Objective To evaluate the antioxidant effect of hesperidin and its effect on transcription of monocyte chemoattractant protein 1 (MCP 1) in rabbits with dietary atherosclerotic lesions. Methods (1) Low density lipoprotein (LDL) was isolated from healthy human plasma by sequential ultra centrifugation and oxidized by copper. The contents of malondialdehyde (MDA) were measured at different dosages of the drug and at different reaction time. (2) Atherosclerotic model of rabbits was established by feeding rabbits with high lipid diet and immune injury. A total of 18 rabbits were divided randomly into three groups: control group, model group, and hesperidin group ( n =6 in each group). Rabbits in the control group were fed with common diet, those in the model group with high lipid diet, and those in the hesperidin group with high lipid diet plus hesperidin. After 10 experimental weeks, blood samples were collected from the marginal ear veins for the detection of the contents of MDA and nitric oxide (NO). The rabbits were sacrificed for the isolation of the thoracic aorta. MCP 1 mRNA transcription in the thoracic aorta was detected by RT PCR. Results Hesperidin could significantly inhibit MDA production in a dose dependent manner in vitro ( P

As the improved understanding of the biological behavior of colorectal cancer and the development of diagnosis and surgical techniques,the prognosis of patients with locally advanced colorectal cancer has been improved significantly.Locally advanced colorectal cancers are best treated with multivisceral resections,but the procedure is high technique-demanding and the indications for the procedure should be strictly followed.In this article,the procedure of right colectomy combined with pancreatoduodenectomy for colon cancer was described in detail in order to share the experiences and skills with surgeons.

Objective To evaluate the significance of the expression of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) as prognostic indicators for patients with stage Ⅱ colorectal cancer. Methods A total of 285 patients with stage Ⅱcolorectal cancer who underwent potentially curative surgery were enrolled in the study. A high CEA level was defined as a level exceeding 5 ng/ml and a high CA19-9 level was defined as a level exceeding 37 U/ml. Patients were followed up every 3 months to review CEA and CA19-9 levels. Two years later, the chest and abdominal CT examination were performed every 3 months, and then every 6 months until 5 years. Results Out of these 285 patients, 99 (42.60%) patients had high CEA levels, 25 (8.77 %) patients had high CA19-9 levels, and 12 (4.21 %) patients had both high CEA and CA19-9 levels. The overall survival rates of patients with both high CEA and CA19-9 levels were significantly worse than those of others (P< 0.05). During the study, 51 recurrences were diagnosed. There were 22 hepatic recurrences, 10 pulmonary recurrences, 9 local recurrences, 8 lymph node recurrences, and 2 peritoneal recurrences. CT, CEA and CA19-9 were the first abnormal examinations in 30, 5 and 8 recurrent patients, respectively. In 27 % of recurrent patients, the recurrence was detected earlier by CEA and CA19-9 than that by CT. Conclusions The detection of preoperative CEA and CA19-9 levels is useful for predicting the prognosis after potentially curative surgery in patents with stage Ⅱ colorectal cancer. For early detection of occult recurrence of colorectal cancer, tumor markers are relevant.

Objective To assess the feasibility and short-term effect of transanal everted extraction of laparoscopic rectal excision without abdominal incision.Methods Eleven patients were operated by transanal everted extraction of laparoscopic rectal excision without abdominal incision.Results All the operations were accomplished successfully,the average operative duration was (189.5±25.2) min,the intra-operative blood loss volume was (25.4±9.4) ml,the average time to flatus was (38.9±8.6) h,the average postoperative hospital stay was (12.7±2.5) d,and the number of lymph nodes harvested was 13.5±4.1.There were no post-operative complications.Conclusion The technique of transanal everted extraction of laparoscopic rectal excision without abdominal incision is safe and feasible,but the long-term effects need more observation.

Objective To explore the effect of mesenchymal stem cells(MSCs) on nervous function in rats with focal cerebral ischemia.Methods The MSCs were cultivated,purified,and proliferated in vitro by density gradient and adherence to plastic dishes method.The models of Wistar rats were prepared after middle cerebral artery occlusion(MCAO) of right lasted 90 min and reperfusion 1 h.Wistar rats were randomly divided into normal control group(A,n=10),sham operation group(B,n=10),no-handle group after cerebral ischemia/reperfusion (C,n=10),free-serm DMEM transplantation group after cerebral ischemia/reperfusion(D,n=10),MSCs transplantation group after cerebral ischemia/reperfusion(E,n=10).After identified by flow cytometry,5 ?L 5-bromo-2-deoxyuridine(BrdU) labeled MSCs(4?105? ?L-1) and 5 ?L serum-free DMEM were respectively injected intracerebraly into ischemic boundary zone of right in D and E groups.Immunohistochemical method was used to detect the expression and survival of BrdU-labeled MSCs in vivo.Nervous function behavioral tests were performed on 1st,3th,7th and 28th day after transplantation by forelimb use asymmetry test and postural reflex test.Results MSCs were successfully purified and proliferated in vitro.The MSCs expressed CD29,CD44,but didn't expressed CD34,CD45,CD31 identified by flow cytometry.transplanted MSCs survived and were localized to the ischemic boundary zone.Behavioral tests of every group were improved with time prolonged.However,MSCs transplantation group was significantly better than any other groups(P

Aim To evaluate the antitumor activity of dianhydrogalactitol ( DAG) in vitro, and further clarify its underlying mechanisms. Methods The inhibitory effect of DAG in NCI-H460 cells was detected by CCK-8 assay and colony formation assay. The morphology of cells treated with DAG was observed under optical mi-croscope. Nuclear morphology was captured by fluores-cence microscopy after Hoechst 33342 staining. Real-time PCR was used to analyze the expression level of topoisomerase Ⅱ ( Topo Ⅱ) mRNA. The protein ex-pression level of Topo Ⅱ was detected by Western blot. Additionally, molecular docking approaches were used to predict the interaction between DAG and TopoⅡ. Results DAG exhibited potent antitumor activity in NCI-H460 cells, and inhibited cell proliferation per-sistently. DAG obviously induced nuclear morphologi-cal changes of NCI-H460 cells. Furthermore, DAG could down-regulate the mRNA and protein expression level of Topo Ⅱ detected by Real-time PCR analysis and Western blot, respectively. Molecular docking predicted that DAG could bind to Topo Ⅱ. Conclu-sion DAG can significantly inhibit the proliferation of NCI-H460 cells, and its underlying mechanisms may involve the down-regulation of Topo Ⅱ mRNA and di-rect binding to Topo Ⅱ, leading to cancer cell death.

Objective To compare the predicting values for Prognosis among Global Risk Classification (GRS),Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery (SYNTAX) score,the European System for Cardiac Operative Risk Evaluation (EuroSCORE) in patients who received stenting because of unprotected left main coronary artery (ULMCA) lesion.Methods Totally 105 successive elderly patients with ULMCA lesion who received stenting were divided into 2 groups:with and without main adverse cardiac events (MACE).The clinical and angiographic characteristics were analyzed and then compared among GRC,SYNTAX score and EuroSCORE.Results As compared with none MACE group,MACE group had higher EuroSCORE score (2.0±2.3 vs.6.5±2.9,t=8.18,P=0.002),and more trivessel disease and left main bifurcation lesion (x2 =8.96,6.96,P =0.011,P =0.008).High risk GRC showed more MACE than medium or low risk GRC [55.9％ (19/34) vs.20.5％(9/44),7.4％ (2/27),x2 =19.77,P=0.001].AUC(95％CI )of GRC,SYNTAX score and EuroSCORE were [0.821 (0.730-0.912),0.586(0.462-0.709) and 0.631 (0506-0.757)],respectively.Compared with SYNTAX score and EuroSCORE,GRC was superior in the MACE predicting value (Z=3.29,2.63,P＜0.01 or P＜0.05).

With the improvement of living standard and the change of diet structure,the incidence of multiple primary carcinoma has increased significantly,which is related to the improvement of diagnosis level.In clinical work,multiple primary carcinoma was easily misdiagnosed with metastatic cancer.Many patients lost their best time to treat,because principles and prognosis of them were distinctly different.Strengthen the understanding of multiple primary carcinoma,in order to detect,diagnose and treat earlier,is beneficial to improve the survival of patients.Based on this background,this article reviewed the epidemiology,etiology,pathogenesis,diagnosis and treatment strategies of multiple primary carcinoma,aiming at improving the prognosis of patients.

OBJECTIVE： To design and optimize the formulation and technology of Theophylline hydrophilic gel matrix sustained-release tablets （self-made sustained-release tablets for short） based on the concept of “Quality by Design” （QbD）. METHODS： Diluent type， tablet diameter， the property of adhesive （ratio of different adhesive types）， the amount of adhesive were regarded as critical process parameters （CPPs）. Similarity factor of dissolution curves of self-made Theophylline sustained-release tablets and reference preparation and its accumulative release rate at different time points were regarded as critical quality attributes （CQAs）. L18（34） orthogonal tablet was adopted for design and trial， and secondary polynomial regression model was established. By using Modde 12.0 software， the design space and its acceptable range （PAR） were calculated through the optimal model. The optimal formulation and technology of Theophylline sustained-release tablets was determined， and validation test and Monte Carlo simulation verification were conducted. RESULTS： The optimal model with good coincidence， accuracy， validity and reproducibility was obtained， which could better fit the relationship between CQAs and CPPs. The design space and PAR value were obtained by further calculation （The optimum value of diluent was lactose； tablet diameter was 9.07-9.33 mm， and the optimal value was 9.20 mm； ratio of HPMC K4M to HPMC was 0.50-0.83， and the optimal value was 0.80； total amount of HPMC was 0.036 0-0.041 3 g per tablet， and the optimal value was 0.038 g per tablet）. The optimal formulation and technology included that ratio of theophylline， HPMC K4M and HPMC K100M were 50％， 15.48％ and 3.87％， respectively； the rest was filled with lactose and the diameter of the tablet was 9.20 mm. The results of validation confirmed that self-made Theophylline sustained-release tablets had similar in vitro release behavior compared with reference preparation. CONCLUSIONS： Based on the concept of QbD， the formulation and technology of Theophylline sustained-release tablets can meet the requirements of design， and the CPPs can be adjusted within the PAR range to meet the requirements of CQAs. This shows that the QbD concept is scientific and effective in the design and optimization of the formulation and technology of sustained and controlled release preparations.

Objective     To systematically evaluate the safety, efficacy, and economics of intracardiac echocardiography (ICE) versus transesophageal echocardiography (TEE) in left atrial appendage occlusion (LAAO). Methods     PubMed, EMbase, The Cochrane Library, CBM, CNKI, VIP and WanFang Database were systematically  searched to collect relevant studies on comparing ICE and TEE-guided LAAO from inception to June 15th, 2022. Two reviewers independently screened the literatures, extracted the data, and assessed the risk of bias of the included studies. Meta-analyses were performed using RevMan 5.3 and R 4.0.3. Retrospective cohort studies were excluded for sensitivity analysis. Subgroup analyses were performed based on the types of occluder and ICE catheter. Results     A total of 14 studies with 6 599 patients were included. Meta-analyses showed no statistical differences in technical success rate, overall complications, device embolization, peri-device leakage, device-related thrombus, stroke, vascular complications, bleeding, operation time, fluoroscopy time, or contrast agent volume between the ICE and TEE-guided LAAO. The total in-room time (MD=–33.47 min, 95%CI –41.20 to –25.73, P<0.000 01) and radiation dosage (MD=–170.20 mGy, 95%CI –309.79 to –30.62, P=0.02) were lower in the ICE group than those in the TEE group, whereas the incidence of pericardial effusion/tamponade was higher than the TEE group (RR=1.57, 95%CI 1.01 to 2.45, P=0.048). Except for pericardial effusion/tamponade, subgroup analyses and sensitivity analysis showed similar results. The analysis based on the cost data from the United States showed comparable or even lower total costs for ICE versus TEE, but comparative domestic cost studies were lacking. Conclusion     Current evidence suggests that ICE-guided LAAO can reduce radiation dosage and total in-room time, and there is no statistical difference in the overall complication rate between the two groups. Owing to the limitations of sample size and quality of the included studies, the conclusion still needs to be verified by large sample size and high-quality randomized controlled trials.