications. But higher require techniques were required for closed reduction. It is not suitable for severe crushed fracture and compressive articular surface fracture.</p>

The influence factors and management of anterior chamber gas bubble emergence during femtosecond flap creation for LASIK / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM:To study the influence factors and management of anterior chamber gas bubble during femtosecond flap creation for laser-assisted in situ keratomileusis ( LASIK) .·METHODS: Totally 9671 eyes of 4859 patients with femtosecond LASIK were included in this study. Preoperative, intraoperative and postoperative parameters of anterior chamber gas bubble patients were analyzed and compared.·RESULTS:A total of 51 cases (0. 53%) occurred anterior chamber gas bubble during femtosecond flap creation. There was no statistical difference between uncorrected visual acuity of postoperative 1mo (-0. 076 ± 0. 09 ) and preoperative best corrected visual acuity (-0. 08±0. 04; t=-0. 34,P=0. 74). And 33 eyes (65%) did not affect the pupil tracking, but there were 18 eyes ( 35%) unable to track the pupil successfully. There was no statistical difference in uncorrected visual acuity of postoperative 1mo between trace group (-0. 06 ± 0. 08 ) and no trace group(-0. 11 ± 0. 09; t = 1. 82, P = 0. 07). The highest incidence of anterior chamber gas bubble was at 9 point, followed by 3 point. There were no statistical differences in spherical equivalent refraction, corneal curvature, corneal diameter, anterior chamber volume, anterior chamber depth and intraoperative femtosecond laser energy between anterior chamber gas bubble eyes and the contralateral eyes (P>0. 05).·CONCLUSION: Anterior chamber gas bubble formation during femtosecond flap creation for LASIK is an uncommon event. It may affect the eye tracking. There is no obvious effect on early postoperative visual acuity if intraoperative disposed properly. The direct or indirect factors of anterior chamber gas bubble formation are unclear.

Clinical efficacy and mechanism of total glucosides from white paeony for radioactive liver damage / 中国中药杂志

To discuss the effects of total glucosides from white paeony on preventing and treating radioactive liver damage, and explore its possible mechanisms. Thirty-six patients with primary hepatic carcinoma from 105th Hospital of Chinese PLA were treated with 3-dimensional conformal radiotherapy and randomly divided into simple irradiation group, total glucosides from white paeony group, and control group. The levels of AST, ALT, HA, LN, PCⅢ, CIV and TGF-β1 in serum of various groups were determined by using ELISA method. As compared with the simple irradiation group and control group, total glucosides from white paeony could obviously decrease the levels of AST, ALT, HA, LN, PCⅢ, CIV and TGF-β1(P<0.05, P<0.01). The results showed that the total glucosides from white paeony could effectively prevent and treat radioactive liver damage, and its mechanism might be associated with decreasing the levels of TGF-β1, and inhibiting the synthesis of collagen synthesis.

Molecular classification of colorectal carcinoma based on integration of gene expression profile and copy number variation / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To classify colorectal carcinoma (CRC) by TNM staging integrated with the gene expression profile and copy number variation (CNV).</p><p><b>METHODS</b>Profile data of gene expression and CNV of CRC were downloaded from public database and processed with batch bias adjustment, quartile normalization, missing value estimation and feature filtration. The processed profiles of mRNA and CNV were introduced into the codes of Bayesian consensus clustering (BCC) method and were used to calculate the subclasses of CRC. With the follow-up information of disease free survival of CRC patients, the prognostic values of the subclasses was investigated and the software of function enrichment analysis was employed to discover the major pathway signaling to each interesting subclass. All statistic analyses were performed under R-3.0.1 environment or by using SPSS 16.0 software.</p><p><b>RESULTS</b>Profile data of gene expression and corresponding CNV from 335 CRC patients with TNM stage Ⅱ-Ⅲ and followed-up information were obtained. After feature filtering, the profiles contained 1578 probes of mRNA and 345 location of CNV. Four CRC subclasses were identified by the integrative analysis with BCC, and the concordances of BCC subclasses and each of gene-based subclasses (Cramer's V=0.49), CNV-based subclasses (Cramer's V=0.51) and Marisa's subclasses (Cramer's V=0.32) were statistically significant (Ps<0.001). Among BCC subclasses, BCC-I had a favorable prognosis, while BCC-Ⅳ had more unfavorable prognosis. The differences of prognosis were significant among BCC-I, BCC-(Ⅱ+Ⅲ) and BCC-Ⅳ with an overall log-rank P<0.001. The top enriched function was DNA damage and repair signaling when BCC-I compared to BCC-Ⅳ, and the new subgroups classified by the genes associated with enriched signaling had the better prognostic value than BCC subclasses but both of them were significantly correlated (Cramer's V=0.39, P<0.001).</p><p><b>CONCLUSION</b>BCC method is effective to integrate multi-type genomic data for molecular classification of colorectal carcinoma, and the BCC-Ⅳ subclass has poor prognosis, which may be associated with the decreased repairing function of DNA damage.</p>

Mutual effect between neuropeptides and inflammatory cytokines in neurogenic SMSCs of human temporomandibular joint / 华中科技大学学报（医学）（英德文版）

In temporomandibular disorders (TMD), pain takes place when neuropeptides stimulate synovial tissue to produce several cytokines such as interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF)-α, which activate neurons and glia of synovial membrane at the bilaminar regions of temporomandibular joint (TMJ). It has been reported that, after neurogenic differentiation, the synovial mesenchymal stem cells (SMSCs), deriving from TMJ, possess the same cytological features as the neuronal cells. This study examined the ability of substance P (SP) and calcitonin gene-related peptide (CGRP) to stimulate SMSCs and neurogenic SMSCs secreting inflammatory cytokines during TMD, evaluated the mutual effects of inflammatory cytokines and neuropeptides and tested the analgesic effect of hyaluronic acid (HA). The levels of IL-1β, IL-6 and TNF-α in SMSCs and neurogenic SMSCs in the presence of neuropeptides were measured by ELISA. SP and CGRP produced by SMSCs and neurogenic SMSCs were determined by RT-PCR and Western blotting. The results showed that the expression of SP and CGRP was significantly enhanced in the neurogenic SMSCs in response to IL-1β, IL-6 and TNF-α, and the effect was remarkably inhibited by HA. IL-1β, IL-6 and TNF-α, in return, could be enhanced in the neurogenic SMSCs upon stimulation by SP and CGRP. Neuropeptides and inflammatory cytokines might work mutually on the TMD pain. The HA-mediated analgesic effect may be implicated in the inhibition of SP and CGRP expression in neurogenic SMSCs.

Detection of the covalently closed circular DNA in peripheral blood mononuclear cells of hepatitis B patients and its clinical significance / 中华传染病杂志

Objective To analyze the correlation between covalently closed circular DNA (cccDNA) in the peripheral blood mononuclear cells (PBMC) of hepatitis B virus (HBV)-infected patients and serum HBV DNA,hepatitis B surface antigen (HBsAg),hepatitis B e antigen (HBeAg) and liver histology of hepatitis B patients,and to explore the clinical significance of HBV cccDNA detection in PBMC.Methods One hundred and eight patients with chronic HBV infection were involved in this study.PBMC were extracted using density gradient centrifugation.HBV cccDNA in PBMC and serum HBV DNA were detected by real-time fluorescence quantitative polymerase chain reaction.HBsAg and HBeAg were detected by chemiluminescence immunoassay.Liver biopsy was conducted in 59 out of the 108 patients.Chi-square test was used to compare the categorical variables.Correlation analysis was used to compare quantitative variables.Nonparametric test was used to compare the non-normal distribution parameters.Results In the overall population,HBV cccDNA in PBMC was positive in 59 patients (54.6％).Eleven of the 15 patients with liver failure were found to be HBV cccDNA positive,which was significantly higher than that in the acute hepatitis B group (only 2 of the 8 patients were HBV cccDNA positive; x2 =4.960,P＜0.05).One hundred and eight patients were categorized into three groups according to their serum HBV DNA levels,with group A:＞5 lg copy/mL,group B:3-5 lg copy/mL and group C:＜3 lg copy/mL.The proportions of HBV cccDNA positivity in PBMC in three groups were 76.1％ (51/67),5/18 and 13.0％ (3/23),respectively.Comparing with patients with lower HBV DNA (group B and C),the proportion of HBV cccDNA positivity was higher in patients with higher HBV DNA (group A; x2=14.751,P＜0.05 and x2 =28.384,P＜0.05,resepectively).The HBV cccDNA quantitation in PBMC was positively correlated with the serum HBV DNA level and HBsAg quantification (r=0.554,P＜0.05 and r=0.497,P＜0.05,respectively).The proportion of HBV cccDNA positivity in PBMC of patients with liver histology ≥G2 and/or ≥S2 was significantly higher than that in patients with liver histology ＜ G2/S2 (x2 =9.159,P＜0.05).Conclusions HBV cccDNA exists in PBMC of hepatitis B patients.The HBV cccDNA quantitation in PBMC is positively correlated with the serum level of HBV DNA and HBsAg quantification,and is also associated with liver histology injury.

Mutual effect between neuropeptides and inflammatory cytokines in neurogenic SMSCs of human temporomandibular joint / 华中科技大学学报（医学）（英德文版）

In temporomandibular disorders (TMD), pain takes place when neuropeptides stimulate synovial tissue to produce several cytokines such as interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF)-α, which activate neurons and glia of synovial membrane at the bilaminar regions of temporomandibular joint (TMJ). It has been reported that, after neurogenic differentiation, the synovial mesenchymal stem cells (SMSCs), deriving from TMJ, possess the same cytological features as the neuronal cells. This study examined the ability of substance P (SP) and calcitonin gene-related peptide (CGRP) to stimulate SMSCs and neurogenic SMSCs secreting inflammatory cytokines during TMD, evaluated the mutual effects of inflammatory cytokines and neuropeptides and tested the analgesic effect of hyaluronic acid (HA). The levels of IL-1β, IL-6 and TNF-α in SMSCs and neurogenic SMSCs in the presence of neuropeptides were measured by ELISA. SP and CGRP produced by SMSCs and neurogenic SMSCs were determined by RT-PCR and Western blotting. The results showed that the expression of SP and CGRP was significantly enhanced in the neurogenic SMSCs in response to IL-1β, IL-6 and TNF-α, and the effect was remarkably inhibited by HA. IL-1β, IL-6 and TNF-α, in return, could be enhanced in the neurogenic SMSCs upon stimulation by SP and CGRP. Neuropeptides and inflammatory cytokines might work mutually on the TMD pain. The HA-mediated analgesic effect may be implicated in the inhibition of SP and CGRP expression in neurogenic SMSCs.

Research advances on colon cancer stem cells / 国际肿瘤学杂志

Colon cancer stem cells(Co-CSCs)are a small fraction of subgroup cells,which show the capabilities of self-renewal,proliferation and differentiation in colon cancer.Co-CSCs are tumorgenic,and they play an important role in the genesis development and metastasis of tumor.These studies of Co-CSCs may help developing effective targets and novel strategies for clinical tumor therapy.

Comparative study on impacted high tibial osteotomy and conventional high tibial osteotomy for the treatment of flexional medial knee osteoarthritis in aged patients / 中国骨伤

<p><b>OBJECTIVE</b>To compare the therapeutic effect of impacted high tibial osteotomy and conventional high tibial osteotomy for the treatment of flexional medial osteoarthritis of knee joint in aged patients.</p><p><b>METHODS</b>From July 2003 to July 2006, 30 patients with flexional medial knee osteoarthritis were treated with impacted high tibial osteotomy or conventional high tibial osteotomy randomly. All patients,aged from 60 to 82 years,were suffered from 7 degrees to 19 degrees knee flexion deformities and 3 to 20 years medical histories. The bone healing periods, the recover of flexion and inversion deformities, and the recover of the knee joint function were observed postoperatively. The patients were followed up at 4, 6, 8, 9, 10, 12 and 16 weeks, and 5, 7, 9 and 12 months postoperatively. The bone healing periods and the recover of flexional and inversion deformities were evaluated and compared. Twelve months postoperatively,the knee joint function were assessed with the Lysholm scoring criteria, and the therapeutic effects were compared between the two groups.</p><p><b>RESULTS</b>There was a significant difference in the average bone healing period between the impacted high tibial osteotomy group (9.26 +/- 2.23) weeks and the conventional high tibial osteotomy group (11.53 +/- 3.15) weeks. The knee joint function were evaluated according to the Lysholm clinical rating scales. One year postoperatively,the average Lysholm score were (88.5 +/- 4.4) points in the impacted high tibial osteotomy group,and the results showed excellent in 14 cases, good in 1. The average Lysholm score were (78.1 +/- 5.7) points in the conventional high tibial osteotomy group. The results showed 8 cases excellent, 5 good, 2 fair, accordingly. Postoperatively, the flexion deformities of the knee in the impacted high tibial osteotomy group were -1.1 degrees to 0 degrees and was corrected averagely (130 +/- 3.30) after surgery, and that in conventional high tibial osteotomy group (140 +/- 3.30) (the same as preoperation). The average postoperative femorotibial angle (FTA) were 170.2 degrees (ranged from 169.1 degrees to 172.3 degrees) and was corrected 12.3 degrees to 12.5 degrees after surgery in both groups.</p><p><b>CONCLUSION</b>Compared with conventional high tibial osteotomy, impacted high tibial osteotomy can significantly shorten the bone healing period, improve the knee flexion, varus deformity, and the knee function.</p>