Bowel preparation before elective surgery for colorectal cancer / 中华胃肠外科杂志

For elective surgery of colorectal cancer, current evidence supports preoperative mechanical bowel preparation combined with oral antibiotics. Meanwhile, for patients with varied degrees of intestinal stenosis, individualized protocol is required to avoid adverse events. We hereby summarize recent high-quality evidences and updates of guidelines and consensus, and recommend stratified bowel preparation based on the clinical practice of our institute as follows. (1) For patients with unimpaired oral intake, whose tumor can be passed by colonoscopy, mechanical bowel preparation and oral antibiotics are given. (2) For patients without symptoms of bowel obstruction but with impaired oral intake or incomplete colonoscopy due to tumor-related stenosis, small-dosage laxative is given for several days before surgery, and oral antibiotics the day before surgery. (3) For patients with bowel obstruction, mechanical bowel preparation or enema is not indicated. We proposed this evidence-based, individualized protocol for preoperative bowel preparation for the reference of our colleagues, in the hope of improving perioperative outcomes and reducing adverse events.

Recent progress in targeting degradation of FAK based on PROTAC / 药学学报

Local focal adhesion kinase (FAK) is a non-receptor intracellular tyrosine kinase that plays an important role in tumor initiation, development, metastasis and invasion, and is considered to be an important target for the development of antineoplastic drugs. It has both kinase-dependent and non-kinase-dependent scaffolding functions. However, traditional small molecular inhibitors can only inhibit its kinase-dependent activity, so it is difficult to target the kinase-independent scaffolding function. Therefore, there is an urgent need for novel strategies to enhance FAK targeting to lay the foundation for determining the druggability and discovery of FAK inhibitors. Proteolysis targeting chimera (PROTAC) is a new drug development strategy that can recruit E3 ligase to specifically ubiquitinylate target proteins for degradation through the proteasome system. The unique mechanism of action of the PROTAC system could be used to target and degrade the FAK protein, thus eliminating the scaffolding function of FAK. In this review, FAK protein, the signaling pathway, and small molecule inhibitors are briefly described, and the latest research progress in targeting the degradation of FAK using PROTAC technology is summarized.

Correlation of coagulation indicators with inflammatory markers for sepsis in the patients with hematological malignancies / 中国实验血液学杂志

This study was aimed to investigate the correlation of coagulation indicators [prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT) and fibrinogen (FIB), antithrombinIII (ATIII), D-dimer (D-D) levels] with inflammatory markers [procalcitonin (PCT), C reactive protein (CRP), interleukin-6 (IL-6), serum amyloid A (SAA)] for sepsis in hematologic malignancy patients. A total of 326 febrile in patients with hematologic diseases from 2062 patients in West China Hospital, Sichuan University from March 2011 to April 2013 were retrospectively analyzed. The patients were divided into sepsis group(n = 72), non-sepsis group(n = 176) and non-sepsis with low Alb group (n = 78) according to blood culture. The results showed that the values of PT, APTT, D-dimer, Plt in sepsis group were higher than those in non-sepsis group, and the difference between them was statistically significant. While the ATIII level in the sepsis group was lower than that in non-sepsis group, and the difference between them was statistically significant (P < 0.05). And the four inflammatory biomarkers in the sepsis patients were higher than those in non-sepsis patients (P < 0.05). TT and FIB level were not significantly different (P > 0.05). There was not a significant difference in these indicators between non-sepsis group and non-sepsis with low Alb group. The correlation analysis suggested that the level of PCT positively correlated with APTT, D-dimer level (P < 0.05); and negatively correlated with the ATIII (P < 0.05). It is concluded that sepsis results in the concurrent activation of inflammatory and procoagulant pathways. The hematologic malignancy patients with sepsis have an obviously higher systemic inflammatory response, and accompanied with coagulation dysfunction.

Pathological change of partial liquid ventilation in a rabbit meconium aspiration lung injury model / 中华儿科杂志

<p><b>OBJECTIVE</b>To observe the pathological change of partial liquid ventilation (PLV) through establishing the rabbit model of acute lung injury (ALI) induced by meconium aspiration.</p><p><b>METHODS</b>Adult, healthy male or female New Zealand white rabbits were randomly allocated into six groups as follows: (1) control group, (2) conventional mechanical ventilation (CMV) group, (3) high-frequency oscillatory ventilation (HFOV) group, (4) CMV combined with PLV group, (5) HFOV combined with PLV group and (6) normal group. The animals were anesthetized with 1% pentobarbital and tracheotomy was performed and endotracheal tube was placed, 20% meconium fluid (3 ml/kg) was quickly injected into the lung through the endotracheal tube and arterial blood gas was analyzed 30 minutes later. ALI was indicated when P/F ratio (PaO2)/FiO(2)) was < or = 300 mm Hg (1 mm Hg = 0.133 kPa) and Cdyn Dynamic Compliance declined by more than 30% of the baseline. The animals were then randomly allocated into one of the 6 groups. In PLV groups (including CMV + PLV and HFOV + PLV) warmed (37 degrees C) and oxygenated perfluorocarbon was slowly instilled into the lungs of the rabbits through the endotracheal tube at a low-dose 3 ml/kg, then set 15-min positive pressure by sacculus proprius to guarantee perfluorocarbon to steadily diffuse in to the lungs. Six hours after ventilation the animals were sacrificed by using overdose of room air instillation via vein. The lungs were taken and fixed in 4% paraformaldehyde (PFA) and were stained with hematoxylin-eosin (HE). Pathological evaluations included inflammatory manifestation, edema and hemorrhage in both alveolar and interstitial area, damages of small airway (alveolar tube and alveolar bursa) and hyaline membrane formation. One way analysis of variance, Student Newman-Keuls (SNK) method and Kruskal-Wallis (K-W) test were used for comparisons.</p><p><b>RESULTS</b>With the exception of normal group 30 minutes after meconium injections blood gas analysis in different groups showed significant changes and PaO(2)/FiO(2) (< 300 mm Hg), Cdyn declined by more than 60% compared with baseline (P < 0.05). The pathological analysis showed that alveolar and interstitial inflammation, edema, alveolar and interstitial hemorrhage, and small airway damage existed in each group. The hyaline membrane formation was found in one of CMV + PLV group rabbits. The perfluorocarbon-treated animals (CMV + PLV and HFOV + PLV) showed significantly less injury in dependent lung and less damage of small airway (CMV + PLV or HFOV + PLV vs. CMV = 1.1 +/- 0.4 or 0.9 +/- 0.3 vs 2.6 +/- 0.5) compared with the animals of CMV group (P < 0.01). HFOV group (2.1 +/- 0.3) also had less alveolar and interstitial inflammation compared with CMV group (3.0 +/- 0) (P < 0.05), and there was less evidence of alveolar and interstitial edema in the animals treated with HFOV + PLV (1.0 +/- 0.7) compared with CMV (2.0 +/- 0.8) (P < 0.01). Treatment with perfluorocarbon did not result in significant difference in alveolar and interstitial hemorrhage. Compared with CMV and HFOV groups, the groups treated with PLV showed lower mortality of animals (21.4% and 14.3%).</p><p><b>CONCLUSIONS</b>PLV can alleviate the histological damage of acute lung injury induced by meconium aspiration and increased survival chance and therefore PLV would be a useful treatment for MAS. The effectiveness and safety of application of PLV should be evaluated in clinical studies.</p>

Non-myeloperoxidase-mediated system activity of neutrophil in newborn infants / 中华儿科杂志

<p><b>OBJECTIVE</b>To evaluate the variety of non-myeloperoxidase-mediated system activity of neutrophils in newborns during bacterial infection and the effect of cord plasma on the activation of non-myeloperoxidase-mediated system.</p><p><b>METHODS</b>An infection model with Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) and a non-infection model with phorbol-12-myristate-13-acetate (PMA) were established to investigate the activation of non-myeloperoxidase-mediated system in neutrophils. According to the intensity of fluorescence, the activation of non-myeloperoxidase-mediated system of neutrophils was detected by flow cytometry (FCM). The blood cells and plasma were separated from cord blood and adult blood and cross-mixed in order to investigate the opsonic activity.</p><p><b>RESULTS</b>In the non-infection model, the activation of non-myeloperoxidase-mediated system with PMA stimulation in cord blood was lower compared with that in adult blood, the statistical difference was significant (t = 3.378, P < 0.01). In the infection model, the activations of non-myeloperoxidase-mediated system in cord blood were also lower compared with those in adult blood, while the statistical difference could only be found in the model with E. coli stimulation (t = 12.150, P < 0.001). Furthermore the experiments demonstrated that cord plasma could deeply depress the non-myeloperoxidase-mediated system activity with E. coli stimulation. On the contrary, adult plasma could successfully recruit the potential of non-myeloperoxidase-mediated system activity of neutrophils in newborns.</p><p><b>CONCLUSION</b>The function of neonatal neutrophils might not developed very well. As a stimulant, E. coli failed to induce the non-myeloperoxidase-mediated system activity in neonates, which might be related to the lower level of immunoglobulins in cord blood. This result indicated that immunoglobulins played a more important modulating role in bacterial killing during gram-negative bacterial infections.</p>

EXPRESSION OF SMAD 2 AND SMAD 4 PROTEINS IN THE ADULT RAT TESTIS / 解剖学报

Objective To study the localization of Smad 2 and Smad 4 proteins, which are intracellular signaling molecules of transforming growth factor ? family in adult rat testis. Method Immunohistochemical ABC method with glucose oxidase DAB nickel enhancement technique was used in the present study. Results Smad 2 immunoreactivity was mainly located in the spermatogonia, spermatocytes, spermatids, Sertoli cells in the seminiferous tubule and Leydig cells in the interstitial tissue. The reactive substance distributes in cytoplasm with negative nuclei. While Smad 4 is mainly expressed in cytoplasm of Leydig cells, and Sertoli cells is weak stained. Conclusion Our findings of Smad 2 expression in spermatogenic cells and Smad 4 expression in Leydig cells provide direct evidence for the molecular mechanism of TGF ? action during spermatogenesis.