Laparoscopic hiatal hernia repair plus fundoplication for gastroesophageal reflux disease: report of 206 cases / 中华普通外科杂志

Objective:To evaluate the effect of laparoscopic hiatal hernia repair plus fundoplication on gastroesophageal reflux disease (GERD).Methods:The clinical data of 206 GERD patients with esophageal hiatal hernia treated by laparoscopic esophageal hiatal hernia repair + fundoplication at the gastroesophageal reflux center of Zhejiang People′s Hospital from Jan 2016 to Jun 2019 was retrospectively analyzed, including basic data, symptom score, auxiliary examination and follow-up.Results:All 206 patients underwent laparoscopic anti-reflux surgery successfully. There was no conversion to open surgery and no death. Preoperative Deemester scores were 46.49±37.42, while Deemester score 6 month after surgery were 6.38±4.69.Mean follow-up time was 15 months and good result were achieved in 98% of follow-up cases.Conclusion:Laparoscopic repair plus fundoplication for GERD is of minimally invasive and satisfactory, while the preoperative evaluation of surgical indications is properly conducted.

Lumbar facet joint degeneration contributes to degenerative lumbar scoliosis induced by asymmetric stress in rabbits / 南方医科大学学报

OBJECTIVE@#To investigate the role of lumbar facet joint degeneration in the development of degenerative lumbar scoliosis caused by asymmetric stress.@*METHODS@#Thirty-six New Zealand white rabbits were randomly divided into 3 groups (n=12): Group A with aspiration of the nucleus pulposus to induce disc degeneration; Group B with removal of the left capsule from the facet joints at L3/4 to L5/6 to induce degeneration; and Group C with both treatments. Springs were deployed on the left adjacent facets at L3/4, L5/6 and L5/6 to stress the facet joints. Serial radiographs were taken at 3 and 6 months, and the facet joint tissues were sampled at 6 months for Safranin O-fast green staining to assess the severity of cartilage degeneration based on the Mankin score.@*RESULTS@#The Cobb angle differed significantly among the 3 groups (=24.865, =0.000). In all the groups, the Cobb angles at 6 months increased significantly as compared with that at 3 months ( <0.05). The Cobb angles were significantly greater in group C than in the other 2 groups at both 3 and 6 months ( <0.05) but showed no significant difference between Groups A and B (>0.05). The severity of facet joint degeneration also differed significantly among the 3 groups (= 22.009, =0.000), and was the most severe in group C ( <0.05); facet joint degeneration was more severe in group B than in group A ( <0.05).@*CONCLUSIONS@#Facet joint degeneration is an important factor that contributes to the development of degenerative lumbar scoliosis. Disc degeneration and facet joints degeneration can lead to lumbar scoliosis, which in turn aggravates disc degeneration, facet joints degeneration and asymmetric stress, thus forming a vicious circle to further exacerbate lumbar scoliosis.

The expression and clinical significance of microRNA -22 in gastric cancer / 中国基层医药

Objective To investigate the expression and clinical value of miRNA -22 in gastric cancer tissues.Methods Real -time PCR was used to detect the miRNA -22 expression in gastric cancer tissues and matched adjacent tissues.The correlations of miRNA -22 expression with clinic pathological features were analyzed. Results 87.5%(77 /88)of the gastric tumor tissues showed aberrant down regulation of miRNA -22 compared with adjacent non -tumor tissues (χ2 =69.32,P 0.05 ). Conclusion The lower expression of miRNA -22 is associated with clinic pathological features.

Expression of miRNA -22 in esophageal and gastric cancer tissues and cell lines / 中国基层医药

Objective To investigate the expression and clinical value of miRNA -22 in esophageal and gastric cancer tissues and cell lines.Methods Realtime -PCR was performed to detect the expression of miRNA -22 in human esophageal cancer cell lines ECA109,TE -1,TE -8,TE -13 and normal esophageal epithelial cells HEEC,48 cases of esophageal cancer tissues and matched adjacent normal tissues,human gastric cancer cell lines SGC -7901,MKN -45,NCI -N87,AGS,NUGC -3,SUN -1,normal human gastric mucosa cell line GES -1 and normal stomach fibroblastic cell NSFC,88 cases of gastric cancer tissues and matched adjacent normal tissues.Results The expression of miRNA -22 was much less in four esophageal cancer cell lines than that of immortalized normal esophageal epithelial cells HEEC,and the expression of miRNA -22 was much less in six gastric cancer cell lines than that of gastric mucosal epithelial cell line GES -1 and normal stomach fibroblastic cell line NSFC.The esophageal cancer tissues showed aberrant down regulation of miRNA -22 compared with the adjacent non -tumor tissues [(3.51 ±1.05)vs.(11.23 ±2.95),t =18.13,P <0.05].The gastric cancer tissues showed aberrant down regula-tion of miRNA -22 compared with the adjacent non -tumor tissues [(2.15 ±1.23)vs.(9.14 ±2.86),t =22.93, P <0.05].Conclusion The expression of miRNA -22 was much lower in esophageal and gastric cancer tissues and cell lines,which provided basement to nosogenesis,early diagnosis and create drug treatment of the cancers.

Expression of matrix metalloproteinases-9 in the brain tissue of experimental hepatic encephalopathy rats / 中国基层医药

Objective To investigate the significance of MMP-9 expression in the pathogenesis of hepatic encephalopathy.Methods 180 rats were randomly divided into the control group,hepatic encephalopathy 4,8 and 12h groups,45 rats in each group.In hepatic encephalopathy group,rats were intraperitoneally injected D-galactosamine (400mg/kg) with lipopolysaccharide (100μg/kg),and then the symptom was observed.Ammonia,the evans blue(EB) content,the brain water content and the MMP-9 mRNA in the brain tissue were assessed by real-time Q-PCR after 4,8 and 12h.Results 2h later the rats in hepatic encephalopathy groups began to appear the symptom.4 hours later,ammonia,the EB content,the brain water content and MMP-9 mRNA content of the hepatic encephalopathy groups began to increase [(74.27 ± 1.77) μ mol/L vs (33.85 ± 1.50) μ mol/L,F =5 983.36 ;(4.84 ±0.43)μg/g vs (3.96 ±0.48)μg/g,F =111.54; (78.63 ± 0.46)％ vs (76.07 ±0.39)％,F =737.25,and (1.037 ± 0.071) vs (0.829 ± 0.053),F =132.10,P ＜ 0.01],and with the extension of time increased obviously [(136.32 ± 3.88) μmol/L and (279.53 ± 9.78) μmol/L,F =5 983.36 ; (5.94 ± 0.35) μg/g and (6.71 ±0.50)μg/g,F=111.54;(80.50±0.32)％ and (82.14±0.30)％,F=737.25;(1.235 ±0.095) and (1.425± 0.113),F =132.10,P ＜ 0.01].Conclusion Blood brain barrier permeability enhancement and brain edema in hepatic encephalopathy rats may be related with MMP-9 mRNA increasing.

Relationship between matrix metalloproteinases-9 and zonula occludens-1 expression and brain edema in rats with hepatic en-cephalopathy / 中国医师杂志

Objective To study the effect of MMP-9 and ZO-1 expressions on the brain edema in rats with hepatic encepha -lopathy.Methods Ninety rats were randomly divided into two groups .In one group, rats were intraperitoneal of D -galactosamine (400mg/kg) with lipopolysaccharide(100μg/kg) to induce hepatic encephalopathy , and then observe the symptom.12 hours later, ammonia, the evans blue(EB)content, the brain water content and the MMP -9 mRNA and the ZO-1 mRNA in the brain tissue was as-sessed by real-time Q-PCR.Results Two hours later the rats in hepatic encephalopathy groups begin to appear the symptom .12 hours later, the ammonia, the EB content, the brain water content and the MMP -9 mRNA content of the hepatic encephalopathy groups was increased significantly[(279.53 ±9.78)μmol /L vs (33.85 ±1.50)μmol/L, (6.71 ±0.50)μg/g vs (3.96 ±0.48)μg/g, (82.14 ±0.30)% vs (76.07 ±0.39)% and 1.4255 ±0.1131 vs 0.8298 ±0.0537, P <0.01],but the ZO-1 mRNA content was decreased (1.0795 ±0.0534 vs 1.4576 ±0.0654, P <0.01).Conclusions Blood brain barrier permeability enhancement and brain edema in hepatic encephalopathy rats, MMP-9 mRNA increase and ZO-1 mRNA decrease may play an important role .

The expression and its significance of detecting carbonic anhydrase Ⅸ(CAⅨ), paxillin and somatostatin receptors (SSTR) in patients with duodenal carcinoma / 中国现代医生

Objective To investigate the expression and significance of detecting carbonic anhydrase Ⅸ(CAⅨ), pax-illin (paxillin) and somatostatin receptors (SSTR) in patients with duodenal carcinoma. Methods The immunohisto-chemistry was used to detect 87 cases of duodenal carcinoma carbonic anhydrase Ⅸ (CA Ⅸ), paxillin (paxillin) and somatostatin receptors (SSTR) expression. Results Among 87 cases of duodenal cancer, CA Ⅸ positive rate of 71.3%(62/87), paxillin positive rate of 74.7% (65/87), was significantly higher than other groups (P<0.05). The rate of so-matostatin receptor-positive rate of 48.2%(42/87),was significantly lower than than other groups (P<0.05). And the positive rate of duodenal CA Ⅸ poorly differentiated cancer group, the positive rate of protein pile, SSTR-positive rate compared with the well-differentiated group (P<0.05). The positive rate of M1 CA Ⅸ of duodenal papilla cancer, the positive rate of paxillin, SSTR-positive rate compared with M0 stage(P<0.05). Conclusion Carbonic anhydrase Ⅸ(CAⅨ), occurrence, development and metastasis of somatostatin receptor (SSTR) and paxillin and three closely related duodenal cancer, can serve as an important indicator of early diagnosis of cancer, can also be used to assess tumor development and prognosis.

The clinical application of chromoendoscopy with acetic acid and indigo carmine dye in the diagnosis of early gastric neoplasia and precancerous lesion / 中国综合临床

Objective To investigate the significance of chromoendoscopy with acetic acid and indigo carmine dye in the diagnosis of early gastric neoplasia and precancerous lesion.Methods After conventional electronic endoscopic diagnosis,From 2011 fanuay to 300 patients of suspicious lesions were randomly divided into endoscopic dye group and control group,each was 150 cases.Patients of endoscopic dye group were directly performed biopsy after acetic acid and indigo carmine dye,while in control group were performed biopsy after only indigo carmine dye.Results In the endoscopic dye group,16 early neoplasia (10.7％),15 severe atypical hyperplasia (10.0％),79 moderate atypical hyperplasia or Intestinal metaplasia (52.7％) and 40 chronic gastritis were found.In the control group,5 early neoplasia (3.3％),10 severe atypical hyperplasia (6.7％),42 moderate atypical hyperplasia or Intestinal metaplasia(28.0％) and 93 chronic gastritis were found.Early gastric cancer and precancerous lesion detection rate of endoscopic dye was significantly higher than that of the control group,and the difference was statistically significant (P ＜ 0.001).After samples were stained with acetic acid and indigo carmine dye,the image of the mucosa of early cancer and severe atypical hyperplasia were faded mucosa,and the image of moderate atypical hyperplasia and Intestinal metaplasia was dyed asymmetrical.Chronic gastritis and normal mucosa was showed dyed equality.Conclusion Chromoendoscopy with acetic acid and indigo carmine dye improve the detection rate of early gastric cancer and precancerous lesion,thereby of high application value.

Expression of Paxillin and carbonic anhydrase Ⅸ in patients with the duodenal papillary carcinoma / 中国综合临床

Objective To investigate the pile protein (paxillin) and carbonic anhydrases Ⅸ (CA Ⅸ)expression and its significance in duodenal papilla carcinoma patients.Methods Eighty-seven cases of duodenal papilla carcinoma were enrolled as our subject.Immunohistochemical staining was used to detect the expressions of paxillin and CAⅨ in site of tumor,adjacent tissue and duodenal papillitis tissue.Results Sixtyfive cases (74.7％ (65/87)) were showed a higher expression of paxillin in cancer site than that of adjacent tissue (41％ (16/39),P ＜ 0.05) and duodenal papillitis tissue (41.3％ (19/46),P ＜ 0.05),and the difference was statisically significant (x2 =19.869,P ＜0.05).While a higher expression of CA Ⅸ in 62 cases (71.3％) in cancer site was seen,higher than that of adjacent tissue (33.3％ (13/39),P ＜ 0.05) and duodenal papillitis tissue (30.4％ (14/46),P ＜ 0.05),and the difference was statisically significant (x2 =26.936,P ＜ 0.05).As the increase of the cancer tissue malignant degree and the surrounding tissue invasion or distant metastasis degree,paxillin and CA Ⅸ expression increased.Conclusion The paxillin and CAⅨ might served as the early indicators for diagnosis and judgment of prognosis of duodenal papilla cancer.

The expression and clinical significance of folate receptor in the tissues of primary hepatocellular carcinoma / 中国基层医药

Objective To investigate the expression of folate receptor(FR) in primary hepatocellular carci noma and to explore its correlation with clinical and pathological features.Methods Immunohistochemistry was used to detect the expression of FR alpha and beta in primary hepatocellular carcinoma (45 cases),cirrhosis (32 cases) and normal liver tissue (20 cases).And then the relationship between the expression of FR alpha and clinic0pathological features was analyzed.Results The positive expression of FR alpha was detected in 88.9％ (40/45) primary hepatocellular carcinoma,18.8％ (6/32) cirrhosis,and there was no positive expression of FR alpha in normal liver tissue.There was no FR beta expression in primary hepatocellular carcinoma and cirrhosis,only 15％ (3/20) normal liver tissue expressed FR beta.The expression of FR alpha did not correlate with gender and age,but the positive expression of early-mid-term patients was higher than that of the advanced patients.Conclusion FR alpha is presented in most liver tissues of primary hepatocellular carcinoma,which provide basis of early diagnosis and molecular drug target.

Effects of Maijun'an Tablets on expression of ET-1 and NOS in spontaneous hypertensive rats / 中华中医药杂志

Objective:To investigate the effects of Maijun'an Tablets on expression of endothelin-1(ET-1) and nitricoxide synthase(NOS) in tissues and plasma of spontaneous hypertensive rats (SHR). Methods:12 spontaneous hypertensive rats (SHR) were divided randomly into normal control group and drug administration group. Rats in drug administration group were orally given with Maijun'an Tablets (hydrochlorothiazide 10 mg?kg-1.d-1,puerarin 36 mg?kg-1.d-1 and total alkaloid of rhynchophylla 122 mg?kg-1.d-1) once a day for 4 weeks,and rats in control group were orally dosed with equal amount of physiological saline. All animals were sacrificed after 4 weeks. The mRNA and protein contents of ET-1 and NOS in plasma,liver,kidnay and blood vessel were determined. Results:Compared with the control group,Maijun'an Tablets can effectively reduce blood pressure of SHRs,regulate down the content of ET-1 and regulate up the content of NOS at mRNA and protein levels. Conclusion:The up-regulation of NOS and down-regulation of ET-1 at mRNA and protein levels were the major antihypertensive machnisam of Maijun'an Tablets for SHRs.