Value of lymph node regional sorting in radical colorectal cancer surgery / 中华普通外科杂志

Objective:To evaluate the value of lymph node regional sorting in radical colorectal cancer surgery.Methods:Between Jan 2021 and Mar 2022, A total of 307 colorectal cancer patients undergoing radical surgery at the Tianjin Medical University General Hospital were retrospectively included and assigned to either the lymph node regional sorting group (123) or no-sorting group (184) according to the lymph node examination methods.Results:There was a significant difference between the two groups in the number of total lymph nodes and negative lymph nodes (26.74±13.08 vs. 16.80±4.87, t=9.381, P<0.001; 25.65±13.25 vs. 16.04±4.87, t=8.979, P<0.001). The number of positive lymph nodes of lymph node regional sorting group increased compared with no-sorting group (1.09±2.28 vs. 0.76±1.34, t=1.589, P=0.113). A total of 52 cases in the lymph node regional sorting group showed metastasis, of which 10 showed lymph node skip metastases. There was no significant difference in tumor location and TNM stage between skip and non-skip lymph node metastasis patients. Conclusions:The lymph node regional sorting increase the number of examined lymph nodes. The method can determine the positive lymph node distribution and ensure the accuracy of staging.

Preliminary study on high resolution mapping in human gastric electrical activities / 中华消化杂志

Objective To investigate the spatio-temporal characteristics of normal gastric electrical activity.Methods From January 1st to February 29th,2016,fasting gastric electric slow wave signal was collected by high resolution mapping (HRM) under anesthesia before operation in patients without gastric lesions but needed laparoscopic surgery.Parameters of slow wave signal activity was calculated,gastric activity map and velocities was drawn and then spatio-temporal characteristics of gastric electrical activity of different part of the stomach were obtained.Independent sample t test was performed for comparison of two groups and one-way analysis of variance was used for multiple group comparisons.Results The normal gastric pacing zone located in the upper middle part of gastric body near greater curvature.Electrical activity of gastric body spread to gastric antrum along the long axis of the stomach.No slow signal was recorded in the gastric fundus and the gastric cardia.The frequencies of slow waves of different parts of gastric was same and the mean value was 2.61 ±0.11 cycle per minute.Compared with that of gastric body,the slow wave amplitude of gastric pacing zone was higher ((4.19±0.73) mV vs (1.67± 0.89) mV) and the speed was faster (7.24± 1.37) mm/s vs (4.94± 0.20) mm/s);the differences were statistically significant (t=18.89 and 4.95,both P＜0.01).The slow wave amplitude of gastric antrum was higher than that of gastric body ((3.21±0.49) mV vs (1.67±0.89) mV) and the speed was also faster ((6.44±0.82) mm/s vs (4.94±0.20) mm/s);the differences were statistically significant (t=4.85 and 4.95,both P＜0.05).The slow wave amplitude of gastric antrum was lower than that of pacemaker area ((3.21±0.49) mV vs (4.19±0.73) mV),and the difference was statistically significant (t =-3.67,P＜0.05);however,there was no significant difference in wave velocity ((6.44±0.82) mm/s vs (7.24±1.37) mm/s,P＞0.05).Conclusions The normal human gastric pacemaker is located in mid and upper corpus near the greater curvature,which produces slow wave and control whole gastric electrical activity.The amplitude and velocity of slow waves are in gradient changes in different gastric regions.HRM is a mature and reliable research method to study the spatio-temporal characteristics of gastric electrical activity,which provides the possibility for the study of abnormal gastric electrical activity.

Preliminary study on high resolution mapping in human gastric electrical activities / 中华消化杂志

Objective To investigate the spatio-temporal characteristics of normal gastric electrical activity.Methods From January 1st to February 29th,2016,fasting gastric electric slow wave signal was collected by high resolution mapping (HRM) under anesthesia before operation in patients without gastric lesions but needed laparoscopic surgery.Parameters of slow wave signal activity was calculated,gastric activity map and velocities was drawn and then spatio-temporal characteristics of gastric electrical activity of different part of the stomach were obtained.Independent sample t test was performed for comparison of two groups and one-way analysis of variance was used for multiple group comparisons.Results The normal gastric pacing zone located in the upper middle part of gastric body near greater curvature.Electrical activity of gastric body spread to gastric antrum along the long axis of the stomach.No slow signal was recorded in the gastric fundus and the gastric cardia.The frequencies of slow waves of different parts of gastric was same and the mean value was 2.61 ±0.11 cycle per minute.Compared with that of gastric body,the slow wave amplitude of gastric pacing zone was higher ((4.19±0.73) mV vs (1.67± 0.89) mV) and the speed was faster (7.24± 1.37) mm/s vs (4.94± 0.20) mm/s);the differences were statistically significant (t=18.89 and 4.95,both P＜0.01).The slow wave amplitude of gastric antrum was higher than that of gastric body ((3.21±0.49) mV vs (1.67±0.89) mV) and the speed was also faster ((6.44±0.82) mm/s vs (4.94±0.20) mm/s);the differences were statistically significant (t=4.85 and 4.95,both P＜0.05).The slow wave amplitude of gastric antrum was lower than that of pacemaker area ((3.21±0.49) mV vs (4.19±0.73) mV),and the difference was statistically significant (t =-3.67,P＜0.05);however,there was no significant difference in wave velocity ((6.44±0.82) mm/s vs (7.24±1.37) mm/s,P＞0.05).Conclusions The normal human gastric pacemaker is located in mid and upper corpus near the greater curvature,which produces slow wave and control whole gastric electrical activity.The amplitude and velocity of slow waves are in gradient changes in different gastric regions.HRM is a mature and reliable research method to study the spatio-temporal characteristics of gastric electrical activity,which provides the possibility for the study of abnormal gastric electrical activity.

One stage cholecystectomy during radical gastrectomy for gastric cancer with gallbladder disease / 中华普通外科杂志

Objective To evaluate radical gastrectomy combined with cholecystectomy for gastric cancer patients with concomitant gallbladder disease.Methods Clinical data of 702 gastric cancer patients undergoing radical gastrectomy (614 patients) only or combined with cholecystectomy during radical gastrectomy from October 2009 to September 2014 in our department was retrospectively analyzed.Results The operating time of patients with simultaneous cholecystectomy was(348 ± 111)min.the operating time of patients with radical gastrectomy only was (274 ± 89) min (t =3.812,P ＜ 0.05).Perioperative and postoperative complications,hospitalization expenses and 5-year survival rates were not statistically significant (P ＞ 0.05).Conclusions Radical gastrectomy with cholecystectomy for gastric cancer with gallbladder disease patients is safe and feasible.

Location of bone marrow mesenchymal stem cells in rats after small intestinal transplantation / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To study the bone marrow mesenchymal stem cells (MSC) settled in rats after small intestinal transplantation.</p><p><b>METHODS</b>Bone marrow MSCs were taken from 1-month male Lewis rats, isolated and cultured by density gradient centrifugation and differential adherent culture. The surface antigens (CD29, CD90, CD34 and CD45) of MSC were identified by flow cytometry. Final concentration of 5 μg/L CFSE was used to mark the third generation of MSCs. Adult male inbred line F344 rats were used as donor and adult male Lewis rats as acceptor. A heterotopic intestinal transplant rat model was established by F344 to Lewis. Labeled MSCs were injected into model rats through vena dorsalis penis after operation. Tissues at postoperative 7-day were collected for frozen pathology to reveal the location of transplanted MSCs under fluorescence microscope.</p><p><b>RESULTS</b>MSCs were successfully isolated from rat bone marrow. The average positive expression rates of surface antigens CD29, CD90, CD34 and CD45 were 96.48%, 99.77%, 2.41% and 1.39% respectively. MSCs were successfully and effectively marked with CFSE. Seven days after operation, a large number of green fluorescence could be observed in transplanted intestine, spleen and thymus. Autograft intestinal tissues only showed trace fluorescence, and the heart, liver and lung tissue basically did not present the green fluorescence.</p><p><b>CONCLUSION</b>Bone marrow MSCs can settle in transplanted small intestine of rat.</p>

Value of E-PASS and mE-PASS in predicting morbidity and mortality of gastric cancer surgery / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the clinical value of Physiologic Ability and Surgical Stress (E-PASS) and modified Estimation of Physiologic Ability and Surgical Stress (mE-PASS) scoring systems in predicting the mortality and surgical risk of gastric cancer patients, and to analyze the relationship between the parameters of E-PASS and early postoperative complications.</p><p><b>METHODS</b>Clinical data of 778 gastric cancer patients who underwent elective surgical resection in Tianjin Medical University General Hospital from Jan. 2010 to Jan. 2014 were analyzed retrospectively. E-PASS and mE-PASS scoring systems were used to predict the mortality of gastric cancer patients, respectively. Univariate and unconditioned logistic regression analyses were performed to assess the relationships between nine parameters of E-PASS system and early postoperative complications.</p><p><b>RESULTS</b>E-PASS and mE-PASS systems were used to predict the mortality in the death group and non-death group. The Z value was -5.067 and -4.492, respectively, showing a significant difference between the two groups (P<0.05). AUCs of mortality predicted by E-PASS and mE-PASS were 0.926 and 0.878 (P>0.05), and the prediction calibration of postoperative mortality showed statistically non-significant difference (P>0.05) between the E-PASS and mE-PASS prediction and actual mortality. Univariate analysis showed that age, operation time, severe heart disease, severe lung disease, diabetes mellitus, physical state index and ASA classification score are related to postoperative complications (P<0.05 for all). Unconditioned logistic regression analysis showed that severe lung disease, diabetes mellitus, ASA classification score and operation time are risk factors for early postoperative complications (P<0.05 for all).</p><p><b>CONCLUSIONS</b>Both mE-PASS and E-PASS scoring system have good consistency in the predicting postoperative mortality and actual mortality, and both are suitable for clinical application. Moreover, the mE-PASS scoring system is clinically more simple and convenient than E-PASS scoring system. Preoperative severe lung disease, diabetes mellitus, ASA classification score and operation time are independent factors affecting the early postoperative complications.</p>

Enantiomeric characterization and structure elucidation of Otamixaban / 药物分析学报

Otamixaban is a potent (Ki ? 0.5 nM) fXa inhibitor currently in late-stage clinical develop-ment at Sanofi for the management of acute coronary syndrome. Being unproductive in obtaining a suitable crystal of Otamixaban, the required enantiomeric characterization has been accomplished using vibrational circular dichroism (VCD) spectroscopy. Selected by a spectrum similarity index, the calculated spectra of several higher energy conformers were found to match well with the observed spectra. The characteristic IR bands of these conformers were also identified and attributed to the solvation effect. Combined with both the single crystal x-ray diffraction results for an intermediate and the proton NMR study, the absolute configuration of Otamixaban is unambiguously determined to be (R,R).

Value of fast track surgery in the perioperative management of laparoscopic cholecystectomy / 中华消化外科杂志

Objective To investigate the clinical value of fast track surgery (FTS) in perioperative management of laparoscopic cholecystectomy in the plateau.Methods The clinical data of 88 patients with gall stone who received laparoscopic cholecystectomy at the No.115 Central Hospital of PLA from March 2011 to July 2012 were retrospectively analyzed.All the patients were randomly divided into the control group (44 patients) and the observation group (44 patients).Patients in the control group received traditional perioperative treatment,while patients in the observation group received FTS treatment.Differences in the operation time,time to out-of-bed activity,time for recovery of bowel function,duration of postoperative hospital stay,medical treatment cost and incidence of complications between the 2 groups were compared.The measurement data were shown in x ± s,and analyzed using the t test,and the count data were analyzed using the chi-square test.Results The operation time of the control group and the observation group were (63 ± 19)minutes and (59 ± 21)minutes,with no significant difference between the 2 groups (t =-1.34,P ＞ 0.05).The time for out-of-bed activity,recovery of bowel function,duration of postoperative hospital stay and medical treatment cost were (25 ± 6) hours,(36 ± 9) hours,(5.6 ± 1.3) days,(10.8 ± 1.1) × 103 yuan in the control group,and (10 ± 4) hours,(23 ± 5) hours,(3.1 ± 1.3) days,(7.9 ± 1.3) × 103 yuan in the observation group,with significant differences between the 2 groups (t =-3.81,-3.67,-6.40,-4.08,P ＜ 0.05).The incidences of complications in the control group and the observation group were 4.5％ (2/44) and 2.3％ (1/44),respectively,with no significant difference between the 2 groups (x2=3.01,P ＞ 0.05).Conclusion FTS can promote the recovery of patients,decrease duration of hospital stay and medical treatment cost without increasing incidence of complication for patients who received laparoscopic cholecystectomy in the plateau.

Inhibitory effect of EGCG on proliferation and HIF-1α/VEGF expression in cell line HepG2 / 中国病理生理杂志

AIM: To study the molecular mechanism of EGCG on inhibiting the growth of hepatic carcinoma. METHODS: The proliferation of hepatic cell line HepG2 cultured with different doses of EGCG was studied by MTT and suspension/adherence methods. The effect of EGCG on the expression of HIF-1α/VEGF at mRNA and protein levels in vitro and in vivo was evaluated by RT-PCR and Western blotting, respectively. The inhibition of EGCG on the growth of tumor implanted into athymic nude mice was also observed. RESULTS: The proliferation of hepatic cell line HepG2 was inhibited by EGCG in a dose-dependent manner. The expression of HIF-1α/VEGF was suppressed markedly by EGCG at protein level. However, the inhibitory effect of EGCG on the mRNA expression was only observed on VEGF, not on HIF-1α. In the animal experiment, the implanted tumor growth was inhibited by 39.8%±5.1%. CONCLUSION: EGCG suppresses the hepatic carcinoma cell growth, and interrupts the HIF-1α/VEGF signaling pathway significantly, indicating a fundamental mechanism of EGCG for inhibiting tumor growth.

4-1BB gene expression in peripheral blood mononuclear cells from orthotopic liver transplant recipients with graft acceptance / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the gene expression of 4-1BB in peripheral blood mononuclear cells (PBMCs) and the possible significance of the 4-1BB pathway after clinical orthotopic liver transplantation (OLT).</p><p><b>METHODS</b>4-1BB mRNA levels in PBMCs from 22 OLT patients were analyzed by RT-PCR. 4-1BB protein expressed on the surface of CD(4)(+) and CD(8)(+) T cells were detected by flow cytometry, and visualized with direct immunofluorescence and confocal fluorescence microscopy. Patients with primary liver cancer (PLC) and healthy volunteers served as controls. Six cases of recently performed liver transplantation were also observed in this study.</p><p><b>RESULTS</b>4-1BB mRNA was detected in PBMCs from both liver transplant patients with long-term graft acceptance (22 cases) and from transplant patients on day 1 to day 3 post-transplantation (6 cases), but was not found in PBMCs from transplant patients on day 7 to day 30 post-transplantation (6 cases). 4-1BB mRNA was also not found in samples from 8 of the healthy controls and 7 of the PLC patients, though very low expression was detected in the other 4 healthy volunteers and 6 PLC patients. Simultaneously, 4-1BB protein was expressed at nearly undetectable levels on CD(4)(+) and CD(8)(+) T cells from healthy controls, PLC patients, as well as OLT patients within the first month post-transplantation (6 cases). However, 4-1BB expression was found on the surface of CD(4)(+) and CD(8)(+) T cells from liver transplant patients with long-term graft acceptance. Direct immunofluorescent staining and confocal fluorescence microscopy clearly revealed evidence of 4-1BB protein on cell membranes of CD(4)(+) and CD(8)(+) T cells from liver transplant patients with long-term graft acceptance. Simultaneously, a significantly higher percentage of CD(3)(+) CD(25)(+) T cells were found in liver transplant patients with long-term graft acceptance group as compared with the healthy control group (P < 0.05). The expression of 4-1BB protein on T cells did not correlate with the survival time of OLT patients postoperation.</p><p><b>CONCLUSIONS</b>This study demonstrates that although patients remain in stable condition after liver transplantation under the treatment of immunosuppressants, activated T cells are present to some extent and 4-1BB protein may be involved in this process. Effector T-cells can exert permanent immunoresponses against grafts under these circumstances. Therefore, we conclude that a new immune response balance is established under the combination of both treatment with immunosuppressants and natural immune responses against alloantigens. Manipulation of the 4-1BB/4-1BBL pathway may provide a therapeutic technique for prolonging graft survival.</p>

Inhibitory effect of EGCG on proliferation and HIF-1?/VEGF expression in cell line HepG2 / 中国病理生理杂志

AIM:To study the molecular mechanism of EGCG on inhibiting the growth of hepatic carcinoma. METHODS: The proliferation of hepatic cell line HepG2 cultured with different doses of EGCG was studied by MTT and suspension/adherence methods. The effect of EGCG on the expression of HIF-1?/VEGF at mRNA and protein levels in vitro and in vivo was evaluated by RT-PCR and Western blotting,respectively. The inhibition of EGCG on the growth of tumor implanted into athymic nude mice was also observed. RESULTS: The proliferation of hepatic cell line HepG2 was inhibited by EGCG in a dose-dependent manner. The expression of HIF-1?/VEGF was suppressed markedly by EGCG at protein level. However,the inhibitory effect of EGCG on the mRNA expression was only observed on VEGF,not on HIF-1?. In the animal experiment,the implanted tumor growth was inhibited by 39.8%?5.1%. CONCLUSION: EGCG suppresses the hepatic carcinoma cell growth,and interrupts the HIF-1?/VEGF signaling pathway significantly,indicating a fundamental mechanism of EGCG for inhibiting tumor growth.