Traditional Chinese Medicine Regulation of MAPK Pathway for Treatment of Obesity： A Review / 中国实验方剂学杂志

With a global rise in morbidity rates， obesity has become a pressing public health issue. With increased adipocyte number and volume as the main characteristics， obesity is also manifested by metabolic disorders to varying degrees. At the same time， obesity is a risk factor for diabetes， hypertension， stroke， cancer， and cardiovascular diseases， imposing burdens on society and families. Influenced by lifestyle， environment， behavior， and genetics， obesity is caused by the interaction of many factors， and its pathological process is complex， involving inflammation， autophagy， and intestinal dysbiosis. The mitogen-activated protein kinase （MAPK） cascade reaction， a pivotal signaling pathway， plays a crucial role in cellular processes such as proliferation， differentiation， apoptosis， and stress responses. Both Chinese and international studies indicate that the MAPK signaling pathway can effectively regulate obesity through various pathways， including the modulation of adipocyte differentiation and apoptosis， appetite control， and inflammation improvement. Moreover， traditional Chinese medicine （TCM） has demonstrated significant efficacy in preventing and treating obesity， leveraging advantages such as multiple targets， diverse components， and minimal adverse effects. Research indicates that the MAPK signaling pathway is a primary focus of TCM regulation in this context， although a systematic review in this field is currently lacking. Therefore， this paper， by reviewing the latest Chinese and international research， provided a concise overview of the basic structure of the MAPK pathway， with a specific emphasis on recent progress in TCM interventions targeting the MAPK pathway for obesity treatment. The results indicate that regulating adipose tissue formation， differentiation， and thermogenesis， reducing inflammation and oxidative stress levels， and improving insulin sensitivity and metabolic disorders seem to be the main ways for TCM to regulate the MAPK pathway to prevent and treat obesity. However， it is necessary to find more research methods and explore potential mechanisms underlying TCM formulations based on the MAPK pathway for obesity prevention and treatment.

Application of CBL combined with 3D imaging technology in thoracic surgery probationary teaching / 中华医学教育探索杂志

Objective:To explore the application effect of case-based learning (CBL) combined with three-dimensional (3D) imaging technology in thoracic surgery probationary teaching.Methods:Ninety thoracic surgery interns in the Affiliated Hospital of Yangzhou University, China in 2019 were selected and divided into the conventional theoretical teaching group (group A), CBL group (group B), and CBL combined with 3D imaging technology group (group C) according to the random number table method. Group A was taught with conventional theory; group B was taught by CBL; in group C, 3D imaging software was used to reconstruct computed tomography data based on CBL. The theoretical scores of the three groups were evaluated respectively, and a questionnaire survey was conducted on the students (including whether the teaching is conducive to stimulating the interest and enthusiasm of learning, whether it is conducive to the establishment of clinical thinking, evaluation of advantages and disadvantages of the teaching method, and whether the teaching method is conducive to the mastery of theoretical knowledge). SPSS 20.0 was used for analysis of variance, t test, and Chi-square test. Results:The theoretical score of group A (85.83±4.62) was the lowest, and the theoretical score of group B was significantly lower than that of group C (89.71±5.84 vs. 94.60±6.28); the answer time of group C (286.68±77.56 seconds) was the shortest, and the answer time of group B was significantly shorter than that of group A (359.78±80.55 vs. 423.31±83.53 seconds, P<0.001). Group C was significantly better than group B and group A in the aspects of stimulating interest and enthusiasm in teaching, conducive to the establishment of clinical thinking, advantages of the teaching method, and conducive to the mastery of theoretical knowledge, and group B was significantly better than group A ( P<0.001). Conclusion:The combination of CBL and 3D reconstruction technology improves the recognition of thoracic surgery interns to the teaching method, increases their theoretical scores, stimulates their learning interest and enthusiasm, cultivates their clinical thinking, and enhances their mastery of theoretical knowledge.

Activity and mechanism of palbinone against hepatic fibrosis and inflammation / 药学学报

The study aims to investigate the anti-hepatic fibrosis and anti-inflammatory activities of palbinone, and to explore the internal regulatory mechanism, so as to lay an active foundation for its development as an anti-non-alcoholic steatohepatitis (NASH) candidate. First, sulforhodamine B (SRB) method was used to detect the effect of palbinone on the proliferation of human hepatic stellate cells LX-2 and rat hepatic stellate cells HSC-T6. Following, in the in vitro hepatic fibrosis cell model that activated by transforming growth factor beta 1 (TGF-β1), quantitative real-time PCR (qRT-PCR) and Western blot were used to detect the inhibitory effect of different concentrations of palbinone on the transcription level and protein expression level of hepatic fibrosis markers. And the regulating mechanism of palbinone on fibrosis-related genes was analyzed at the same time. In addition, in the inflammatory cell model that induced by lipopolysaccharide (LPS) and nigericin, ELISA was used to detect the effect of palbinone on the released interleukin-1β (IL-1β) level. At the same time, Western blot was used to detect the effect of palbinone on the related proteins of inflammatory pathway. The results showed that palbinone could significantly inhibit the proliferation activity of LX-2 and HSC-T6, and their half maximal inhibitory concentration (IC50) values ​​were (375.11 ± 55.45) and (260.27 ± 36.81) nmol·L-1, respectively. In addition, palbinone showed a dose-dependent inhibitory effect on the expression levels of TGF-β1-induced fibrosis-related genes, including collagen type Ⅰ α 1 (COL1A1), TGF-β1, α-smooth muscle actin (α-SMA) and tissue inhibitor of metalloproteinase 1 (TIMP1). Mechanism study showed that palbinone may decrease the expression level of Yes-associated protein (YAP), thereby weakening its activation effect on the downstream fibrosis pathway. In addition, palbinone also exerted an anti-inflammatory effect by inhibiting the activity of nuclear factor kappa-B (NF-κB) signaling pathway and reducing inflammatory factors cysteinyl aspartate specific proteinase-1 (caspase-1) and IL-1β release. In conclusion, palbinone can not only inhibit the proliferation and activation of hepatic stellate cells by inhibiting the expression of YAP, but also inhibit the expression and release of inflammatory factors at the same time. All these studies provide theoretical support for the development of palbinone as an anti-nonalcoholic steatohepatitis drug.

Comparative study on short and long-term intervention impacts of six Chinese herbs with cold or heat property on lipid and energy metabolism in mice / 中国中药杂志

This study selected three typical Chinese herbs with cold property(Rhei Radix et Rhizoma, Scutellariae Radix, and Coptidis Rhizoma) and another three with heat property(Cinnamomi Cortex, Zingiberris Rhizoma, and Aconiti Lateralis Radix Praeparata) to observe their regulatory effects on metabolism in animal organism, especially on lipid and energy metabolism in mice after a short-(7 d) and long-term(35 d) intervention. The mRNA expression levels of lipid metabolism genes in epididymal adipose tissue and liver were determined by real-time PCR. The oxygen consumption, carbon dioxide production, and energy consumption were detected by metabolic system. After the short-term intervention, the Chinese herbs with heat property significantly reduced epididymal adipose tissue index and elevated the expression levels of acetyl-CoA carboxylase(ACC), lipoprotein lipase(LPL), and carnitine-palmityl transferase 1(CPT-1) in liver and epididymal adipose tissues. However, those with cold property promoted the expression of above-mentioned genes in epididymal adipose tissue. After the long-term intervention, cold and heat Chinese herbs had no significant effect on epididymal adipose tissue index of animals, while cold Chinese herbs could increase carbon dioxide production and energy consumption and reduce activity. These findings demonstrated that the short-term intervention effects of cold and heat Chinese herbs on animal metabolism were significantly stronger than the long-term intervention effects. Specifically, the short-term intervention with cold Chinese herbs enhanced the lipid metabolism in epididymal adipose tissue, while the heat Chinese herbs promoted lipid metabolism in epididymal adipose tissue and liver. The long-term intervention with cold and heat Chinese herbs resulted in no obvious change in lipid level, but long-term intervention with cold Chinese herbs accelerated energy consumption of the body. This study preliminarily observed the effects of cold and heat Chinese herbs on normal animal physiology from lipid and energy metabolism, which would provide reference for explaining the biological basis of Chinese herbs with cold or heat property based on biological response.

Mechanism study of Si Miao Formula on alleviating insulin resistance by increasing the abundance of Akkermansia muciniphila in mice / 药学学报

In our previous study, we found that Si Miao Formula (SMF) had the effect of improving the disorder of glucose metabolism caused by high fat and high sucrose diet, and significantly altered the composition of gut microbiota, especially increasing the level of Akkermansia muciniphila (A. muciniphila). However, it is unclear that the role of intestinal flora and A. muciniphila play in SMF improving blood glucose homeostasis, and the mechanism of how SMF increases the level of A. muciniphila. Therefore, this study will explore the correlation between SMF improving the insulin resistance and increasing the level of A. muciniphila, as well as the mechanism of SMF-induced growth of A. muciniphila using the in vitro and in vivo experiments. We explored the effect of intestinal flora and A. muciniphila on SMF-improved insulin resistance through fecal microbiota transplantation (FMT) and antibiotic intervention. In order to study the mechanisms underlying SMF on elevating A. muciniphila, we disassembled SMF to find the key component which can particularly elevate the number of A. muciniphila. Using the in vitro anaerobic culture system combined with cell and animal experiments, we explored the mechanism of the key component in elevating A. muciniphila. The research was approved by the Animal Ethical and Welfare Committee of Shanghai University of Traditional Chinese Medicine. Our results showed that the gut microbiota altered by SMF can improve high fat and sucrose diet induced insulin resistance in recipient mice, and the improvement was closely related to the abundance of A. muciniphila. Cortex Phellodendri played the most important role in regulating the composition of intestinal flora and increasing the number of A. muciniphila, of which, berberine was the key component of Cortex Phellodendri which up regulated A. muciniphila. We have found that berberine cannot directly promote the growth of A. muciniphila in vitro, but it can stimulate the expression of mucin, which, in turn, promote the growth of A. muciniphila. The above results show that the improved insulin sensitiviy by SMF depends on the increased level of A. muciniphila. The effect of SMF on elevating the amount of A. muciniphila might be correlated with the increased expression of mucin stimulated by berberine.

Preparation and characterization of dissolving microneedles with nano-enhanced mechanical properties / 药学学报

In this paper, the effects of the blend of nanoparticles and microneedle matrix materials on the mechanical properties of dissolving microneedles were studied mainly, so as to construct microneedles with excellent mechanical properties. Different kinds of nanoparticles (calcium carbonate, hydroxyapatite, silica), particle sizes (20, 60, 100 nm) and the proportion of prescription (2%, 6%, 10%) were blended with the matrix material [polyvinyl pyrrolidone (PVP), poly(1-vinylpyrrolidone-co-vinyl acetate)(PVP/VA)] to form dissolving microneedles. The effects of nanoparticles on the elastic modulus and hardness of the microneedles were investigated using a nanoindenter. The results showed that the elastic modulus and hardness of PVP microneedles were significantly improved by nano-calcium carbonate (P < 0.001), and the elastic modulus and hardness of PVP/VA microneedles were significantly improved by nano-hydroxyapatite (P < 0.001). When the particle size of hydroxyapatite was 20 nm, the elastic modulus of PVP/VA microneedles was (10.6 ± 1.0) GPa, and the hardness was (0.47 ± 0.06) GPa. As the size of the nanoparticles increases, the mechanical performance of the microneedles decreases. When the mass proportion of nano-hydroxyapatite increased from 2% to 6%, the elastic modulus and hardness of the microneedles were significantly improved (P < 0.001), but the effect of continue increasing the proportion of nanoparticles on the microneedles was not significant. The nano-enhanced PVP/VA dissolving microneedles has no irritant effect on intact skin and has a slight irritation to damaged skin, but they disappear completely after 72 h. Animal experiments have been approved by the Laboratory Animal Welfare and Ethics Committee of Zhejiang University of Technology. Therefore, the nano-enhanced dissolving microneedles has good biological safety. To sum up, it is necessary to select the appropriate kind of nanoparticle, particle size, and prescription ratio when microneedles constructing with a given matrix material, so as to effectively improve its mechanical performance.

The Impact of IONPs and PBNPs Nanoparticles in Regulating Stemness of Ovarian Carcinoma Cells / 中国药学杂志

OBJECTIVE: To study the effects of iron oxide nanoparticles (IONPs) and prussian blue nanoparticles (PBNPs) on the stemness of epithelial ovarian cancer (EOC) cell lines, which may provide experimental basis and reference significance for the application of nanoparticles in the treatment of EOC. METHODS: SKOV3 and HO8910 cell lines were treated with IONPs and PBNPs respectively, then the drug-resistant genes in mRNA and protein levels were detected by RT-PCR and Western blot. The change of cell proliferation ability were detected by cell proliferation and clone formation experiments, and the expression of surface stemness-related molecules were detected by flow cytometer. RESULTS: The expression of ABCG2 and ALDH1A1 were both down regulated in SKOV3 and HO8910 cell lines treated with IONPs and PBNPs, respectively, while IONPs decreased the CD44+CD117+ subpopulation, and PBNPs increased the CD44+CD117+ subpopulation. Compared with the control cells, the proliferation of SKOV3 cells treated with IONPs and PBNPs were significantly reduced, however, there were no effects on HO8910 cell's proliferation after the cells treated with PBNPs. CONCLUSION: Drug-resistance genes and stem cell subpopulation of EOC SKOV3/HO8910 cell lines treated with IONPs were markedly reduced. However, PBNPs can improve the stem cell subpopulation and promote the cancer stem cell's characteristic of EOC cells but the drug-resistance genes were decreased.

Pepstatin Pr show anti-fibrosis effect related to YAP-TGFβ-Smad pathway / 药学学报

Liver fibrosis is a tissue repair compensatory response to liver injury caused by various chronic factors, ultimately leading to liver cirrhosis, liver failure and even hepatocellular carcinoma. Abnormal activation of hepatic stellate cells is the cellular basis of liver fibrosis development. Pepstatin Pr, the derivative of pepstatin A, was isolated from Streptomyces sp. CPCC 202950. Our purpose was to investigate the anti-fibrotic activity of pepstatin Pr and explore its molecular mechanism. Hepatic stellate cell LX-2 was stimulated by TGFβ1 and sub- sequently treated with pepstatin Pr. Its cytotoxicity was detected by sulforhodamine B (SRB) assay. The expression of COL1A1, α-SMA and cathepsin D, signaling proteins TGFβ, Smad and YAP/TAZ were detected by Western blot or real-time PCR. The results showed that pepstatin Pr was not cytotoxic to LX-2 cells. And pepstatin Pr significantly reduced the mRNA and protein expression of COL1A1 and α-SMA, which are important liver fibrosis markers. Pepstatin Pr also repressed the protein expression level of cathepsin D, TGFβ1, YAP/TAZ, the phospholation level of Smad2, and YAP nuclear translocation. In conclusion, pepstatin Pr exhibits anti-fibrotic effects in TGFβ1-stimulaed LX-2 cells by mediating YAP-TGFβ-Smad pathway.

The expression and methylation status of Dickkopf-3 gene in oral squamous cell carcinoma / 实用口腔医学杂志

Objective: To explore the expression of Dickkopf-3(DKK-3) mRNA in oral squamous cell carcinoma(OSCC) and the relationship between the promoter methylation status and the carcinogenesis of OSCC. Methods: The expression of DKK-3 gene in 51 cases of OSCC and corresponding normal mucosa tissue was detected by PT-PCR and methylation-specific PCR, respectively. The relationship between DKK-3 and the clinical pathological features of the patients was analyzed with SPSS 13. 0. Results: The expression level of DKK-3 in OSCC group was lower than that in the control(t =-12. 580, P＜ 0. 05). The methylation rate of DKK-3 gene promoter region in OSCC group was significantly higher than that in the control(χ2 = 19. 273, P＜ 0. 05). The mRNA expression level of DKK-3 gene in OSCC with methylation group was lower than that in the control(t =-2. 817, P＜ 0. 05). Conclusion: Down-regulation of DKK-3 gene expression and hypermethylation of promoter region are important mechanisms in the pathogenesis of OSCC. The hypermethylation of DKK-3 promoter may be the main cause of transcriptional silencing.

Effect of anesthetic sensitivity to propofol after biliary decompression in common bile duct ligation rats / 临床麻醉学杂志

Objective To investigate if anesthetic sensitivity to propofol will be restored after biliary decompression.Methods Twenty-four adult male SD rats were randomly assigned into 3 groups:sham group (group S),irreversible obstructive jaundice group (group Ⅰ) and reversible obstructive jaundice group (group R).The serum total bilirubin (TBL) and total bile acid (TBA) concentratins were detected in the rat blood samples collected from the caudal vein before and after the operation,3,7,14,21 d respectively.Propofol was administered to measure the time of loss of righting reflex and recovery pre or 7th and 21th day post ligation.Results Serum TBL and TBA in group Ⅰ and serum TBA in group R were significantly higher than that in group S on 3rd,7th,14th,21th day post surgery(P＜0.05).Compared with group S,seum TBL in group R were significantly high on 3rd,7th,14th day post-surgery.Serm TBL and TBA in group R were significantly lower than group Ⅰ on 14th,21th day post-surgery (P＜0.05).Compared with group S,the time to loss of righting reflex in group I and group R were significantly shortened and the time to recovery were significantly increased on 7th day post-surgery (P＜0.05).Conclusion Obstructive jaundice could significantly potentiate the ability of propofol to induce a loss of righting reflex,and the increased anesthesia sensitivity will be restored after biliary decompression.

Ganoderma triterpenes slow cyst growth in polycystic kidney disease / 中国药理学与毒理学杂志

OBJECTIVE Autosomal dominant polycystic kidney disease (ADPKD) is a common inherited disease with a high morbidity around 1/1000-1/400, characterized by progressive enlargement of fluid-filled cysts derived from renal tubular epithelial cells. Massive cysts gradually compress renal parenchyma destroying normal renal structures and compromising renal functions. Unfortunately, it will cause end-stage renal disease in most of the patients but without effective therapy now, who have to live on hemodialysis or kidney transplantation. Based on this present situation, it is of great significance to find early intervention to inhibit renal cyst development. The projective of this study was to investigate whether Ganoderma triterpenes (GT) can inhibit renal cyst development and study the related mechanism. METHODS and RESULTS First, we used MDCK cyst model, cultivated MDCK cells in vitro to form fluid-filled cysts surrounded by monolayer cells. GT inhibited MDCK cyst formation significantly, and inhibited cyst enlargement dose-dependently proving GT cyst inhibition in vitro. Then we used an embryonic kidney cyst model, wile-type mice kidneys were taken out on embryonic day 13.5 to form renal cysts stimulated with 8-Br-cAMP. GT inhibited embryonic kidney cyst development significantly in a dose-dependent and reversible manner proving GT cyst inhibition at organ level. Furthermore, we used two ADPKD mouse models with severe cystic kidney disease phenotypes. GT dramatically inhibited renal cyst development, decreased ADPKD mouse kidney volume and the cyst index inside proving GT cyst inhibition in vivo. By Western blot, we proved GT down-regulated Ras/MAPK signal pathway without detectable effect on mTOR signal pathway both in MDCK cells and two ADPKD mouse kidneys. CONCLUSION GT retard renal cyst development both in vitro and in vivo significantly. The related mechanisms were involved in GT promoting renal tubular epithelial cell differentiation, down-regulating intracellular cAMP level and Ras/MAPK signal pathway.

Expression and clinical significance of MIF and MMP-9 in gastric cancer / 安徽医科大学学报

Objective To investigate the expression and clinical significance of migration inhibitory factor ( MIF) and matrix metalloproteinase-9(MMP-9) in human gastric cancer tissue and corresponding adjacent normal tissue. Methods Selected surgery and pathologically confirmed 80 cases of gastric cancer as the experimental group, took another 80 cases of corresponding adjacent tissues as a control group. The expressions of MIF and MMP-9 were de-tected in 80 cases of gastric cancer patients cancer tissue and corresponding adjacent normal tissue by immunohisto-chemical SP method. Results ①The expression of MIF and MMP-9 of gastric cancer in varying degrees:The pos-itive rates of MIF and MMP-9 were 68. 8% and 67. 5%,which were higher than that in adjacent normal tissues, 32. 5% and 37.5% (P <0.05);② The expression of MIF was significantly associated with the clinical stage, depth of invasion,degree of differentiation,lymph node metastasis and TNM staging (P<0.05), nothing to do with other clinicopathological parameters;the expression of MMP-9 was significantly associated with the depth of inva-sion,degree of differentiation, lymph node metastasis and TNM staging (P<0.05), nothing to do with other clini-copathological parameters;③ There was positive correlation between the expression of MIF and MMP-9 in gastric cancer tissue (χ2 =9. 154, P<0. 01,r=0.338). Conclusion The expressions of MIF and MMP-9 show a posi-tive expression in gastric carcinoma, there maybe have a positive correlation between MIF and MMP-9. Their ex-pressions of varying degrees are closely related with the occurrence and development of gastric cancer, guidance gastric diagnosis, treatment and prognosis.

Asymmetric index analysis on the orthodontic-orthognathic treatment of facial asymmetry patients in skull positioning posterior-anterior radiographs / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To analyze the asymmetry of measurements in facial asymmetry patients with skull positioning posterior-anterior radiographs after orthodontic-orthognathic treatment.</p><p><b>METHODS</b>Posterior-anterior cephalometric radiography and cephalometric analysis were performed in forty-five patients with different degrees of facial asymmetry. A single sample t-test was conducted to compare the asymmetry of measurements before treatment and individual normal occlusion. The measurement and reference values in facial asymmetry patients who underwent orthodontic-orthognathic treatment were summated by analyzing the correlation coefficient. The paired t-test was employed to compare the difference between the two groups before and after the treatment.</p><p><b>RESULTS</b>Fourteen measurements were significantly different before the treatment and individual normal occlusion (P < 0.05). Me[X] exhibited a higher correlation index of Ag[X] in forty-five cases. Twenty-eight patients showed the main asymmetry in the mandibular body, whereas fifteen patients in the ramus. Two patients showed the main asymmetry in both mandibular body and ramus. Fifteen measurements were significantly different before and after the treatment (P < 0.05).</p><p><b>CONCLUSION</b>Facial asymmetry is mainly concentrated in one-third of the surface, primarily manifested in the mandibular body. Orthodontic-orthognathic treatment is preferred when Ag[X] is greater than the minimum reference value of 11.31%, Go[X] is greater than 9.79%, and Me[X] is greater than 5.2 mm.</p>

Influence of obstructive jaundice on neuromuscular blocking effect and drug metabolism of rocuronium / 第二军医大学学报

Objective: To observe the effect of obstructive jaundice on the neuromuscular blocking effect and drug metabolism of rocuronium, so as to guide proper use of rocuronium during anesthesia for patients undergoing hepatobiliary surgeries. Methods: Thirty patients (with normal renal function and without muscle or nerves diseases, ASA I - II) receiving elective surgery were divided into 2 groups: obstructive jaundice group (group I, n=15) and control group (group II, n=15). All patients received continuous peridural anesthesia and general anesthesia. Neuromuscular blockade was evaluated with train-of-four (TOF) stimuli of the ulnsar nerve using TOF Watch SX nerve stimulators. The onset time, clinical duration of rocuronium, the time of TOFR from 0 to 70% and recovery index (T1 from 25%-75%) were observed. Liquid chromatography-tandem mass spectrometry (LC/MS/MS) was used to determine the concentration of rocuronium in the plasma at 30, 60, 90, 120, and 180 min after administration of 0. 9 mg/kg rocuronium. Results: The age, body mass index, and prothrombin time were matched between the two groups. The total bilirubin, direct bilirubin and indirect bilirubin in group I were significantly higher than that in group II (P<0.01). The onset time was similar between the two groups; the clinical duration of rocuronium, the time of TOFR from 0 to 70%, and the recovery index (to 10%, 25%, 50%, and 75% of T1) in group I were significantly longer than those in group II (P<0.01). The plasma concentrations of rocuronium in group I were significantly higher than those in group II at 60, 90, 120 min after administration of rocuronium (P<0. 01 or P<0.05). Conclusion: Obstructive jaundice may prolong the duration of rocuronium action and recovery time, and slows down the metabolism of rocuronium. So patients with obstructive jaundice should have a longer interval for drug addition. Peri- and post-operative monitoring of neuromuscular function is suggested for proper drug use and anesthesia extubation.

Effects of sufentanil, remifentanil or fentanyl on cardiac output of elder patients during induction of general anesthesia / 中国基层医药

Objective To compare the effects of equivalent dose sufentanil,remifentanil or fentanyl on hemodynamic and cardiac output in the elderly patients during induction of general anesthesia.Methods Ninety elderly patients(ASA Ⅰ ～ Ⅱ) undergoing elective abdominal surgery under general anesthesia were randomly divided into sufentanil group(group S),remifentanil group(group R) and fentanyl group(group F),30 patients in each group.Patients in group S,group R and group F received sufentanil 0.2μg/kg,remifentanil 2μg/kg and fentanyl 2μg/kg Ⅳ,respectively,using an blind method before intubation.SBP,DBP,MAP,HR,CO,CI and SVR were recorded before of anesthesia (T0),immediately after induction (T1),1,3 minutes after tracheal intubation (T2,T3).Changes of SBP and HR during observation were also recorded.Results The MAP and HR in three groups at T1 were significantly lower than those at T0 and decreased significantly in group R than those in group F and S(P ＜0.05).The MAP and HR in group F significantly increased at T1 than T0.The MAP and HR in group R were significantly decreased after tracheal intubation.Compared with the baseline,the MAP and HR in group S at T1,T2,remained unchanged.In group R,there were two patients whose HR were under 50 bpm.In group F,the MAP at T1,T2 were significantly higher than those at T.In group S,there were no significant changes in CO,CI,SVR which were all within normal range (P ＞ 0.05).Conclusion Both sufentanil and remifentanil effectively inhibit the stress response during induction of general anesthesia.At the same time,sufentanil has better hemodynamic stability.

Application of surgical robotic system in patients with gastric cancer: a report of 120 cases / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the safety, feasibility, and efficacy of robotic gastrectomy for gastric cancer using da Vinci surgical system.</p><p><b>METHODS</b>A total of 120 patients who underwent robotic gastrectomy using da Vinci surgical system for gastric cancer from May 2010 to April 2012. Data regarding surgical and early oncological outcomes were systematically collected in a specific database for statistical analysis.</p><p><b>RESULTS</b>There were 74 males and 46 females, with a mean age of 58.5 (22-80) years old. The type of robotic operation included 62 distal subtotal gastrectomies, 35 total gastrectomies, and 23 proximal gastrectomies. Reconstruction of the alimentary tract was achieved using extracorporeal method through a minilaparotomy in 55 cases, and intracorporeal robot-sewn anastomosis in 65 cases. There was 1 conversion (0.9%). The operative time was (245±50) min and the docking time (17±5) min. The blood loss was (70±45) ml. The number of harvested lymph nodes was 22.5±10.7. The resection margins were negative in all surgical specimens. The postoperative pathological stage consisted of stage I B in 24 cases, stage II in 28, stage III A in 47, and stage III B in 21. Six patients (5%) developed postoperative complication including 1 case of duodenal stump leakage, 2 cases of esophagus-gastric leakage, 1 case of small bowel obstruction, 1 case of delayed gastric emptying, and 1 case of abdominal bleeding. All the complications were cured by reoperation or conservative therapy, and there were no postoperative 30-day deaths. The postoperative hospital stay was (6.3±2.6) days.</p><p><b>CONCLUSION</b>Robotic gastrectomy for the treatment of gastric cancer is a feasible and safe procedure, and is advantageous in terms of lymphadenectomy and alimentary tract reconstruction.</p>

Retrospective analysis of 56 patients with advanced gastric cancer treated with combination of intravenous and intra-arterial intensified neoadjuvant chemotherapy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Pre-operative chemotherapy has gained widespread interest while treating advanced gastric cancer in eastern countries. However, there is currently no established standard regimen for gastric cancer. The aim of this research was to explore the value of preoperative chemotherapy with a combination of intravenous and intra-arterial intensified chemotherapy in advanced gastric cancer.</p><p><b>METHODS</b>A total of 56 histologically proven gastric cancer patients, who were considered to be stage II or higher with metastatic lymph nodes and with or without distant metastasis (T2-4, N1-3, and M0-1), were treated with a neoadjuvant chemotherapy. Patients received a combination of intravenous 5-Fu (370 mg/m2) and leucovorin (200 mg/m2) on days 1-5, and intra-arterial etoposide (80 mg/m2) and cisplatin (80 mg/m2) on days 6 and 20. After two cycles of preoperative chemotherapy, patients with resectable tumors underwent laparotomy.</p><p><b>RESULTS</b>All patients finished two cycles of chemotherapy. The overall response rate was 78.57% (44 cases), of which 7.14% (four cases) clinical complete response. Forty-six patients underwent resection, including 21 initially unresectable diseases. R0 resection rate for prechemotherapy resectable and unresectable diseases was 96.15% (25/26 cases) and 66.67% (20/30 cases), respectively. Pathological complete response was observed in 8.70% of patients. Toxicity was moderate and there were no chemotherapy-related deaths. With a median follow-up of 31 months (range 6-76 months), the 5-year survival rate for the whole group and patients with initially resectable tumors were 21.8% and 42.3%, respectively. The median survival for initially resectable and unresectable patients were 41 months (95%CI, 31.006-50.994) and 18 months (95%CI, 13.399-22.601; P<0.01), respectively.</p><p><b>CONCLUSION</b>Preliminary results proved that the combined intensive chemotherapy was a safe and promising regimen for pre-operative treatment of advanced gastric cancer.</p>

Changes in Nitrate and Nitrite Levels of Blanched Amaranthus During Refrigeration Storage / Jurnal Sains Kesihatan Malaysia

Changes in nitrate and nitrite contents (leaves and stem) of Amaranthus gangeticus (AG) and Amaranthus paniculatus (AP), resulting from blanching, storage time (0-4 days), storage temperature (0 and 4ºC), and reheating were analysed. Results showed that fresh AG (1859 ± 7.07 mg/kg) had higher nitrite content than AP (1262 ± 2.12 mg/kg). Nitrites content was 506 ± 2 and 825 ± 3.5 mg/kg for AG and AP, respectively. Reheating and storage times significantly increased the conversion of nitrate to nitrite in AG and AP. Storage at 0 and 4oC exhibited a significant change (P < 0.05) in nitrate and nitrite contents for both samples. Higher nitrite content was found in AP when stored at 4oC and 0oC. The present study indicated that storage time and temperature affected the nitrite contents in blanched AG and AP when stored in low temperatures. Apart from that reheating was also found to increase the formation of nitrite.

Robot-assisted laparoscopic right hemicolectomy for colonic cancer / 中华普通外科杂志

Objective To investigate the safety and feasibility of robot-assisted laparoscopic right hemicolectomy for colonic cancer. Methods These 5 patients with ascending colonic cancer received robot-assisted laparoscopic right hemicolectomy. Results All operations were performed successfully. There was no postoperative complications. Da Vinci surgical system was found to be associated with fewer hemorrhage, rapid postoperative intestinal recovery, and therefore a shorter hospital stay. Conclusions Robot-assisted laparoscopic right hemicolectomy can be applied safely and with feasibility for colonic cancer.

Robotic-assisted laparoscopic colectomy for colon cancer: a report of 13 cases / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the safety and feasibility of robotic-assisted laparoscopic colectomy for colonic cancer.</p><p><b>METHODS</b>The clinical outcomes of 13 patients with colon cancer undergoing robotic-assisted laparoscopic colectomy from May 2010 to November 2010 were retrospectively evaluated.</p><p><b>RESULTS</b>All the operations were performed successfully, including 5 right colectomies, 3 left colectomies, and 5 sigmoidectomies. The operative time was (171.5±31.8) minutes. The estimated blood loss was (54.6±21.8) ml. Time to the return of bowel function was (60.9±15.8) hours and postoperative hospital stay was (6.4±3.6) days. There was one patient developed fat liquefaction at the incision. No bleeding, anastomotic fistula, anastomotic stenosis, or other complications were found.</p><p><b>CONCLUSION</b>Robotic-assisted laparoscopic colectomy is safe and feasible for colon cancer resection.</p>