Effect of Compound Phylanthus urinaria Ⅱ in Regulating Expression of lncRNA CCAT1 in Hepatocellular Carcinoma HepG2 Cells / 中国实验方剂学杂志

Objective:To explore the anti-hepatoma effect of compound <italic>Phylanthus urinaria</italic> Ⅱ （ CPU Ⅱ） by inhibiting the expression of the long non-coding RNA （lncRNA） colon cancer associated transcript-1 （CCAT1） and restoring the expression of microRNA let-7a. Method:Real-time fluorescence quantitative polymerase chain reaction （PCR） was used to detect the expression of lncRNA CCAT1 in normal liver cells （LO2 cells） and hepatocellular carcinoma HepG2 cells， and the differences in expression between these two types of cells were compared. The methylthiazolyl tetrazolium（MTT） assay was used to detect the proliferation of HepG2 cells after treatment with different concentrations of CPU Ⅱ and 5-fluorouracil（5-FU） for 24， 48 and 72 h. Hepatocellular carcinoma HepG2 cells were cultured <italic>in vitro </italic>and set into three gropes： cell control group， CPU Ⅱ low-dose group （0.8 g·L^-1） and high-dose group （1.6 g·L^-1）. Real-time PCR was used to detect the mRNA expression of lncRNA CCAT1， microRNA let-7a and its target genes high mobility group protein A2（HMGA2）， and N-RAS in each grope. Western blot was used to detect the protein expression of HMGA2， and Cyclin D₁ in each grope. Result:As compared with LO2 cells， expression of lncRNA CCAT1 in HepG2 cells was significantly up-regulated （<italic>P</italic><0.05）. Results of MTT assay showed that the 50% inhibiting concentration（IC₅₀）of CPU Ⅱ and 5-FU on hepatocellular carcinoma HepG2 cells was 1.649， 0.044 648 g·L^-1respectively. As compared with the control group， CPU Ⅱ high-and low-dose groups （1.6， 0.8 g·L^-1） significantly inhibited the proliferation of HepG2 cells （<italic>P</italic><0.05）， and the effect was most remarkable in CPU Ⅱ high-dose group （<italic>P</italic><0.05）. The results of Real-time PCR showed that as compared with control group， the expression of lncRNA CCAT1 mRNA was significantly inhibited in CPU Ⅱ high-and low-dose groups （<italic>P</italic><0.05）， and the expression of microRNA let-7a mRNA was obviously up-regulated in high-dose group （<italic>P</italic><0.05）， but the expression of HMGA2 mRNA in CPU Ⅱ high-and low-dose groups as well as the expression of N-RAS mRNA in CPU Ⅱ low-dose group were down-regulated （<italic>P</italic><0.05）. Western blot results showed that as compared with the cell control group， the protein expression of HMGA2 and Cyclin D₁ in CPU Ⅱ high-and low-dose groups （1.6， 0.8 g·L^-1） was significantly down-regulated （<italic>P</italic><0.05）. Conclusion:CPU Ⅱ can inhibit the expression of lncRNA CCAT1， recover the expression of microRNA let-7a， and suppress the mRNA and protein expression of related downstream target genes in hepatoma cells line HepG2， thereby inhibiting the proliferation of hepatocellular carcinoma cells and exerting anti-hepatocellular carcinoma effect.

Prevention of diabetic foot complications

This paper discussed the importance of prevention of diabetic foot ulcers and our institution's protocol for prevention, reviewing the existing evidence in the literature regarding the effectiveness of the preventive approach. Diabetes mellitus is the second most significant cause of disease in Singapore after ischaemic heart disease. National University Hospital, Singapore, adopts a two-pronged strategy for the management of diabetic foot ulcers. The most important strategy is prevention, and education is key. Education should mainly be directed at patients and caregivers, but also professionals (general practitioners, allied health professionals and nurses) so that they can effectively educate patients and caregivers. Patient education includes care of diabetes mellitus, care of the foot and use of appropriate footwear. Patients also tend to have poor foot hygiene. Annual foot screening for diagnosed diabetics plays an important role. However, prolonged and sustained government intervention is necessary to provide education and screening on a national scale.

Exploration on neoadjuvant chemoradiation in the treatment for locally advanced low rectal cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the possibility of further improvement of the efficacy of neoadjuvant chemoradiotherapy in locally advanced lower rectal cancer and the management of patients with clinical complete regression.</p><p><b>METHODS</b>From May 2001 to August 2007, 192 cases with locally advanced lower rectal cancer (T3/T4 or N(+)) received preoperative radiotherapy 40 - 46 Gy/20 - 23 fractions and concomitant oral capecitabine 625 mg/m(2) bid for 10 weeks prior to surgery. Curative resection with total mesorectal excision (TME) was carried out 6 weeks after the end of radiation.</p><p><b>RESULTS</b>As a result, 117 cases (60.9%) experienced adverse events but only 2 suffered from G3 side effects. Seventeen cases (8.9%) had a clinical complete tumor regression without surgery; 175 patients underwent curative resection, of them 134 cases with low anterior resection (LAR), 32 cases with ultra-low anterior resection with Park's coloanal anastomosis (6 cases with diverting temporary colostomy) and 9 cases with abdominal pelvic resection (APR). Sphincter preservation was achieved in 94.9%. Twenty-four patients (12.5%) got pathological complete response (CR), 17 patients with clinical CR and the overall CR rate was 21.4%. According to the pathological staging post operation: T0N0 41 cases, T2N0 43 cases, T3N0 77 cases, T4N0 5 cases, T2N1 11 cases, T3N1 13 cases, T4N1 2 cases; Graded under Dworak's tumor regression: TRG0 8 patients, TRG1 32 patients, TRG2 28 patients, TRG3 83 patients and TRG4 24 patients, with an overall pathological tumor downstaging in 77.14%. No operative death occurred, 5 patients suffered from rectovaginal fistulas and 4 anastomotic leakages with an overall anastomotic leakage rate of 5.1% (9/175) and all the patients recovered uneventfully after properly managed. All patients were followed up for a median time of 42 months (range, 12 - 87 months). During the time, 11 patients developed lung metastases, 6 liver metastases and 7 had local recurrences. The 3 years disease-free survival (DFS) was 86.6% and overall survival (OS) was 92.6%.</p><p><b>CONCLUSIONS</b>Neoadjuvant chemoradiotherapy has high efficacy in locally advanced lower rectal cancer, resulting in tumor down-staging, improved resectability and sphincter preservation, and reduced local recurrences. Meanwhile the cases with clinical complete response can be followed up closely and safely without surgery.</p>

Diagnostic significance and management principles of colorectal intraepithelial neoplasia / 中华外科杂志

<p><b>OBJECTIVE</b>To discuss the significance of pathological diagnosis of colorectal intraepithelial neoplasia and its treatment principles.</p><p><b>METHODS</b>One hundred and fifty-eight cases with colorectal tumors were treated between January 2004 and June 2008, among them 73 cases of tumors were diagnosed as low grade intraepithelial neoplasia and 89 tumors as high grade intraepithelial neoplasia on biopsy. Five patients with adenoma were treated with endoscopic polypectomy, 49 patients with radical colectomy, 74 patients with low anterior resection (LAR), 16 patients with local excision, 2 patients with Hartmann operation, 4 patients with abdominal perineal resection, 7 patients with Parks coloanal anastomosis and 1 patient with sigmoid colostomy. The postoperative pathological examination result was compared with preoperative biopsy examination.</p><p><b>RESULTS</b>With postoperative pathological examination, 109 cases (67.3%) were identified as infiltrative adenocarcinoma, among them 80 cases (89.9%) had been diagnosed as high grade intraepithelial neoplasia and the other 29 cases (39.7%) had been diagnosed as low grade intraepithelial neoplasia before the operation. In patients with infiltrative adenocarcinomas, 2 cases developed hepatic metastasis, 18 were classified as phase T4, and 26 cases (23.9%) were found with lymph nodes metastasis after the operation.</p><p><b>CONCLUSIONS</b>We should pay more attention to tumors with a diagnosis of intraepithelial neoplasia due to its high potential of malignancy. When the lesion was highly suspected to be malignant, and the resection of the tumor would save the anal sphincter, the tumor should be treated with segmental resection. If the tumor could be confirmed as a infiltrating one then a curative resection is the first choice.</p>

Effect of neoadjuvant chemoradiotherapy on the healing of anastomosis following low anterior resection in locally advanced rectal cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of the neoadjuvant chemoradiotherapy (NCR) on the healing of anastomosis following low anterior resection in patients with locally advanced rectal cancer.</p><p><b>METHODS</b>Between May 2001 and August 2007, 192 patients with T3 and T4 low rectal cancer (distance from the tumor to anal verge </= 6 cm) enrolled in the study. All patients were subjected to preoperative radiotherapy to pelvis, with a total dose of 40 - 46 Gy in 20 days fractions of 2 Gy each in 4 weeks and simultaneously combined with oral capecitabine (CAP) of 1250 mg/m(2) bid continuously for 10 weeks up to surgery. The patients were operated on 6 weeks after the end of radiotherapy according to the rule of TME technique.</p><p><b>RESULTS</b>All patients fulfilled the study. Of the patients, 17 cases were diagnosed tumor free after the neoadjuvant therapy and were not operated on. Other 24 cases were found got complete tumor response with pathological examination after the operation. A total of 41 cases (21.4%) got complete tumor response with the neoadjuvant therapy. Surgery was performed in 175 patients, and 166 patients (95.3%) with sphincter-saving resection, 134 patients with low anterior resection (LAR, double stapling technique) and 32 patients with Park's endoanal anastomosis. Six patients were operated with abdomino-perineal resection (APR) and 3 patients with Hartmann's procedure. Anastomotic leakage was found in 9 patients (5.1%), 6 patients (4 cases of rectovaginal leakage) with LAR(double stapling technique) and 3 patients (1 case of rectovaginal leakage) with Parks technique (P > 0.05). Anastomotic leakage occurred in 2 - 10 days post operation, and were managed properly and got desirable results.</p><p><b>CONCLUSION</b>Neoadjuvant chemoradiotherapy would not affect the healing of anastomosis obviously if being applied reasonably in locally advanced low rectal cancer.</p>

Efficacy of neoadjuvant radiochemotherapy in treatment of locally advanced low rectal cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To explore efficacy of neoadjuvant radiochemotherapy in locally advanced low rectal cancer.</p><p><b>METHODS</b>From May 2001 to August 2005, 105 patients with locally advanced low rectal cancer (T3, T4) were treated by preoperative radiotherapy to pelvis, 2.0 Gy daily up to 40-46 Gy in 4-5 weeks concomitantly with oral capecitabine at 1250 mg x m(-2) x d(-1) for 10 weeks up to surgery. In all patients surgery was carried out under the rule of total mesorectal excision technique.</p><p><b>RESULTS</b>All patients finished the course of neoadjuvant radiochemotherapy. Among them, 36 patients experienced adverse effects. Thirteen patients resulted in complete tumor response and spared the operation. Ninety-two patients were operated on with radical resection, among them 71 patients with low anterior resection, 17 with Parks' colo-anal anastomosis and 4 with abdomino-perineal resection, so sphincter preservation was achieved in 96.2%. In postoperative pathological studies, 11 cases showed complete tumor regression. According to the TNM staging system, 24 cases were ranged T0N0, and 23 cases T2N0, 43 cases T3N0, 2 cases T4N0, 5 cases T2N1, 8 cases T3N1; and according to Dworak's tumor regression grading, 5 cases were ranked TGR0, and 18 cases TGR1, 11 cases TGR2, 47 cases TGR3, 24 cases TGR4. Pathologic downstaging was achieved in 78.1%, including complete response (TGR4) and intermediate response (TGR2 + 3). No operative death occurred. Anastomotic leakage was found in 5 cases, including 3 rectovaginal fistula. All patients have been followed up for 16-67 months, and lung metastasis occurred in 4 cases, liver metastasis in 2 patients and local recurrence in 4 patients. Three patients died of distant metastasis. The 3-year disease-free survival was 82.8% and overall survival was 96.5%.</p><p><b>CONCLUSIONS</b>Neoadjuvant radiochemotherapy brings tumor down-staging and increases resectability and sphincter preservation, decreases recurrence and improves survival in locally advanced low rectal cancer.</p>

Common mistakes and nonstandard expressions in English abstracts of medical literatures / 中南大学学报(医学版)

The mistakes in English abstracts of medical literatures influence the international communication of medical information. The misuse of words, grammar mistakes, and improper expressions are common problems. Moreover, nonstandard expressions also include the names of Chinese herbal medicines, numbers, punctuations, and so on.