Application of the Left Lateral Decubitus Position in Laparoscopic Right Posterior Lobectomy

OBJECTIVE

To investigate the value of the left lateral decubitus position in laparoscopic right posterior lobe tumor resection.

PATIENTS AND METHODS

The clinical data of patients who underwent laparoscopic right posterior lobectomy from January 2020 to March 2023 were retrospectively collected and divided into group A (left lateral decubitus position group, n=30) and group B (conventional position group, n=35) according to different body positions. Intraoperative and postoperative data were collected and compared between the 2 groups.

RESULTS

The operation time (210.43±57.56 vs. 281.97±65.89, t =5.887, P <0.05), hilar occlusion time (23.97±14.25 vs. 35.79±12.62, t =4.791, P <0.05), intraoperative blood loss (162.14±72.61 vs. 239.65±113.56, t =5.713, P <0.05), postoperative feeding time (1.13±0.36 vs. 1.57±0.67, t =3.681, P <0.05), postoperative visual analog scale score (5.16±0.89 vs. 7.42±1.31, t =3.721, P <0.05), postoperative abdominal drainage tube indwelling time (4.58±1.34 vs. 5.42±1.52, t =4.553, P <0.05), incidence rate of complications (43.33% vs. 82.86%, χ 2 =11.075, P <0.05) in group A were lower than those in group B ( P <0.05). Symptoms/side effects (32.42±3.42 vs. 27.44±3.31, t =4.331, P <0.05), and there were significant differences in social function (33.55±2.56 vs. 29.31±3.32, t =4.863, P <0.05).

CONCLUSION

For right posterior lobe tumors of the liver, the left lateral decubitus position has many advantages in laparoscopic right posterior lobectomy, such as a wide field of view, simple steps, a short operation time, less bleeding, and a high postoperative quality of life. It is an effective treatment for right posterior lobe tumors of the liver and is worthy of being widely popularized.

Protein profiles reveal MSH6/MSH2 as a potential biomarker for hepatocellular carcinoma with microvascular invasion

AIM

Microvascular invasion (MVI) is an independent risk factor for postoperative recurrence and metastasis in hepatocellular carcinoma (HCC). However, the specific protein expression profiles that differentiate HCC with MVI from those without MVI remain unclear.

METHODS

The profiles of proteins in early-stage HCC tissues and normal liver tissues were characterized by quantitative proteomics techniques. Immunohistochemical (IHC) staining was undertaken on tissue microarrays from 80 HCC patients to assess the expression of MSH2 and MSH6. Cell counting, colony formation, migration, and invasion assays were carried out in vitro.

RESULTS

We identified 5164 proteins in both HCC tissues and adjacent normal liver tissues. Compared to HCC without MVI, 148 upregulated proteins and 97 downregulated proteins were found in HCC with MVI. Particularly noteworthy was the remarkable upregulation of MSH6/MSH2 among these dysregulated proteins in HCC with MVI. Further validation through bioinformatics prediction and IHC confirmed the elevated expression of MSH6/MSH2, which correlated with aggressive disease characteristics and poor prognosis. Receiver operating characteristic curve analyses revealed a substantial area under the curve of 0.761 (specificity 71.79%, sensitivity 73.17%) for the combined use of MSH6/MSH2. Knockdown of MSH6/MSH2 significantly inhibited HCC cell proliferation and invasion in vitro.

CONCLUSIONS

Our study establishes MSH6 or MSH2 as an oncogene that is prominently overexpressed during HCC progression, which provides new targets for HCC with MVI.

Management of priming fluids in cardiopulmonary bypass for adult cardiac surgery: network meta-analysis

BACKGROUND

Cardiopulmonary bypass (CPB) is frequently employed for cardiac surgery, and selecting a suitable priming fluid is a prerequisite for CPB. Currently, the commonly used priming fluids in clinics are classified as crystalloids and colloids, including balanced crystalloids, albumin, dextran, gelatin and hydroxyethyl starch (HES). This network meta-analysis compared the effects of eight fluids used during CPB in adults to determine optimal priming fluid during CPB surgery.

METHODS

Randomised controlled trials assessing priming fluids for CPB in adult cardiac surgery published before 13 April 2023 were searched across Ovid MEDLINE(R) ALL, OVID EMbase, and Cochrane Central Register of Controlled Trials. Various priming fluids were classified into eight categories, including balanced crystalloids, 0.9% NaCl, iso-oncotic human albumin, hyperoncotic human albumin, HES with molecular weight 130k, HES with molecular weight 200k, gelatin and dextran.

RESULTS

The NMA of platelet counts revealed no significant differences in any result. In direct comparison results, only the comparison of HES with molecular weight 130k vs. gelatin (standard mean difference = -0.40, 95% confidence interval [95%CI: -0.63, -0.16) revealed a significant difference. According to the SUCRA, balanced crystalloids had the highest platelet count, followed by gelatin, and HES with a molecular weight of 130k had the lowest platelet, followed by HES with a molecular weight of 200k.

CONCLUSION

Patients using dextran have a low mortality rate and a short mean CPB time, the use of balanced crystalloids is beneficial in terms of platelet count, and HES with molecular weight 130k is beneficial for postoperative urine volume at 24h. However, all priming fluids have pros and cons quite, and the optimal choice of priming fluids remains unsupported by current evidences. When performing CPB surgery, the type of priming fluid should be selected according to the actual situation in CPB for adult cardiac surgery.

[Effect of Dendrobii officinalis superfine powder on overeating greasy-induced metabolic hypertension in rats]

Dendrobii officinalis, with a definite effect of nourishing Yin and clearing heat, has been a folk habit for drinking after being mixed with water. Because its superfine powder has the advantages of high dissolution and convenient drinking, we observed the effect of D. officinalis superfine powder on metabolic hypertension model rats and its possible mechanism in this experiment, which can be used as a reference for its clinical application for hypertension. The overeating greasy-induced metabolic hypertension model was established with high-fat, high-sugar and high-purine diet. These rats were orally administered with 400 mg·kg~(-1) and 200 mg·kg~(-1) of D. officinalis superfine powder for 20 consecutive weeks. During this period, blood pressure, blood lipid, blood glucose, insulin and other related indexes of glucose and lipid metabolism were monitored; the levels of lipopolysaccharide(LPS), C-reactive protein(CRP), interleukin 6(IL-6) and other inflammatory mediators were measured; the levels of nitric oxide(NO) and endothelin-1(ET-1) were detected, and the histomorphological and ultrastructural changes of aorta were observed. In addition, the expression of LPS/TLR4 pathway-related molecules in aorta was determined. The results showed that long-term administration of D. officinalis superfine powder significantly reduced the levels of systolic blood pressure(SBP), diastolic blood pressure(DBP) and mean arterial pressure(MBP) in metabolic hypertension model rats, decreased the levels of total cholesterol(TC), triglyceride(TG), low density lipoprotein cholesterol(LDL-c), glucose(Glu), and insulin(INS) levels in blood, increased the contents of high density lipoprotein cholesterol(HDL-c),decreased the LPS, CRP, IL-6 and ET-1 levels in blood and increased NO content. Furthermore, it improved the abnormality of aortic histomorphology and endothelial ultrastructure, and inhibited the protein expression of TLR4, myeloid differentiation factor(MyD88), IL-6, interleukin-1 β(IL-1β), and tumor necrosis factor-α(TNF-α) as well as mRNA expression of TNF-α and IL-1β in aorta. In conclusion, D. officinalis superfine powder may improve the abnormal function and structure of blood vessels by inhibiting the activation of LPS/TLR4 pathway, thus playing a role against metabolic hypertension.

Prediction of lymph node metastasis in rectal cancer: comparison between shear-wave elastography based ultrasomics and MRI

PURPOSE

We aimed to explore the diagnostic efficiency of shear-wave elastography (SWE) ultrasomics in the preoperative prediction of lymph node (LN) metastasis in rectal cancer.

METHODS

This study included 87 patients with pathologically confirmed rectal cancer, with data gathered from August 2017 to August 2018. A total of 1044 ultrasomics features of rectal tumor were collected with AK software from the SWE examinations. The least absolute shrinkage and selection operator (LASSO) regression model was used for feature selection and building a SWE ultrasomics signature. The diagnostic performance was evaluated with an area under the receiver operating characteristic curve (AUC) analysis. Then, the diagnostic performance of the SWE ultrasomics signature was compared with magnetic resonance imaging (MRI).

RESULTS

Of the 87 patients, 40 (46.0%) had LN metastasis. Thirteen ultrasomics features of rectal tumor were selected as the most significant features. The SWE ultrasomics signature correlated with LN metastasis (p < 0.001). Patients with LN metastasis had higher signature than patients without LN metastasis. In terms of diagnostic performance, SWE ultrasomics signature was significantly superior to MRI (AUC, 0.883 vs. 0.760, p = 0.034). The diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of SWE ultrasomics signature were 82.8%, 87.5%, 78.8%, 77.8%, and 88.1%, respectively, while those of MRI were 75.9%, 77.5%, 74.5%, 72.1%, and 79.6%, respectively.

CONCLUSION

SWE ultrasomics is a more accurate predictive method for identifying LN metastasis preoperatively than MRI. Thus, SWE ultrasomics might be used to better guide preoperative individual therapies for patients with rectal cancer.

A lysosomal enigma CLN5 and its significance in understanding neuronal ceroid lipofuscinosis

Neuronal Ceroid Lipofuscinosis (NCL), also known as Batten disease, is an incurable childhood brain disease. The thirteen forms of NCL are caused by mutations in thirteen CLN genes. Mutations in one CLN gene, CLN5, cause variant late-infantile NCL, with an age of onset between 4 and 7 years. The CLN5 protein is ubiquitously expressed in the majority of tissues studied and in the brain, CLN5 shows both neuronal and glial cell expression. Mutations in CLN5 are associated with the accumulation of autofluorescent storage material in lysosomes, the recycling units of the cell, in the brain and peripheral tissues. CLN5 resides in the lysosome and its function is still elusive. Initial studies suggested CLN5 was a transmembrane protein, which was later revealed to be processed into a soluble form. Multiple glycosylation sites have been reported, which may dictate its localisation and function. CLN5 interacts with several CLN proteins, and other lysosomal proteins, making it an important candidate to understand lysosomal biology. The existing knowledge on CLN5 biology stems from studies using several model organisms, including mice, sheep, cattle, dogs, social amoeba and cell cultures. Each model organism has its advantages and limitations, making it crucial to adopt a combinatorial approach, using both human cells and model organisms, to understand CLN5 pathologies and design drug therapies. In this comprehensive review, we have summarised and critiqued existing literature on CLN5 and have discussed the missing pieces of the puzzle that need to be addressed to develop an efficient therapy for CLN5 Batten disease.

Loss of PR55α promotes proliferation and metastasis by activating MAPK/AKT signaling in hepatocellular carcinoma

Background

PR55α plays important roles in oncogenesis and progression of numerous malignancies. However, its role in hepatocellular carcinoma (HCC) is unclear. This study aims to characterize the functions of PR55α in HCC.

Methods

PR55α expressions in HCC tissues and paired healthy liver samples were evaluated using Western blot and tissue microarray immunohistochemistry. We knocked down the expression of PR55α in SMMC-7721 and LM3 cell lines via small interfering and lentivirus. In vitro cell counting, colony formation, migration and invasion assays were performed along with in vivo xenograft implantation and lung metastases experiments. The potential mechanisms involving target signal pathways were investigated by RNA-sequencing.

Results

PR55α expression level was suppressed in HCC tissues in comparison to healthy liver samples. Decreased PR55α levels were correlated with poorer prognosis (P = 0.0059). Knockdown of PR55α significantly promoted cell proliferation and migration, induced repression of the cell cycle progression and apoptosis in vitro while accelerating in vivo HCC growth and metastasis. Mechanistic analysis indicated that PR55α silencing was involved with MAPK/AKT signal pathway activation and resulted in increased phosphorylation of both AKT and ERK1/2.

Conclusions

This study identifies PR55α to be a candidate novel therapeutic target in the treatment of HCC.

CT-based radiomics scores predict response to neoadjuvant chemotherapy and survival in patients with gastric cancer

BACKGROUND

Neoadjuvant chemotherapy is a promising treatment option for potential resectable gastric cancer, but patients' responses vary. We aimed to develop and validate a radiomics score (rad_score) to predict treatment response to neoadjuvant chemotherapy and to investigate its efficacy in survival stratification.

METHODS

A total of 106 patients with neoadjuvant chemotherapy before gastrectomy were included (training cohort: n = 74; validation cohort: n = 32). Radiomics features were extracted from the pre-treatment portal venous-phase CT. After feature reduction, a rad_score was established by Randomised Tree algorithm. A rad_clinical_score was constructed by integrating the rad_score with clinical variables, so was a clinical score by clinical variables only. The three scores were validated regarding their discrimination and clinical usefulness. The patients were stratified into two groups according to the score thresholds (updated with post-operative clinical variables), and their survivals were compared.

RESULTS

In the validation cohort, the rad_score demonstrated a good predicting performance in treatment response to the neoadjuvant chemotherapy (AUC [95% CI] =0.82 [0.67, 0.98]), which was better than the clinical score (based on pre-operative clinical variables) without significant difference (0.62 [0.42, 0.83], P = 0.09). The rad_clinical_score could not further improve the performance of the rad_score (0.70 [0.51, 0.88], P = 0.16). Based on the thresholds of these scores, the high-score groups all achieved better survivals than the low-score groups in the whole cohort (all P < 0.001).

CONCLUSION

The rad_score that we developed was effective in predicting treatment response to neoadjuvant chemotherapy and in stratifying patients with gastric cancer into different survival groups. Our proposed strategy is useful for individualised treatment planning.

Baseline and early 3D-CUBE volume reconstruction of locally advanced rectal cancer to predict tumor response after neoadjuvant chemotherapy

PURPOSE

To explore whether volumetric measurements of 3D-CUBE sequences based on baseline and early treatment time can predict neoadjuvent chemotherapy (NCT) efficacy of locally advanced rectal cancer (LARC).

MATERIAL AND METHOD

73 patients with LARC were enrolled from February 2014 to January 2018. All patients underwent MRIs during the baseline period before NCT (BL-NCT) and the first month of NCT (FM-NCT), and tumor volume (TV) was measured using 3D-CUBE, and tumor volume reduction (TVR) and tumor volume reduction rate (TVRR) were calculated. In addition, tumor invasion depth, tumor maximal length, range of tumor involvement in the circumference of intestinal lumen and distance from inferior part of tumor to the anal verge were measured using baseline high-spatial-resolution T2-weighted MRIs. All patients were categorized into sensitive and insensitive groups based on post-surgical pathology after completion of the full courses of NCT. The receiver operating characteristic (ROC) curve was used to analyze the value of different MRI parameters in predicting efficacy of NCT.

RESULTS

Statistically significant differences in TV of BL-NCT, TVR and TVRR from BL-NCT to FM-NCT were detected between sensitive and insensitive groups (P < 0.05, respectively). The areas under the curves (AUC) of ROC of TVR and TVRR in predicting efficacy of NCT (0.890 [95% CI, 0.795∼0.951], 0.839 [95% CI, 0.735∼0.915]) were significantly better than that of TV (0.660 [95% CI, 0.540∼0.767]) (P < 0.05, respectively).

CONCLUSION

Reconstruction of 3D-CUBE volume in the first month of NCT is necessary, and both TVR and TVRR can be used as early predictors of NCT efficacy.

Clinical analysis of hepatic angioleiomyoma: Two case reports

RATIONALE

Angioleiomyoma is an uncommon benign tumor that originates from the vascular smooth muscle cells and contains thick-walled vessels. It can appear anywhere in the body but more frequently in the extremities (especially in the lower limbs) and rarely invades the internal organs.

PATIENT CONCERNS

A 52-year-old Chinese woman was referred to our hospital because of finding liver neoplasm 2 weeks ago (case first) and a 64-year-old Chinese woman was admitted to hospital with enlargement of the hepatic neoplasm revealed in follow-up, who was diagnosed with angioleiomyoma of left kidney 2 years ago (case second).

DIAGNOSIS

All patients were diagnosed with hepatic angioleiomyoma by pathological results.

INTERVENTIONS

All patients received surgical treatment, with laparoscopic hepatectomy of the IVb segment in case 1 and laparoscopic hepatic left lateral lobectomy in case 2.

OUTCOMES

The 2 patients have eventually recovered, and no recurrences or other complications have been observed so far.

LESSONS

Because of atypical clinical symptoms, no specificity in laboratory examination, and lack of characteristic imaging findings, angioleiomyoma is easily misdiagnosed for another disease of the liver. But with complete resection, the prognosis is generally good.

Bouveret's syndrome: A rare presentation of gastric outlet obstruction

Bouveret's syndrome refers to gastric outlet obstruction caused by the formation of a cholecystoduodenal fistula with subsequent migration and impaction of a large gallstone into the duodenum. A case of a 59-year-old male who presented to our institution with consistent abdominal pain and nausea is reported herein. Bouveret's syndrome was diagnosed after conducting a computed tomography scan. Surgery was performed wherein gallstone removal was followed by cholecystectomy and fistula repair associated with a pyloric bypass via gastro-jejunostomy. The patient recovered well following surgery and has remained free of symptoms for the last year.

Evaluating the prognostic value and functional roles of transcription factor AP4 in colorectal cancer

The basic helix-loop-helix transcription factor AP4 (TFAP4) gene serves an important function in the genesis and progression of tumors. However, few studies to date have defined the role of this gene in colorectal cancer (CRC). The aim of the present study was to assess the expression of TFAP4 in CRC and its impact on the prognosis of patients with CRC. In the present study, the expression of TFAP4 was detected in 30 matched pairs of fresh CRC tissues, 187 cases of clinical paraffin-embedded CRC tissues and CRC cell lines using the reverse transcriptase-quantitative polymerase chain reaction, immunohistochemistry or western blot analysis. Survival analysis was based on TFAP4 expression. The effects of TFAP4 on CRC cell function were investigated by ectopic expression or knockdown of TFAP4 in vitro. TFAP4 expression was revealed to be increased in human CRC tissues and cell lines. The overall survival (OS) time of patients with high TFAP4 expression was significantly decreased compared with patients with low TFAP4 expression (P<0.001). In addition, TFAP4 was revealed to be an independent prognostic factor for the OS time of patients with CRC (hazard ratio, 2.607; 95% confidence interval, 1.469-4.627; P=0.001). Ectopic TFAP4 expression promoted CRC cell proliferation, migration and invasion in vitro, and the silencing of TFAP4 expression resulted in the inhibition of these events. These results demonstrated that TFAP4, which was overexpressed in CRC tissues and cell lines, increased the malignant potential of CRC cells and may serve as an indicator for poor prognosis in patients with CRC.

Lymphovascular invasion is a high risk factor for stage I/II colorectal cancer: a systematic review and meta-analysis

The prognostic value of lymphovascular invasion (LVI) in stage I/II colorectal cancer (CRC) does not reach a consensus. To systematically assess prognostic significance of LVI, databases of PubMed, Web of Science, and Embase were searched from inception up to 10 Dec 2016. The pooled hazard ratio (HR) and 95% confidence intervals (CI) were used to determine the prognostic effects. Nineteen relevant studies including 9881 total patients were enrolled. Our results showed that LVI is significantly associated with poor prognosis in overall survival (OS) (HR=2.15, 95 % CI=1.72–2.68, P < 0.01) and disease-free survival (DFS) (HR=1.73, 95% CI=1.50–1.99, P < 0.01), which is similar in stage II patients. Further subgroup analysis revealed that the significance of the association between LVI and worse prognosis in CRC patients is not affected by below factors, including geographic setting, LVI positive rate, treatment, tumor site, and quality of the study. The current meta-analysis suggests that LVI may be a poor prognostic factor for stage I/II CRC patients.

Transabdominal Ultrasound Colonography for Detection of Colorectal Neoplasms: Initial Clinical Experience

We investigated the feasibility of using ultrasound colonography (USC) to visualize the healthy colon and rectum and detect colorectal polyps. Eight healthy volunteers underwent USC after standard bowel preparation. The feasibility and image quality of USC in different segments were evaluated. Then, USC was conducted on eight patients with known colonic neoplasms using colonoscopy as the reference standard. For volunteers, USC examinations were successfully performed on four (50.0%) ascending, three (37.5%) transverse and eight (100%) descending colons, as well as all sigmoid colons and rectums. One of four (25.0%) ascending, two of eight (25.0%) descending and all sigmoid colons and rectums were well visualized and free of artifacts. For patients, colonoscopy revealed that eight patients had 17 neoplasms in the distal sigmoid colon and rectum, which included 3 lesions ≤5 mm, 3 lesions 6-9 mm and 11 lesions ≥10 mm. USC visualized 12 of 17 (70.6%) neoplasms. Lesion detection by USC was 0% (0/3), 33.3% (1/3) and 100% (11/11) for neoplasms ≤5, 6-9 mm and ≥10 mm in size. USC can visualize the sigmoid colon and rectum well and detect distal sigmoid and rectal neoplasms ≥10 mm in diameter.

Systemic immune-inflammation index for predicting prognosis of colorectal cancer

AIM

To investigate the clinical significance of preoperative systemic immune-inflammation index (SII) in patients with colorectal cancer (CRC).

METHODS

A retrospective analysis of 1383 cases with CRC was performed following radical surgery. SII was calculated with the formula SII = (P × N)/L, where P, N, and L refer to peripheral platelet, neutrophil, and lymphocyte counts, respectively. The clinicopathological features and follow-up data were evaluated to compare SII with other systemic inflammation-based prognostic indices such as the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in patients with CRC.

RESULTS

The optimal cut-off point for SII was defined as 340. The overall survival (OS) and disease-free survival (DFS) were better in patients with low NLR, PLR, and SII (P < 0.05). The SII was an independent predictor of OS and DFS in multivariate analysis. The area under the receiver-operating characteristics (ROC) curve for SII (0.707) was larger than those for NLR (0.602) and PLR (0.566). In contrast to NLR and PLR, SII could effectively discriminate between the TNM subgroups.

CONCLUSION

SII is a more powerful tool for predicting survival outcome in patients with CRC. It might assist the identification of high-risk patients among patients with the same TNM stage.

Optimal adjuvant chemotherapy for resected pancreatic adenocarcinoma: a systematic review and network meta-analysis

Adjuvant chemotherapy improves survival in patients with resected pancreatic cancer but the optimal regimen remains unclear. We aim to compare all possible adjuvant chemotherapy in terms of overall survival and toxic effects. Pubmed, Trial registries and Cochrane library databases for randomized controlled trials were searched until November 2016. Thirteen trials were included for network analysis and the hazard ratios (HRs) for survival and odds ratios for toxic effects were assessed via Aggregate Data Drug Information System software. Only S-1 chemotherapy improved 1-year, 3-year and 5-year survival compared with observation (HR (95% CI): 3.94 (1.18–12.34); 4.08 (1.58–8.24) and 5.09 (1.16–29.83) respectively). Although not significant, gemcitabine plus uracil/tegafur was associated with poorer 1-year and 3-year survival compared with observation (HR (95% CI): 0.85 (0.16–4.03) and 0.86 (0.23–2.95)). Adding radiation to chemotherapy has no significant improvement in survival. S-1 and gemcitabine plus capecitabine are currently the most effective adjuvant therapies for pancreatic cancer. While S1 has only been validated in Asian people, higher toxicity is an issue for gemcitabine plus capecitabine.

Value of liver function test for prediction of asymptomatic common bile duct stones in patients with cholecystolithiasis

AIM

To investigate the diagnostic value of abnormal liver function parameters for concomitant asymptomatic choledocholithiasis in cholecystolithiasis patients.

METHODS

The clinical data of 398 patients with cholecystolithiasis treated at our hospital from January 2012 to January 2016 were retrospectively analyzed. According to the presence of concomitant asymptomatic choledocholithiasis or not, the patients were divided into two groups: choledocholithiasis group and cholecystolithiasis group. The risk factors for the disease were evaluated. The receiver operating characteristic (ROC) curves for the significant parameters were generated to assess their sensitivities and specificities for diagnosis of concomitant asymptomatic choledocholithiasis in cholecystolithiasis patients.

RESULTS

There were no significant differences in serum levels of alanine transaminase (ALT), aspartate transaminase (AST), total bilirubin (TBIL), or indirect bilirubin (DBIL) between the choledocholithiasis and cholecystolithiasis groups. Serum levels of γ-glutamyltransferase (GGT) and alkaline phosphatase (ALP) in the choledocholithiasis group were significantly higher than those in the cholecystolithiasis group (P < 0.05). The ROC curve analysis showed that the areas under the ROC curve of GGT and ALP were 0.914 and 0.569, and the corresponding cut-off values were 89.5 U/L and 136 U/L (sensitivity: 89.9% and 45.8%; specificity: 79.18% and 71.90%), respectively.

CONCLUSION

Abnormally elevated GGT and ALP have value for prediction of concomitant asymptomatic choledocholithiasis in cholecystolithiasis patients.

[Effect of CIK on long-term survival in the treatment of HCC after RFA combined TACE]

OBJECTIVE

To evaluate the clinical effects of autologous cytokine-induced killer cell(CIK) on the cumulative survival and reactivation rate of hepatitics B virus(HBV) after radiofrequency ablation(RFA) combined with transcatheter arterial chemoembolization(TACE).

METHODS

A total of 156 patients with hepatocellular carcinoma treated from June 2006 to September 2012 in Shengli Oilfield Central Hosptial were divided into control group(RFA, TACE) and research group(RFA, TACE, CIK). According to the tumors number, diameter and vascular invasion condition, the patients were divided into another 4 groups: the high and low risk group with tumor ≤5 cm, the high and low risk group with tumor>5 cm.The prognosis of these groups was analyzed. The effects on HBV reactivation rate between antiviral and unantiviral patients were respectively analyzed .

RESULTS

The ratios of the research and control group over 1-, 3-, 5-year were 75.3%(70/93), 58.9%(53/90), 21.5%(20/93)vs 71.4%(45/63), 55.6%(35/63), 22.2%(14/63)(P>0.05), the ratios of the research and control group in the high risk group with tumor≤5 cm were 75.0%(18/24), 58.3%(14/24), 37.5%(9/24)vs 58.8%(10/17), 41.2%(7/17), 23.5%(4/17)(P<0.05). The incidences of HBV reactivation for the research and control group were 6.0% and 24.3%(P<0.05).

CONCLUSION

Postoperative adjuvant CIK therapy with tumor≤5 cm after RFA combined with TACE is beneficial to the high risk group and decreases the risk of HBV reactivation.

Case of metachronous bilateral isolated adrenal metastasis from colorectal adenocarcinoma and review of the literature

Rarely has a solitary, metachronous bilateral adrenal metastasis of colorectal cancer been reported. We depict a 41-year-old man who underwent sigmoid colon cancer radical surgery followed by adjuvant chemotherapy for a locally ulcerative sigmoid adenocarcinoma with metachronous bilateral adrenal metastasis revealed by a computed tomography scan. Histopathological examination showed adenocarcinoma, compatible with metastasis from the rectal cancer. The level of serum carcinoembryonic antigen had indicative significance for the presence of adrenal metastasis in the reported series. We performed a literature analysis related to this pathological characteristic and attach importance to consistent, vigilant radiological surveillance of the adrenal glands in the patients’ follow up for colorectal cancer with or without subsequent adrenal metastasis.

Significance of Onodera's prognostic nutritional index in patients with colorectal cancer: a large cohort study in a single Chinese institution

The preoperative nutritional and immunological statuses have an important impact in predicting the survival outcome of patients with various types of malignant tumors. Our study aimed to explore the clinical significance and predictive prognostic potential of Onodera’s prognostic nutritional index (PNI) in patients with colorectal carcinoma. This retrospective study included a total of 1321 patients who were diagnosed with colorectal cancer and who had been surgically treated between January 1994 and December 2007. The PNI level was determined according the following formula: 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (per mm³). The impact of PNI on clinicopathological features and overall survival (OS) was determined. The optimal cutoff value of PNI was set at 45. Patients in the low-PNI group had a greater potential to have aggressive histological features, advanced tumors (T), nodal involvement (N), metastasis (M), and TNM stage than those in the high-PNI group. The low-PNI group had a worse OS than the high-PNI group (5-year survival rate 56.1 vs 64.8 %, respectively; P < 0.05). Furthermore, the PNI value was an independent prognostic factor for colorectal cancer in this study. The OS was significantly lower in the low-PNI group than in the high-PNI group in patients with TNM stage II and III diseases. Preoperative PNI is a simple and useful marker to predict clinicopathological features and long-term survival outcome in patients with colorectal carcinoma. PNI analysis should be included in the routine assessment of patients with locally advanced colorectal cancer.

Novel immunological and nutritional-based prognostic index for gastric cancer

AIM: To assess the prognostic significance of immunological and nutritional-based indices, including the prognostic nutritional index (PNI), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio in gastric cancer.

METHODS: We retrospectively reviewed 632 gastric cancer patients who underwent gastrectomy between 1998 and 2008. Areas under the receiver operating characteristic curve were calculated to compare the predictive ability of the indices, together with estimating the sensitivity, specificity and agreement rate. Univariate and multivariate analyses were performed to identify risk factors for overall survival (OS). Propensity score analysis was performed to adjust variables to control for selection bias.

RESULTS: Each index could predict OS in gastric cancer patients in univariate analysis, but only PNI had independent prognostic significance in multivariate analysis before and after adjustment with propensity scoring (hazard ratio, 1.668; 95% confidence interval: 1.368-2.035). In subgroup analysis, a low PNI predicted a significantly shorter OS in patients with stage II-III disease (P = 0.019, P < 0.001), T3-T4 tumors (P < 0.001), or lymph node metastasis (P < 0.001). Canton score, a combination of PNI, NLR, and platelet, was a better indicator for OS than PNI, with the largest area under the curve for 12-, 36-, 60-mo OS and overall OS (P = 0.022, P = 0.030, P < 0.001, and P = 0.024, respectively). The maximum sensitivity, specificity, and agreement rate of Canton score for predicting prognosis were 84.6%, 34.9%, and 70.1%, respectively.

CONCLUSION: PNI is an independent prognostic factor for OS in gastric cancer. Canton score can be a novel preoperative prognostic index in gastric cancer.

Effect of somatostatin in advanced gastric cancer after D2 radical gastrectomy

AIM: To study the effect of somatostatin in patients with advanced gastric cancer who received D2 lymphadenectomy and vagina vasorum dissection.

METHODS: Using a prospective, single-blind, placebo-controlled design, patients with advanced gastric cancer were randomized into a study group (n = 61) and a control group (n = 59). Patients in the study group were given somatostatin for 5-7 d starting 6 h after the operation, and patients in the control group were given normal saline. Preoperative and nonoperative complications in the perioperative period, as well as different types of postoperative drainage in the two groups were compared.

RESULTS: There was no significant difference between the study group and the control group for preoperative clinicopathological indicators. We found no significant difference between the two groups for the overall incidence of complications, but a lower percentage of peritoneal effusion was observed in the treatment group (1.6% vs 10.2%, P < 0.05). There were no significant differences between the two groups in the incidence of postoperative pancreatic dysfunction and chylous fistula. However, there were significant differences in the amylase concentration in drainage fluid, volume and duration of drainage, volume and duration of chylous fistula and peritoneal drainage, and volume and duration of gastric tube drainage. The study group did not show any increase in mean hospitalization cost and the cost reduced when the postoperative complications occurred.

CONCLUSION: Postoperative somatostatin reduces volume and duration of surgical drainage and related complications. Somatostatin may improve safety of gastric cancer surgery, reducing postoperative complications and promoting recovery.

Efficacy and complications of polyethylene glycols for treatment of constipation in children: a meta-analysis

Constipation is a common childhood complaint. In 90% to 95% of children, constipation is functional, which means that there is no objective evidence of an underlying pathological condition. Polyethylene glycol (PEG or macrogol) solution is an osmotic laxative agent that is absorbed in only trace amounts from the gastrointestinal tract and routinely used to treat chronic constipation in adults. Here, we report the results of a meta-analysis of PEG-based laxatives compared with lactulose, milk of magnesia (magnesium hydroxide), oral liquid paraffin (mineral oil), or acacia fiber, psyllium fiber, and fructose in children. This meta-analysis was conducted in accordance with PRISMA guidelines and involved searches of MEDLINE, Cochrane, EMBASE, and Google Scholar databases up to February 10, 2014, using the keywords (Constipation OR Functional Constipation OR Fecal Impaction) AND (Children) AND (Polyethylene Glycol OR Laxative). Primary efficacy outcomes included a number of stool passages/wk and percentage of patients who reported satisfactory stool consistency. Secondary safety outcomes included diarrhea, abdominal pain, nausea or vomiting, pain or straining at defecation, bloating or flatulence, hard stool consistency, poor palatability, and rectal bleeding. We identified 231 articles, 27 of which were suitable for full-text review and 10 of which were used in the meta-analysis. Patients who were treated with PEG experienced more successful disimpaction compared with those treated with non-PEG laxatives. Treatment-related adverse events were acceptable and generally well tolerated. PEG-based laxatives are effective and safe for chronic constipation and for resolving fecal impaction in children. Children's acceptance of PEG-based laxatives appears to be better than non-PEG laxatives. Optimal dosages, routes of administration, and PEG regimens should be determined in future randomized controlled studies and meta-analyses.

[Influence of slide-blown on plasma characterization of laser dressing for bronze-bonded diamond wheel by a fiber laser]

The effects of assistant side-blown operating parameters on the behavior of plasma characteristics and plasma geometry were studied with the aid of high-speed camera in laser dressing of bronze-bonded diamond grinding wheel. The results showed that: high pressure argon plasma reduces swelling height, and as the pressure increases, argon blowing side of the plasma effect is more obvious. Plasma emission spectrum was studied on the grinding wheel radial maximum value with the change in argon gas pressure through the acquisition of plasma emission spectroscopy using spectrometer, and according to the Boltzmann slash and Stark broadening method, the maximal values of plasma electron temperature and electron density in the wheel radial were calculated. It was found that the plasma spectral line intensity first increased and then decreased as gas pressure reached the peak at 0. 2 MPa, Larger argon pressure can significantly reduce the temperature and density of plasmas. With optical 3D scanner the wheel surface topography before and after adding side-blown gas was compared. The results indicated that: the topography of grinding wheel with 0. 5 MPa side-blown argon is better than that without adding side-blown gas.

Clinicopathological features and trend changes of gastric carcinoma in Southern China

AIM: To investigate the clinicopathological features of gastric carcinoma in southern China and disease trends changes over the last 18 years.

METHODS: We designed a retrospective study in the Department of Gastrointestinal Surgery, the first affiliated hospital, Sun Yat-sen University. A total of 2100 adult patients with definitely diagnosed, histologically proven gastric carcinomas treated with radical gastrectomy from 1994 to 2013 were examined retrospectively. In all cases patient age, gender, tumor location, Borrmann type, histopathological type and grade, and pTNM stage were identified and recorded. The information was obtained from hospital records. The data were analyzed with Stata12.0 software.

RESULTS: In this study, the mean age of patients was 57 years with a range from 19-89 years. A higher incidence was found in patients over 60 years of age. In the study population, 67.38% of patients were male and 32.62% were female. Women had a higher disease incidence than men in patients less than 40 years of age (P < 0.001). No obvious change of patient age and gender was observed in the last 18 years. The rates of disease by location were the following: antrum (44.57%), followed by fundus/ body (24.95%) and cardia/gastroesophageal junction (23.00%). The mean tumor diameter was 5.57 cm, and advanced gross type Borrmann III was most common. Most patients were at advanced stages when first diagnosed, and patients with early stage disease were relatively rare. More early stage patients were detected in recent years, especially after 2000 (P < 0.001). Gastric carcinoma has different features in young and old patients. The young patients had the following features: more frequently female, tumors in the antrum, larger tumor size, poorly differentiated carcinoma, high rate of metastasis to other sites and advanced stages (P < 0.05).

CONCLUSION: In southern China, gastric carcinoma was more frequent in old men and young women. Young and old patients should be treated differently for having different features.

Value of alpha-fetoprotein and clinical characteristics in patients with liver neoplasm

This article aimed to investigate the value of α-fetoprotein (AFP) for the diagnosis of hepatocellular carcinoma (HCC) and to evaluate the relationship between AFP and various clinical variables of HCC comprehensively. A retrospective study of postoperative patients diagnosed with liver neoplasm from two Chinese centers was enrolled in our study.A total of 3050 patients were included. The best cut-off point of AFP for the diagnosis of HCC was 20ng/ml with ideal sensitivity (69.74%), specificity (91.18%), LR (4.12) and YI (0.61). Non-HBV infection patients showed the highest specificity (94.44%) but lowest sensitivity (60.13%). In HBV infection. Patients, HBsAg, HBeAb, and HBcAb positive patients had the highest sensitivity (79.55%) and specificity (58.49%). AFP levels increased significantly in symptomatic patients (p=0.011). Those patients with tumor sizes ≥10cm had much higher serum AFP level compared with smaller tumors ones (p=0.014). AFP levels increased remarkably in patients with vascular invasion (p=0.015). Stepwise logistic regression showed tumor size (≥10cm) was an independent predictor of elevated AFP (OR=2.743, 95%CI: 1.167-6.447, P=0.021). The best discriminating AFP value for the diagnosis of HCC is 20ng/ml; HBsAg, HBeAb and HBcAb positive patients have the optimal sensitivity and specificity; tumor size ≥ 10cm is an independent predictor of elevated AFP.

Adjuvant interferon therapy after surgical treatment for hepatitis B/C virus-related hepatocellular carcinoma: A meta-analysis

AIM

This meta-analysis aimed to determine whether interferon (IFN) therapy could improve clinical effects of patients with chronic hepatitis B virus (HBV)or hepatitis C virus (HCV) infection-related primary hepatocellular carcinoma (HCC) after surgery.

METHODS

An electronic search from January 1998 to December 2012 was conducted to identify comparative studies evaluating IFN therapy on recurrence and survival after surgical treatment of HCC.

RESULTS

The estimated odds ratios (OR) for the 1-, 2-, 3- and 5-year overall survival rates of HBV-related HCC were 3.37 (95% confidence interval [CI], 1.18-6.27), 2.36 (95% CI, 1.45-3.83), 1.81 (95% CI, 1.21-2.72) and 1.93 (95% CI, 1.35-2.75), respectively; and the OR for the 1-, 2-, 3- and 5-year recurrence rates were 0.63 (95% CI, 0.44-0.91), 0.84 (95% CI, 0.60-1.18), 0.88 (95% CI, 0.63-1.22) and 0.78 (95% CI, 0.56-1.07), respectively. The overall survival rates of HCV-related HCC were significantly higher in IFN groups than in control groups at 1, 2, 3 and 5 years (OR, 2.10; 95% CI, 0.96-4.55; OR, 1.71; 95% CI, 1.01-2.89; OR, 1.76; 95% CI, 1.09-2.83; and OR, 3.03; 95% CI, 1.97-4.65, respectively); and the recurrence rates of IFN groups were lower than control groups at 1, 2, 3 and 5 years (OR, 0.60; 95% CI, 0.38-0.92; OR, 0.57; 95% CI, 0.41-0.81; OR, 0.58; 95% CI, 0.41-0.80; and OR, 0.52; 95% CI, 0.36-0.75, respectively).

CONCLUSION

In conclusion, IFN therapy in this meta-analysis shows a significant clinical effect in postoperative patients of HCC, particularly in HCV-related HCC.

Pathological diagnosis is maybe non-essential for special gastric cancer: Case reports and review

Histopathological results are critical for the diagnosis and surgical decision regarding gastric cancer. However, opposite opinions from radiology and pathology can sometimes affect clinical decisions. The two cases reported in this article were both highly suspected as gastric cancer by clinical manifestations and radiologic findings, although both showed negative results in the first biopsy examination. One was confirmed as gastric cancer by the time of the 6^th biopsy, while the other was still negative even after 8 biopsies. With a definite pathologic result and the agreement of the patient for the latter case, both of them finally received surgery. Postoperative pathological examination revealed findings that were the same as Borrmann type IV gastric cancer. We believed that duplicate biopsies under radiologic guidance were necessary for highly suspected gastric cancer cases in the absence of a definite pathology result, and patients should be under close follow-up. We propose that, if gastric cancer is highly suspected when typical radiology changes of widely diffuse gastric parietal lesions suffice to exclude lymphoma and other similar situations, and even in absence of a positive biopsy result, a diagnostic laparotomy under laparoscopy and even radical gastrectomy may be reasonably performed by an experienced gastric cancer center with the agreement of the patient after being decided by a multidisciplinary discussion team.

Hepatocytes transduced with human TERT gene acquire a prolonged lifespan in culture and retain permissiveness to hepatitis B virus

Hepatitis B virus (HBV) can be propagated in vitro in primary cultures of human hepatocytes and some stable hepatoma cell lines maintained under specific conditions. The lack of simple and non-neoplastic cell culture systems for HBV has hampered the analysis of virus life cycle and development of antiviral compounds. In this study, we succeeded in prolonging the lifespan of human hepatocytes in primary culture by transducing them with human telomerase reverse transcriptase (hTERT) gene. The transgenic cells expressed hTERT constitutively and propagated HBV up to 5x105 DNA copies/ml for 28 days.

Tumor-associated macrophages promote angiogenesis and lymphangiogenesis of gastric cancer

BACKGROUND AND OBJECTIVES

This study was conducted to investigate whether and how macrophages recruited to tumor microenvironments (tumor-associated macrophages, TAMs) were involved in angiogenesis and lymphangiogenesis of gastric cancer (GC).

METHODS

TAMs, microvessel density (MVD), and lymphatic vessel density (LVD) in 115 cases of GC tissue were assessed by immunohistochemistry (IHC) staining of CD68, CD34, and D2-40, respectively. Preoperative blood samples from 43 patients were obtained to detect serum levels of vascular endothelial growth factor (VEGF) and VEGF-C. A co-culture system was also developed to study effects and underlying mechanisms of THP-1 macrophages on SGC7901 GC cells.

RESULTS

TAMs numbers were closely related to serosa invasion, lymph node metastasis and tumor, nodes, and metastases stage and a positive correlation existed between the TAMs count and MVD and LVD. Additionally, TAMs were associated with preoperative serum levels of VEGF and VEGF-C, the expression of VEGF and VEGF-C protein in macrophages was up-regulated in the co-culture system, and inhibition of the NF-κB pathway in macrophages induced a significant reduction in the expression of VEGF and VEGF-C in both macrophages and GC cells (all P<0.05).

CONCLUSIONS

TAMs may promote angiogenesis and lymphangiogenesis of GC, possibly by enhancing VEGF and VEGF-C expression.

Abnormal expression of E-cadherin in tumor cells is associated with poor prognosis of gastric carcinoma

BACKGROUND AND OBJECTIVES

The purpose of this study was to clarify the relationship of hepatocyte growth factor (HGF), c-Met, and E-cadherin with clinicopathological parameters and prognosis in gastric carcinoma (GC).

METHODS

114 specimens were collected from GC patients and expression of HGF, c-Met, and E-cadherin in tissue microarray was evaluated by immunohistochemical staining. Correlation between immunostainings and clinicopathological parameters, follow-up data of patients, was analyzed statistically.

RESULTS

Abnormal E-cadherin expression was found in 60.5% (69/114) and associated with tumor depth (P = 0.003), lymph node metastasis (P = 0.001) and advanced clinical stage (P = 0.001). High-expression of HGF and c-Met were found in 64.0% (73/114) and 82.4% (94/114), respectively. High c-Met expression was significantly associated with advanced clinical stage (P = 0.001) and lymph node metastasis (P = 0.011) of GC. In univariate survival analysis, high-expression of HGF and c-Met, and abnormal E-cadherin were significantly associated with poor prognosis of GC patients. However, only abnormal E-cadherin expression (P = 0.001) and tumor depth (P = 0.010) emerged as strong independent prognostic factors for overall survival of GC patients.

CONCLUSION

We found significant correlation among HGF/c-Met, E-cadherin expression and worse prognosis of patients with GC. Abnormal E-cadherin expression may serve as an independent predictive factor for prognosis of GC patients.

Reversible ferromagnetism study in un-doped ZnO thin films

Room temperature ferromagnetism in pure ZnO thin films prepared by spin-coating method was observed. X-ray photoelectron spectroscopy and inductively coupled plasma-mass spectrometry showed no or extremely little presence of impurities, which were unlikely to be responsible for the large magnetization moment observed. In order to study the origin of ferromagnetism, ZnO thin films were rapidly annealed in N2 and O2 ambient in a repetitive way. Electrical and magnetic performance after each annealing was measured. It is found that ferromagnetism is diminished and re-appeared, in accordance with the decrease and increase of conductivity. Cathodoluminescence spectra show evidence of reversible variation of oxygen vacancy defect in the annealing process. These results provide strong evidence that oxygen vacancies play a significant role in inducing ferromagnetism in ZnO thin films.

Hepatitis C virus infection of mouse hepatoma cell expressing human CD81 or LDLR

Hepatitis C virus (HCV) infection represents a serious public health problem worldwide. Development of new therapeutics against HCV has been hampered by the lack of a small-animal model. Until now, it has been unclear which host factors influence the HCV infection. It was known that human CD81 (hCD81) or low-density lipoprotein receptor (hLDLR), the putative HCV receptors, induce concentration of viral particles on the cell surface. In this study, recombinant plasmids containing hCD81 or hLDLR genes were transfected to mouse hepatoma Hepa 1-6 cells and transgenic cell lines expressing hCD81 (hCD81/1-6 cell line) or hLDLR (hLDLR/1-6 cell line) on their surface have been established. HCV infection of these cell lines showed that the virus was bound, entered the cell, and replicated inside the cell. This finding is essential for the development of mouse model for the study of HCV replication in vivo.

Evidence of intrinsic ferromagnetism in individual dilute magnetic semiconducting nanostructures

Semiconductors doped with magnetic ions, also known as dilute magnetic semiconductors, are both semiconducting and ferromagnetic. It remains unclear, however, whether this ferromagnetism is intrinsic, as is required for spintronic applications, or is due instead to dopant clustering. Here, we report conclusive evidence for intrinsic ferromagnetism in individual ZnO nanoparticles doped with transition metal ions. Through a simultaneous magnetic and microstructural characterization using electron magnetic chiral dichroism and channelling-enhanced electron energy loss microanalysis, respectively, we show that ZnO nanoparticles have intrinsic ferromagnetism when doped with cobalt, but not when doped with iron.

Identification and degradation characterization of hexachlorobutadiene degrading strain Serratia marcescens HL1

A bacterium (strain HL1) capable of growing with hexachlorobutadiene (HCBD) as sole carbon and energy sources was isolated from a mixture of soil contaminated with HCBD and activated sludge obtained from petrochemical plant wastewater treatment plant by using enrichment culture. Biochemical characteristics and phylogenetic analysis based on 16S rDNA sequence indicate that strain HL1 clearly belongs to Serratia marcescens sp. Resting cells of strain HL1 were found to remove HCBD from culture fluids with the concomitant release of chloride ion under aerobic conditions. The ranges of pH value and temperature for satisfactory growth of strain HL1 cells were from 7.0 to 8.0 and 25 to 30 degrees C, respectively. Capability of resting cells to degrade HCBD was induced by HCBD in the culture fluids. HCBD (20mg/l) was removed from culture fluids by resting cells in 4 d without lag phase, but for 50mg/l and 80mg/l HCBD 7 days were needed with lag phase. Growth of strain HL1 cells was inhibited by HCBD at the concentration up to 160mg/l. First order kinetics could be fitted to the biodegradation of HCBD by HL1 cells after lag phase at initial concentrations of 20, 50, and 80mg/l. Strain HL1 also showed strong capacity to degrade chloroprene, trichloroethylene, tetrachloroethylene, and vinyl chloride at solely initial concentration of 50mg/l. Results could offer useful information for the application of strain HL1 in bioremediation or control of HCBD-polluted environment.

Radial Hilbert transform with Laguerre-Gaussian spatial filters

We analyze the point spread function (PSF) of the image processing system for radial Hilbert transform and propose a novel spiral phase filter, called the Laguerre-Gaussian spatial filter (LGSF). Theoretical analysis and real experiments show that the LGSF possesses some advantages in comparison with the conventional spiral phase plate (SPP). For example, the PSF of the imaging system with a LGSF presents smaller suboscillations than that with the conventional SPP, which allows us to realize a radial Hilbert transform for achieving a high contrast edge enhancement with high resolution.

Novel molecular device based on electrostatic interactions in organic polymers

A number of researchers have reported attempts to design molecular level devices. One approach is to make use of electrostatic interactions in different parts of a polymeric molecule. This paper reports a means to achieve this by adding space charge to a molecule consisting of symmetric and asymmetric subgroups. Physically, space charge residing in a subgroup produces a dipolar charge layer thereby creating a potential trough in the polymer backbone. By lifting or lowering this potential minimum, it is possible to modify the terminal current. The effect of space charge on the potential profile in the polymer backbone was examined and the change correlated to data on carrier mobilities for OC1C10-PPV reported in the literature. Modulation of space charge in the subgroup allows the manipulation of current flow along the polymer backbone, forming the basis for the development of a molecular device. A first-order analysis suggested that such a device could have current-voltage (I-V) characteristics similar to those of a MOSFET at subthreshold, with an estimated transconductance approximately 1-2 pAV and a cutoff frequency approximately 10(15) Hz.

The relationship between activation of TLR4 and partial hepatic ischemia/reperfusion injury in mice

BACKGROUND

Toll-like receptors (TLRs) are a group of evolutionarily conserved pattern recognition receptors involved in the activation of the immune system in response to various pathogens. In this study, we elucidated the relationship between activation of TLR4 and liver injury in partial hepatic ischemia/reperfusion (I/R) injury in mice.

METHODS

BALB/c mice were used in a model of partial hepatic I/R injury, and the changes of TLR4 gene expression in ischemic liver lobes were detected with real-time polymerase chain reaction (RT-PCR). The levels of plasma ALT and endotoxin in the portal vein were measured. TLR4-deficient mice (C3H/Hej) and wild type mice (C3H/Heouj) were used in a model of I/R injury; liver function impairment and the level of serum TNF-alpha were observed.

RESULTS

After one hour ischemia, the expression of TLR4 mRNA increased at the 1st, 3rd hour of reperfusion, indicating the value of deltaCt (1st hour: 1.21+/-0.87 vs. 5.85 +/-1.07, t=13.72, P<0.01; 3rd hour: 0.85+/-0.92 vs. 6.11+/-1.24, t=16.33, P<0.01). No endotoxemia developed in every group of mice. At the 3rd hour of reperfusion, the level of serum TNF-alpha was significantly higher than that of sham group (Hej: 152+/-43 pg/ml vs. 18+/-10 pg/ml, t=5.26, P<0.01; Heouj: 249+/-52 pg/ml vs. 25+/-13 pg/ml, t=7.24, P<0.01). At the 1st, 3rd hour reperfusion, the level of plasmid ALT in Hej mice was lower than that in Heouj mice (1st hour 662+/-106 U/L vs. 1216+/-174 U/L, t=4.21, P<0.01; 3rd hour 1145+/-132 U/L vs. 2958+/-187 U/L, t=13.72, P<0.01). The level of serum TNF-alpha was lower than that in Heouj mice (152+/-43 U/L vs. 249+/-52 U/L, t=3.94, P<0.01) at the 3rd hour reperfusion.

CONCLUSION

TLR4 activation causes partial hepatic I/R injury through release of TNF-alpha.

Effect of nitric oxide on toll-like receptor 2 and 4 gene expression in rats with acute lung injury complicated by acute hemorrhage necrotizing pancreatitis

BACKGROUND

Toll-like receptor (TLR) 2/4 might play important roles in mediating proinflammatory cytokine synthesis and release. And nitric oxide (NO) has been used to treat acute respiratory distress syndrome (ARDS). This study aimed to investigate the changes in TLR2/4 gene expression in the lungs of rats with acute lung injury (ALI) complicated by acute hemorrhage necrotizing pancreatitis (AHNP) and the effect of NO on the TLR2/4 gene expression.

METHODS

One hundred and ten SD male rats were randomly divided into sham-operated group (n=10), AHNP group (n=30), chloroquine-treated group (n=30), and L-Arg-treated group (n=40). The lungs were dissected for lung histological scoring, and bronchoalveolar lavages were harvested for lung injury indexing. TLR2/4 mRNA expression in the lungs was measured by RT-PCR.

RESULTS

TLR2/4mRNA was detected in the lungs with low values in the sham-operated group (0.016+/-0.210E-2, 0.112+/-0.750E-2), but it was markedly increased at 3 hours in the AHNP group (0.787+/-0.751E-2, 1.512+/-1.794E-2), peaking at 12 hours (1.113+/-6.141E-2, 2.957+/-2.620E-2; P<0.05 or P<0.01). When lung injuries were aggravated, TNF-alpha concentrations in the lungs were increased, but NO concentrations were decreased (P<0.05 or P<0.01). When TLR2/4mRNA was inhibited by CQ (3h: 0.313+/-5.491E-2, 0.005+/-1.419E-3; 6h: 0.488+/-7.442E-2, 0.010+/-1.518E-3; 12h: 0.883+/-8.911E-2, 0.024+/-2.760E-3; P<0.05 or P<0.01), lung injuries were relieved. NO concentrations in the lungs were increased but TNF-alpha concentrations were decreased (P<0.05 or P<0.01). When the rats with AHNP were treated with L-Arg, TLR2/4mRNA expression in the lungs could be effectively inhibited (50 mg-T: 0.656+/-3.977E-2, 1.501+/-6.111E-2; 100 mg-T: 0.260+/-0.891E-2, 0.732+/-5.135E-2; 200 mg-T: 0.126+/-0.914E-2, 0.414+/-1.678E-2; 400 mg-T: 0.091+/-0.399E-2, 0.287+/-0.176E-2;P<0.05 or P<0.01) and lung injuries were relieved. At the same time, NO concentrations in the lungs were markedly increased, but TNF-alpha concentrations were decreased (P<0.05 or P<0.01).

CONCLUSIONS

The expression of TLR2/4mRNA is increased in the lungs in rats with AHNP and lung injuries are aggravated.TLR2/4mRNA gene expression of the lungs of rats with AHNP could be markedly inhibited by NO, leading to the relief of lung injuries.

[Treating metastatic vertebral tumor with percutaneous vertebroplasty: a report of 28 cases]

BACKGROUND & OBJECTIVE

Treating metastatic vertebral tumor is a common difficulty. Conservative treatment can't efficiently release the pain, and establish the spinal column; while operation may destroy normal tissue, and cause many complications, which would prolong the time of in-hospital, and delay the treatment of primary disease, at the same time, operation is not suitable for multiple metastatic spinal tumors. This study was designed to investigate the efficacy of percutaneous vertebroplasty (PVP) on metastatic spinal tumor under the guidance of digital subtraction angiography (DSA).

METHODS

A total of 58 patients with metastatic spinal tumor were divided into 2 groups according to their intention, 28 (group A) were treated with PVP combined radiochemotherapy, 30 (group B) were treated with routine radiochemotherapy. Baselines of the 2 groups have no significant difference. Two months after treatment, the life quality, therapeutic response, stabilization of the vertebral column, and toxic effect were compared between group A and group B.

RESULTS

After treatment, both groups showed significant changes in life quality, and therapeutic response (P < 0.05, t(1)=2.74, t(2)=11.74). Group A showed no complication. Group B showed 5 cases of pathologic constrictive fracture in spinal body.

CONCLUSION

PVP is a simple and minimally invasive treatment with few complications, which can release pain, decrease incidence of pathologic constrictive fracture in spinal body, and improve life quality of patients with metastatic spinal tumor.

Variable-temperature scanning tunneling microscopy and scanning tunneling spectroscopy study on copper phthalocyanine ultrathin films on a Au(111) surface

Variable-temperature high-resolution scanning tunneling microscopy (STM) images reveal that well-ordered copper phthalocyanine (CuPc) strips can be self-assembled by depositing CuPc molecules on a Au(111) surface. The self-assembled strips are supposed to result from the balance of the intermolecular interaction and the interaction between the molecules and substrate during annealing. The energy band (approximately 1.9-2.1 eV) of CuPc, measured by scanning tunneling spectroscopy (STS), is comparable to the optical band gap (approximately 1.7 eV). Spectroscopic measurements confirm that a dipole layer and/or an effect of image force exist at the CuPc/Au(111) interface.

A novel ethacrynic acid sensor based on a lanthanide porphyrin complex in a PVC matrix

Lanthanide porphyrin complexes synthesized by a solid state method were used to prepare a novel ethacrynic acid (EA) sensor. The sensor, based on pentane-2,4-dionato(meso-tetraphenylporphinato)terbium [TbTPP(acac)] with an optimized membrane composition, exhibits a Nernstian response to EA- ion in the concentration range 7.4 x 10(-6)-1.0 x 10(-1) mol l-1 with a pH range from 3.2 to 6.8 and a fast response time of 30 s. The electrode shows improved selectivity towards EA- ion with respect to common co-existing ions compared with the previously reported EA sensor. As electroactive materials, lanthanide porphyrin complexes show better potentiometric response characteristics than copper porphyrin complexes. The effect of solvent mediators and lipophilic ion additives was studied and the experimental conditions were optimized. The electrode was applied to the determination of EA in human urine samples with satisfactory results.