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Objective To investigate the predictive value of metastatic lymph node ratio (MLNR) combined with preoperative serum carcinoembryonic antigen (CEA) in the detection of distant metastasis of stage Ⅱ-Ⅲ colon cancer after radical resection.Methods A retrospective study was performed on the clinical data of 325 patients with stage Ⅱ-Ⅲ colon cancer undergoing radical resection in the Second Hospital of Lanzhou University from Jan 2010 to Jan 2015.Results MLNR was correlated with the maximum diameter of tumors,the degree of differentiation of tumors,clinical TNM stage and distant metastasis (P ＜ 0.05),serum CEA was correlated with the maximum diameter of tumors,clinical TNM stage,nerve or vascular invasion and distant metastasis (P ＜ 0.05).Logistic regression analysis showed that low differentiation of tumor tissue,TNM Ⅲ stage,high MLNR and high serum CEA were independent risk factors for distant metastasis of colon cancer after radical operation.Conclusions The combined detection of MLNR and serum CEA has a good predictive value for distant metastasis with stage Ⅱ-Ⅲ colon cancer.
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Objective To investigate the effects of Ligustilide on the withdrawal syndromes syn-dromes and monoamine neurotransmitters of hypothalamus and nucleus accumbens in morphine-dependent rats. Methods Totally 60 SD rats were divided into control group,model group,clonidine group and Ligust-ilide high(80 mg/kg),medium(40 mg/kg) and low(20 mg/kg) dose group according to the random number table with 10 in each group. Rats were given in gradual increasing doses of morphine to produce physical de-pendence. Morphine withdrawal syndrome was precipitated by naloxone and withdrawal symptoms were evalu-ated by Ryuta Tomoji score. The level of norepinephrine ( NE), dopamine ( DA) and 5-hydroxytryptamine (5-HT) in rats were tested with enzyme-linked immunosorbent assay(ELISA). Results The total score of somatic withdrawal syndromes in the control group,model group,clonidine group and Ligustilide low,medium and high dose group were 0,(31. 83±7. 33),(17. 92±6. 88),(25. 58±5. 99),(19. 88±4. 82) and (16. 75 ±4. 01) . Compared with the model group,the morphine withdrawal syndromes scores of Ligustilide low,me- dium and high dose groups and clonidine group were reduced(all P<0. 05). The level of NE,DA and 5-HT in hypothalamus and nucleus accumbens were increased compared with that of control group. Compared with the model group,the level of NE,DA and 5-HT in hypothalamus and nucleus accumbens of Ligustilide low, medium and high dose groups and clonidine group were significantly reduced (P<0. 05). Conclusion Ligu-stilide can effectively alleviate the symptoms in morphine-withdrawal rats,which may be related to the inhibi-tion of excessive release of monoamine neurotransmitters in hypothalamus and nucleus accumbens.
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Objective To investigate the general surgeon growth time, and to probe into the factors affecting the surgeon growth. Methods 72 surgeons who worked more than 15 years in the field of general surgery in 12 hospitals of Gansu Province were investigated, focusing on education, resident rotation train-ing, teachers' qualification, refresher training, the frequency of intra-hospital technical exchange, and scale of hospital employed. SPSS 18.0 statistical software was applied to analyze the data. t test was used in com-parison between groups, and multiple groups were compared by using single factor analysis of variance. Results The surgeon growth time was (9.84±1.51) years averagely. In the process of growing up, the growth time of the general surgeons who experienced hospital resident rotated training, refresher training, intra-hos-pital technical exchange was significantly shorter than that of no-related-experienced surgeons. The higher the education, the higher the quality of the teachers and the higher the level of medical institutions, the shorter the doctor's growth time. Conclusion In the same medical institutions, the resident rotated training, the teacher's qualification, higher hospital training, and the frequency of intra-hospital technical exchange have the positive function to the surgeon's general growth, so in making young doctor training plan we should consider the value of the above-mentioned factors.
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OBJECTIVE:To systematically review the efficacy of folic acid in the prevention of gastrointestinal(GI)tumors in elder,and provide evidence-based reference for the clinical treatment. METHODS:Retrieved from Cochrane Library,PubMed,EM-Base,Web of Science,CMB,CJFD,VIP and Wanfang Database,the randomized controlled trials (RCT) about folic acid (test group)versus placebo(control group)in the prevention of GI tumors in elder(age>50 years old). After quality evaluation and da-ta extract,Meta-analysis was performed buy using Rev Man 5.3 statistics software. RESULTS:A total of 9 RCT were included,in-volving 29 494 patients. Results of Meta-analysis showed there was no significant difference in the incidence of GI tumors between 2 groups[RR=0.91,95%CI(0.74,1.12),P=0.38]. Results of subgroup analysis showed the incidence of GI tumors was not affected by GI tumor stage,age,basic serum folic acid level,type and dose of folic acid and follow-up time during follow-up period. CON-CLUSIONS:Folic acid supplement can not effectively prevent the incidence of GI tumors in elder. The incidence of GI tumors in elder with different ages and baseline of folic acid are not decreased by any dose and duration,without obvious adverse reactions. It indicates that folic acid supplement should be careful and give full conscideration to the patients’general situation. Due to the limit of methodological quality and sample size,it remains to be further verified with more rigorously designed and long-term follow-up of large-scale RCT.
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Pancreatic cancer is one of common malignant tumors in the digestive system.There is still no effective means for the early diag-nosis of pancreatic cancer.As a mixture of oral gland secretion and oral mucosal transudate,saliva contains abundant biological information including microorganisms,proteins,and nucleic acids,which will change when the disease occurs.So saliva can be used for the early diag-nosis of pancreatic cancer.Through summarizing and analyzing the current studies and advantages of its application for early diagnosis,this article suggests that saliva bioinformatics holds promise for the application in the early diagnosis of pancreatic cancer.
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Objective To assess the effects of gastric bypass versus medical therapy in patients with obesity and type 2 diabetes. Methods The Cochrane library, Embase, PubMed, Chinese biomedical literature database and Wanfang database up to April 2014 were searched. Randomized controlled trails(RCTs) of frequently-used bariatric surgery for obese patients with type 2 diabetes were included. Study selection, data extraction, quality assessment, and data analyses were performed according to the Cochrane standards. Results Four RCTs involving 157 patients in the gastric bypass groups and 152 patients in the medical therapy group were enrolled. Compared with medical therapy, gastric bypass for type 2 diabetes significantly decreased the levels of HbA1C(mean difference = -1. 85% , 95% CI -2. 15 ~ -1. 56, P< 0. 01), fasting blood glucose( standard mean difference = - 0. 90 mmol/ L, 95% CI-1. 24 ~ -0. 57, P<0. 01), body weight(mean difference=-23. 39 kg, 95% CI -29. 17 ~ -17. 61, P<0. 01), waist circumference(mean difference= -15. 36 cm, 95% CI -17. 51 ~ -13. 22, P<0. 01) and the dose of hypoglycemic medicine; while it increased the number of patients with HbA1C<6% (RR=5. 49, 95% CI 2. 22 ~ 13. 56, P<0. 01), the rate of adverse events(RR=1. 96, 95% CI 1. 42 ~ 2. 70, P<0. 01), and the level of high-density lipoprotein-cholesterol(mean difference=1. 24 mmol/ L, 95% CI 0. 64 ~ 1. 84, P<0. 01). Conclusions Gastric bypass surgery is more effective compared with medical therapy alone for obese patients with type 2 diabetes. Further intensive RCTs of high-quality in multiple centers with long-term follow-up should be carried out to provide more reliable evidences.
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Diabetic rat model accompanied by insulin resistance was established by intraperitoneal injection of streptozocin.Following metformin treatment for 5 weeks,ELISA was used to detect the level of plasma secreted frizzled-related protein (SFRP) 5,and immunohistochemistry was used to detect the expression of p-JNK in the liver.insulin resistance(IR) and p-JNK were significantly increased in diabetic group compared with the control group (P＜0.05),while plasma SFRP5 level was reduced (P＜0.01).After metformin treatment,the plasma SFRP5 levels were significantly increased (P＜0.05),while IR and p-JNK was decreased (P＜O.05).Metformin may ameliorate insulin resistance via upregulating the SFRP5 expression of diabetic rats.
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Objective To study the perioperative predictors of portal vein thrombosis (PVT) after splenectomy in cirrhotic patients.Methods We searched the Web of Science,PubMed,EMBASE,Science Direct,CNKI,VIP,CSCD,and Wan Fang Databases up to April 2014.Only case-controlled studies which evaluated predictive factors of portal vein thrombosis (PVT) after splenectomy in cirrhotic patients were included.The Stata 12 software was used to perform the meta-analysis.Results Twenty-four casecontrolled studies were included.The sample size was 4 335,and the incidence rate of PVT was 25.0％.The risk factors of PVT included splenic volume (WMD =13.75,95％ CI:6.47 ～21.00),splenic vein diameter (WMD =1.34,95％ CI:0.39 ～ 2.30),portal vein diameter (WMD =1.54,95 ％ CI:0.56 ～ 2.52 ;WMD=2.09,95％CI:0.55 ～3.64),portal venous flow (WMD =-5.78,95％ CI:-10.46 ～-1.10;WMD =-5.57,95 ％ CI:-5.92 ～-5.22),difference in portal venous pressure (WMD =1.90,95 ％ CI:1.29～2.50) and ascites (OR =1.83,95％ CI:1.19,2.82).There were no significant differences between patients with and without PVT in terms of sex,age,Child-Pugh classification,prothrombin time,PLT,D-dimer,operating time.Conclusion The risk factors of portal vein thrombosis after splenectomy in cirrhotic patients were splenic volume,splenic vein diameter,portal vein diameter,portal venous flow,difference in portal venous pressure and ascites.
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<p><b>OBJECTIVE</b>To investigate the association of hepatitis C virus (HCV) genotype with glycolipids iron metabolism in Gansu Han population.</p><p><b>METHODS</b>The genotypes of HCV 1b type and 2a type were detected in Gansu Han HCV carriers. The Glu, Insulin, CHOL, TG, UIBC, TRF, TIBC, SF, Serum Iron, AST, ALT, TBil, IBil, DBil, ALP, GGT were measured and compared between patients with different HCV genotypes.</p><p><b>RESULTS</b>There were 84 cases with HCV1b type and 136 cases with 2a type. There were significant differences in TG, ALT, TRF, TIBC between 1b type and 2a type genotype HCV carriers.</p><p><b>CONCLUSION</b>The 2a type HCV carriers may be more inclined to develop hyperlipidemia and liver damage, and 1b type HCV carriers are likely to have iron metabolism defect.</p>
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Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Glicemia , Metabolismo , China , Epidemiologia , Genótipo , Hepacivirus , Genética , Hepatite C , Sangue , Epidemiologia , Ferro , Sangue , Lipídeos , SangueRESUMO
Objective To explored vascular epithelium growth factor (VEGF) and transforming growth factor-β1 (TGF-β1) expression profiles in rat liver regeneration after selective portal vein embolization (SPVE).Methods The SPVE model was constructed by embolization of the left portal vein and regenerative liver tissues were collected in postoperative days 1-9.Fifty of the SD rats were divided into the SPVE group (45 rats) and control group (5 rats).The expressions of VEGF and TGF-β1 in regenerative rat liver tissues were detected with immunohistochemistry and Western blot.The relationship between VEGF/TGF-β1 and time-phased rat liver regeneration was analyzed.Results In the SPVE group compared to the control group,the expression of VEGF increased from post operative day 1 to 5,peaking at day 5.The expression of TGF-β1 increased from post operative day 3 to 7,peaking at day 7.Conclusions The results suggest that after SPVE,VEGF fluctuation may correlate with the start of hepatic regeneration,and TGF-β1 fluctuation may correlate with the termination of hepatic regeneration.
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Objectives To investigate medical students' satisfaction degree clinical practice,to find out the shortages of the clinical practice teaching,and to further put forward the measures of clinical practice.Methods By using a selfdesigned questionnaire,115 student interns were surveyed with anonymous questions,to collect data about the satisfaction degree of the hospital teaching conditions,conditions of teachers,practice quality of clinical departments,management department intern management work,the practical effect and views of clinical practice and other information.99 effective copies were retrieved using Excel analyze data.Results Interns' overall satisfaction with clinical practice is not high,and the satisfaction degree to the management department' work is the lowest,the satisfaction degree to the conditions of teachers of hospital is the highest.Conclusion Medical students'clin-ical practice satisfaction needs improving.To this end,we should improve the system and teaching conditions and strengthen management to meet the needs of students and improve their practice quality.
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Sicknesses caused by colonic transit dysfunction are commonly seen in clinical practice.The transit dysfunction of the colon has been studied in recent decades on the primary abnormalitie,the secondary damage of the colon enteric nervous system,the distribution of Cajal interstitial cells with the c-kit protein expression of its surface,the damage of smooth muscle by autoimmune,the absorption of water by colon,viral infections and the genetic aspects.
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Lupeol,a triterpene,is found in various edible and medicinal plants.Lupeol has been shown to exhibit strong anti-inflammatory,anti-arthritic,gene mutation prevention and anti-malarial effect.Recently,it is found that lupeol is the main active ingredients of inhibiting the growth of a several kinds of cancers and carcinomas in some antineoplastic plants.Lupeol has antineoplastic effect.
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Objective To determine the association of gallstone,cholecystectomy and colorectal cancer.Methods From 2000 through 2007,a historical cohort study was carried out in the check analysis of the cumulative incidence of colorectal cancer of 3809 gallstone patients who had had cholecystectomies (cholecystectomy sub-group),1764 gallstone patients who had not had cholecystectomies(noncholecystectomy sub-group)and 8187 nongallstone patients(control group)were also included in the analysis of the incidence of colorectal cancer.Results(1)The cumulative incidence of colorectal cancer of the gall-stone group was 0.43 ％(24/5573)while that of the control group was 0.13 ％(11/8187)(x2 =11.879,P =0.001).(2)The cumulative incidence of colorectal cancer in cholecystectomy sub-group was 0.45％(17/3890)while that of the non-cholecystectomy sub-group was 0.40％(7/1764)(x2=0.069,P =0.793).(3)The cumulative incidence of colorectal cancer was 0.23％(8/3467)in gallstone patients with a conrse ＜ 15 years,while that was 0.76％(16/2106)when the course ≥ 15 years(x2 =8.550,P =0.003).(4)Serum triglyceride level elevated in 20.83％(5/24)colorectal cancer cases of gallstone group,however serum triglyceride level elevated only in 5.86％(325/5549)of gallstone group with non-colorectal cancer cases(x2 =9.621,P =0.002).(5)The incidence of colorectal cancer in gallstone group was not related to gender,age,overweight,hypertension,diabetes mellitus and dysfunction of liver(x2 =1.444,P =0.229;x2=7.833,P=0.251;x2 =1.151,P=0.283;x2 =0.797,P=0.372;x2 =0.939,P=0.332;x2 =2.103,P =0.147).(6)The ratio of rectal cancer,right colonic cancer,left colonic cancer and multifocal carcinoma were 41％(10/24),38％(9/24),17％(4/24)and4％(1/24),respectively.Conclusions Gallstone is a high risk factor of colorectal cancer irrespective of whether or not a cholecystectomy is carried out.Over fifteen-years course of gallstone and hypertriglyceridemia significantly increases the risk of the colorectal cancer in gallstone patients.The incidence of rectal cancer and right colonic cancer is more frequently seen in gallstone related colorectal cancer.
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Alpha-fetoprotein is an important molecular marker for clinical diagnosis, evaluation of curative effect and prognosis of cancer for long time, especially for hepatocellular carcinoma. But for physiological function of alpha-fetoprotein, we know less than its clinical significance. So here this article presents a review about physiological function of alpha-fetoprotein and its application in molecular therapy of hepatocellular carcinoma.
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It has been confirmed that hepatocellular carcinoma belongs to gene related disease.Biological characteristic of hepatocyte can be infected by abnormal expression of related genes,resulting in normal cell transformed to carcinoma cell,therefore,we should do further research to find new methods for diagnosis and treatment of HCC.As a new technique for gene knockdown,RNAi has been applied more in the fields of gene function and gene therapy.This paper is a review about recent advance in HCC gene therapy with RNAi.
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Objective To prepare patent-blue-lipesomes(PB-LPS),a lymph-mapping developer.Methods PB was encapsulated in the liposomes using the passive loading method.The female Wistar rats were injected subcutaneously with the PB-LPS,PB,blank liposomes or isotonic rmtrium chloride at the heel solos,to study the stained situation of the lymph nodes and chemical analysis oftheir ALT,AST,BUN,Cr.Results The lymph nodes were obviously blue staining after injected PB-LPS or PB,the blue smimng ratios were 40%,20%(P<0.05),and the effect of PB-LPS on tracing of lymphy nodes was better than PB.No significant difference was found in ALT,AST,BUN and Cr.Conclusion The PB-LPS can be successfully prefabricated with such advantage as avirulence and high entrapment efficiency by passive loading method.
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Objective To investigate the protective effect of melatonin on renal injury induced by bile duct ligation in rats. Methods Sixty four rats were randomly divided into four experimental groups ( n =16 rats per group): the control group (CN), sham operative group (SO), bile duct ligation group (BDL) and bile duct ligation melatonin treatment group (BDL+Mel). Obstructive jaundice was induced by common bile duct ligation. Plasma level of nitric oxide (NO), total bilirubin (TB), direct bilirubin (DB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), urea nitrogen (BUN) and creatinine (Cr) were measured 4 d and 8 d after operation. NO and inducible nitric oxide synthase (iNOS) in renal tissue were detected at the same time point, too. Histopathological changes of kidneys were examined by HE staining. Results In BDL group, the plasma levels of NO, TB, DB, ALT, AST, BUN and Cr were higher than those of SO group ( P
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Objective To study the changes of lipopolysaccharide binding protein (LBP) in the serum of Wistar rats with obstructive jaundice and to investigate its potential mechanism.Methods Eighty male Wistar rats were randomly divided into obstructive jaundice group (OJ group, n =40) and sham operation group (SO group, n =40). Before operation and the 5th, 10th, 15th, 20th day after common bile duct ligation, the levels of LBP, endotoxin, tumor necrosis factor alpha (TNF ?) and interleukin 6 (IL 6) in plasma were detected in all the rats. Results LBP levels in serum increased significantly in OJ group on the 10th day after operation compared with those of SO group. Moreover, LBP levels gradually increased in OJ group with the prolongation of obstructive time. A positive correlation existed between serum LBP and plasma endotoxin, TNF ? and IL 6.Conclusion The study demonstrates that LBP in serum is high and plays an important role in the pathogenesis of multiple organ injury secondary to obstructive jaundice. It may be an appropriate way to treat patients with obstructive jaundice by decreasing LBP levels in serum.
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Objective To analyse the significance and relation between soluble P-selectin (sP-selectin),D-dimer (D-d) and endotoxin (ET) in the patient with obstructive jaundice (OJ). Methods Blood plasma sP-selectin and D-d in OJ group,acute cholecystitis group and healthy group were detected by ELISA and ET was detected by the colorimetric method, Results In healthy group,the concentration of blood plasma sP-selectin was ( 93.43 ? 17.65 ) ng/ml,ET(0.0030?0.0004)EU/ml,and D-d(0.39?0.21)mg/L; in acute cholecystitis group,sP-selectin was (233.32?82.12) ng/ml, ET(0.4012?0.1506) EU/ml,and D-d(0.76?0.27)mg/L; in OJ group,sP-selectin was (351.90?93.83) ng/ml ,ET (0.3814?0.1430)EU/ml,and D-d(2.14?0.37)mg/L.The sP-selectin, D-d and ET in the acute cholecystitis group and the OJ group were higher than those in healthy group (P 0.05). sP-selectin and D-d in the OJ group were significantly higher than that in the acute cholecystitis group (P