Fluoropyrimidines are still the basic agents for adjuvant chemotherapy of colon cancer,a regimen containing 5-FU/LV/oxaliplatin (FOLFOX or FLOX) is the new standard for adjuvant settings,and FU/LV alone (Mayo,Roswell Park or LV5FU2) or single agent of capecitabine should be a choice of treatment for some particular patients; irinotecan should not be used for the adjuvant setting of colon cancer,because currently there is no evidence to show additional survival benefi t with addition of irinotecan to the adjuvant treatment,but increased risk of chemotherapy-related toxicity. Stage Ⅲ colon cancer is the main and defi nite indication for adjuvant chemotherapy,while adjuvant chemotherapy should not be routinely considered for stage Ⅱ colon cancer,except those with high risk factors including T4 tumor,obstruction,perforation,poor differentiation,invasion to nerve or vessels,and less than 12 examined lymph nodes. The age should not exclude the adjuvant chemotherapy if there is an adequate performance status. Adjuvant chemotherapy should be started within 8 weeks after surgery,and the current optimal duration for adjuvant chemotherapy of colon cancer should be six months.

Objective To study the relationship between serum HBV DNA level and apoptosis of peripheral blood mononuclear cells (PBMC) , and the relationship between serum HBV DNA level and the activity of caspase-8 in the patients with chronic hepatitis B (CHB). Method 30 CHB patients were selected as experimental group, and it was divided into three subgroups according to the serum HBV DNA level, subgroup A (high serum HBVDNA), subgroup B (medium serum HBVDNA), and subgroup C (low serum HBVDNA). 10 healthy adults were random selected as control group. PBMC were isolated from two groups by separating medium of lymphocytic cell and culturing it with phytohemagglutinin (PHA) in vitro for 72 hours. The PBMC was stained with PI and the apoptosis was assayed with flow cytometry. At the same time, the aetivity of caspase-8 of PBMC was assayed by color matching. Results The apoptosis rate of PBMC of experimental group ( 26. 88 ± 7.37 ) % were higher than that of the control group ( 14. 95 ±2. 53)% ( P <0. 01 ). In the experimental group, the apoptosis rate of PBMC of subgroups A, B and C showed decreasing order (34. 75 ± 4. 59)%, (25.63 ± 3.55 )%, ( 18. 91 ± 3. 81 )%. The activity of caspase-8 of experimental group 2. 99 ±0. 82 were higher than that of the control group 1.43 ±0. 91 ( P <0. 01 ). The activity of caspase-8 of subgroup A, B and C showed the same decreasing order: 3. 87 ±0. 35,2. 95 ± 0. 36, 1.95 ± 0. 29. There was a positive correlation between the apoptosis level of PBMC and the activity of caspase-8 in experimen tal group ( r = 0. 610, P < 0. 01 ). Conclusion AICD of PBMC was found in patients with CHB. The activity of caspase-8 increased in that process, and it may participate in the transduction of apoptosis signal. Serum HBV DNA level was related with the apoptosis rate of PBMC and the activity of caspase-8, and it may be one of the reasons of apoptosis in PBMC.

Objective To evaluate the clinicopathological characteristics of early gastric carcinoma for prognosis and the long term consequences of gastrectomy for quality of life in the aged. Methods The clinicopathological features and late postoperative complications by follow up study for 71 patients during 1973 1999 with early gastric cancer were reviewed by using hospital records. Results Forty six cases(64.8%) were diagnosed by routine gastroscopic checkup. 56 cases out of 71 (74.6%) were mucosal cancer without lymph node metastasis, 18 cases were submucosal cancer with lymph node metastasis in 2 cases. By histological study, we found that 32 lesions (45.1%) were located at the antrum, differentiated tubular adenocarcinoma was found in 43 cases, and multiple primary carcinoma in 5 cases and gastric stump cancer in 3 cases. The disorders of gastric stump included anastomotic gastritis, empting disturbance, erosion, ulcer, reflux esophagitis were found in 31, 7, 6, 4 and 3 cases, respectively. Fourteen patients showed weight loss and 9 showed anemia. Patients with proximal gastrectomy suffered more from disoders than the patients with distal gastrectomy. Conclusions Our results suggest that special attention should be given to the patients with chronic atrophic gastritis diagnosed by routine gastroscopy. Lymph node metastasis, multiple primary cancer and gastric stump cancer might affect the prognosis. Our results support the fact that the incidence of disorders of gastric stump are high; and the surgical treatment with gastroscopic procedure is recommended for the mucosal cancer in order to improve the patients' quality of life.

Risk Factors ; Tars ; toxicity ; Tobacco Products ; standards ; toxicity ; Tobacco Use Disorder ; etiology ; prevention & control

Animals ; Apoptosis ; Caspase 3 ; metabolism ; Caspase 8 ; metabolism ; Cells, Cultured ; HSP70 Heat-Shock Proteins ; metabolism ; Heat Stress Disorders ; metabolism ; Myocytes, Cardiac ; metabolism ; Rats ; Rats, Wistar

Objective To investigate the changes of circulating endothelial progenitor cells (EPCs) in patients with acute cerebral infarction or chronic cerebral ischemia and discuss the related clinical significance.Methods Circulating EPCs were isolated using staining markers of CD34,CD133,and kinase insert domain receptor (KDR).Peripheral venous blood was collected from patients with acute cerebral infarction within 24 hours of onset (infarction group,n =30),with chronic cerebral ischemia (ischemia group,n =20),and without cerebral ischemia (control group,n =10) to quantify circulating level of EPCs using flow cytometry and measure parameters of systolic pressure,glycosylated hemoglobin (HbAlc),total cholesterol (TC),and triglyceride (TG),and low density lipoprotein-cholesterol (LDL-C),and high density lipoprotein-cholesterol (HDL-C).Results CD34-,CD34/CD133-,and CD34/KDR-positive cells counted (14.2 ± 8.1)‰,(7.1 ± 4.1)‰ and (5.0 ± 3.7)‰ in infarction group,(28.5 ± 9.9)‰,(15.2 ± 3.7)‰ and (6.8 ± 2.0)‰ in ischemia group,and (44.8 ± 9.5) ‰,(22.1 ± 6.6) ‰ and (16.7 ± 6.9) ‰ in control group.Taken together,circulating level of EPCs lowered substantially in infarction and ischemia groups compared to control group (P ＜ 0.05) and a far lower level was observed in infarction group (P ＜ 0.05).Circulating level of EPCs in infarction group was in a moderate negative correlation with systolic pressure,TC,TG,and LDL-C (P ＜ 0.05).Conclusions Decreased circulating level of EPCs may be a risk factor to the development of cerebral ischemia in acute cerebral infarction patients.Therefore,level of EPCs is vital for prediction,prevention and treatment of acute cerebral infarction.

Background The mitochondrial Na+/Ca2+exchanger, NCLX, plays an important role in the balance between Ca2+influx and efflux across the mitochondrial inner membrane in endothelial cells. Mitochondrial metabolism is likely to be affected by the activity of NCLX because Ca2+activates several enzymes of the Krebs cycle. It is currently believed that mitochondria are not only centers of energy produc-tion but are also important sites of reactive oxygen species (ROS) generation and nucleotide-binding oligomerization domain receptor 3 (NLRP3) inflammasome activation. Methods&Results This study focused on NCLX function, in rat aortic endothelial cells (RAECs), induced by glucose. First, we detected an increase in NCLX expression in the endothelia of rats with diabetes mellitus, which was induced by an injection of streptozotocin. Next, colocalization of NCLX expression and mitochondria was detected using confocal analysis. Suppression of NCLX expression, using an siRNA construct (siNCLX), enhanced mitochondrial Ca2+influx and blocked efflux induced by glucose. Un-expectedly, silencing of NCLX expression induced increased ROS generation and NLRP3 inflammasome activation. Conclusions These findings suggest that NCLX affects glucose-dependent mitochondrial Ca2+signaling, thereby regulating ROS generation and NLRP3 in-flammasome activation in high glucose conditions. In the early stages of high glucose stimulation, NCLX expression increases to compensate in order to self-protect mitochondrial maintenance, stability, and function in endothelial cells.

Objective: To explore the effects of ranitidine on pharmacokinetics of rhein in rats after oral administration of Dachengqi Decoction (DCQD), a compound traditional Chinese herbal medicine. Methods: Twelve male Sprague-Dawley rats were divided into DCQD group and DCQD plus ranitidine group, and were orally administered with DCQD at a dose of 10 g/kg or DCQD (10 g/kg) combined with ranitidine (150 mg/kg), respectively. Blood samples were gathered after a series of time intervals. Metabolism of rhein was determined with a reversed-phase high-performance liquid chromatography with internal standard of 1, 8-dihydroxyanthraquinone and the data were analyzed with DAS 2.1 program. The pharmacokinetic parameters were compared between the two groups. Results: The pharmacokinetic parameters of rhein in the DCQD group, including peak concentration (C(max)), area under the plasma concentration-time curve (AUC), distribution phase half-life (t(1/2alpha)), elimination rate constant (K(10)) and central to peripheral transfer rate constant (K(12)), were significantly different to those in the DCQD plus ranitidine group (P<0.05, P<0.01). There were no significant differences in the other parameters between the two groups. Conclusion: Ranitidine can influence the pharmacokinetics of rhein in rats after oral administration of DCQD.

0.05); When the IAP level reached 20 cm H2O, there was significant elevation (P

Objective To analyze the epidemic characteristics of multidrug-resistant tuberculosis(MDR-TB)in Hunan Province from 2013 to 2016,and provide theoretical basis for the prevention and control of tuberculosis.Methods Information about TB patients in Hunan Province reported by China Information System for Disease Control and Prevention between January 2013 and December 2016 was analyzed retrospectively.Results From 2013 to 2016,the total drug resistance registration rate in Hunan Province was 5.53/million(1 496/270 330 000),multidrug registration rate was 5.40/million(1 459/270 330 000),drug resistance rate and multidrug resistance rate showed an upward trends(trend x2 =113.605,96.590,respectively,both P<0.001).Among MDR-TB patients,male were more than females(74.09%vs 25.91%),most were more than 25 years of age,especially 45～age group(27.07%);the proportion of patients with MDR-TB retreatment was higher than that of the initial treatment(69.91%vs 30.09%).From 2013 to 2016,distribution range of MDR registration rates in different regions were 4.07/million-7.23/million.Conclusion MDR-TB in Hunan Province in 2013-2016 is increasing year by year,and mainly concentrate on young people over 20 years old.There are more cases of male and retreatment;it is necessary to strengthen regular treatment and prevention of key population,enhance the ability to identify and diagnose MDR-TB patients,and reduce the spread of MDR-TB.