BACKGROUND:We tried to combine 8-bromo-7-methoxychrysin and sorafenib in order to offset the tolerance of hepatocelular cancer stem cels to sorafenib, thereby comprehensively improving the therapeutic efficacy on hepatocelular carcinoma. OBJECTIVE:To observe the effects of 8-bromo-7-methoxychrysin, sorafenib and their combination on apoptosis of liver cancer stem-like cels SMMC-7721, and to analyze their mechanisms. METHODS:SMMC-7721 cels were treated with 8-bromo-7-methoxychrysin, sorafenib alone and their combination for 24 hours. Then, flow cytometry was used to detect cel apoptosis and western blot assay was used to determine nuclear factor-κB protein expression. RESULTS AND CONCLUSION:Compared with 8-bromo-7-methoxychrysin group and sorafenib group, the apoptotic rates of SMMC-7721 cels were significantly enhanced after treatment with the combination of 8-bromo-7-methoxychrysin group and sorafenib (2.5, 5, 10, 50 μmol/L), and meanwhile, the protein expression of nuclear factor-κB was down-regulated significantly. These findings indicate that the combined therapy of 8-bromo-7-methoxychrysin group and sorafenib can enhance the apoptosis of SMMC-7721 cels, which may be associated with down-regulation of nuclear factor-κB protein.

Objective:To analyze and investigate the clinical efficacy on repairing soft tissue defects of the thumb distal with dorsal neurocutaneous vascular flap.Methods:Select 100 cases of patients with soft tissue defects of the thumb distal from January 2014 to December 2016,who were randomly divided into two groups,the control group and observation group.Take the abdominal skin flap to repair soft tissue defects of the thumb distal in the control group,with the thumb distal with dorsal neurocutaneous vascular flap in the observation group.The survival condition,the indicators of feelings,the appearance of skin flap,as well as the DASH score of the hand fimction have been recorded and analyzed through follow-up patients,to observe the effects on repairing soft tissue defects in the two groups.Results:All transplanted tisssues were all survived in the observation group and control group.Compared with control group,the sense of touch,temperature sense,monofilament,two-point discrimination,scar contracture of the observation group were better(P＜0.05),the incidence of bloat was lower (P＜0.05).The DASH scores were 29.56± 2.14,38.13± 3.12 in the observation group and control group,which was significantly lower in the observation group than that of the control group(P＜0.05).Conclusion:The clinical efficacy of the dorsal neurocutaneous vascular flap is better than that of abdominal skin flap on repairing soft tissue defects of the thumb distal.For no injury for major vascular nerves,little influence on donor area,being simple to operate,being better feelings of the finger pulp,appearance,dorsal neurocutaneous vascular flap on repairing soft tissue defects of the thumb distal is an ideal choice.

Objective To investigate the clinical effect of the treatment for hand trauma with free flap of radial artery superficial palmar branch.Methods Selected 100 cases of patients with hand trauma who were treated in our hospital from January 2013 to December 2015.All the patients were treated with free flap of radial artery superficial palmar branch.The postoperative necrosis rate,survival rate,and infection rate of flap of all the patients were observed.All the patients were followed up for 6 months,and the healing of fracture were evaluated by X-ray examination so as to evaluate the hand function recovery.Results After the treatment,there were 9 cases of flap local necrosis and 10 cases of local infection,and the necrosis rate and infection rate were 9% and 10% respectively.The infection was controlled effectively after the symptomatic treatment and the flaps all survived.The swelling degree of skin flap was slight and the appearance was good.After 6 months of follow-up, the 100 cases all get epithelization completely.The X-ray examination showed that the fracture healing is good,with 7 cases of hook nail deformity and 5 cases of slow nail regeneration.The hand function recovery was excellent in 73 cases (73%),good in 16 cases (16%),and medium in 10 cases (10%).Conclusion It is an effective treatment for hand trauma with free flap of radial artery superficial palmar branch,as it can receive high flap survival rate and good recovery of hand function.

Objective To investigate the expression and significance of estrogen receptor alpha in renal tissue of immunoglobulin A (IgA) nephropathy.Methods Fifty renal tissue samples including forty five cases of IgA nephropathy and five cases of normal expression were collected.The expression of estrogen receptor αt (ERα) was detected by immunohistochemistry method,and its relationship with clinical parameters and the degree of glomerular damage were analyzed.Results ERα was located in the glomerular and renal tubules.With the severity of the lesion,the expression of ERα in renal tissue of IgA nephropathy decreased gradually (P =0.001) and its expression was associated with estimated glomerular filtration rate (eGFR),serum creatinine (Scr),and pathologic grade of IgA nephropathy (r =0.876,-0.818,and -0.736,P ＜ 0.05),The expression of ERα was significantly decreased in hypertensive patients with IgA nephropathy,and the difference was statistically significant compared with that in non-hypertensive group (P =0.011).Conclusions The expression of ERα in renal tissue of IgA nephropathy was significantly decreased and there was a correlation between the degree of renal tissue damage,suggesting that ERα might play a role in the development of renal disease.

Objective To investigate the relationship between leptin level of IGR patients and intima-media thickness (IMT) of carotid arterial. Methods One hundred and eighteen IGR patents were enrolled into the following three groups according to the result of oral glucose tolerance test (OGTT): 38 cases of the purely impaired fasting glucose (IFG) group, 42 cases of the purely impaired glucose tolerance (IGT) group and 42 cases of the IFG combining with IGT (IFG + IGT) group. Thirty-eight cases with normol glucose tolerance (NGR) were enrolled in the NGR group. The blood fat, fasting blood-glucose (FBG), fasting insulin (insulin), fasting C peptide , 2 h-postprandial blood glucose , 2 h-insulin , 2 h-C peptide , glycosylated hemoglobin (HbA1C), C-reactive protein (CRP), body mass index (BMI), leptin and IMT were determined in patients of the three groups and the healthy controls. The multiple linear regression was used to analyze the relationship between leptin level and IMT , and person correlation was further used to analyze the affinity degree between leptin level and IMT. Results Compared with the NGT group, the inter-group comparison showed that leptin level was significantly increased in the IFG, IGT and (IFG + IGT) groups (P < 0.05, respectively). Compared with the IFG and IGT groups, IMT and the leptin level were increased in the (IFG + IGT) group (P < 0.05, respectively). The multiple linear regression analysis showed that leptin level was correlated with the increase of IMT in the (IFG + IGT) group (P < 0.05), but not in the IFT group and the IGT group. Conclusion The leptin level in the IGR group and the IMT in the IFG + IGT ) group were significantly increased , the leptin level was closely associated with IMT.

Objective To analyze the CT and MRI features of pancreatic serous micro-cystic cystadenoma (SMCA).Methods CT and MRI data of 17 patients with SMCA confirmed by pathology were analyzed retrospectively.Tumor's location,diameter,septation,contrast-enhancement features,calcification,central scar, and the extent of pancreaticobiliary duct dilatation were recorded.Results Seventeen patients were enrolled.10 underwent CT,6 underwent MR(2 patients also underwent MRCP), and 1 underwent both CT and MR.Tumors were located at pancreatic head in 2 cases,neck in 2 cases,and body/tail in 13 cases.Lesion size ranged from 1.7 cm to 14 cm with an average of 5.2 cm.Septation was seen in 16 cases.Central scar was seen in 9 cases Septation and scar were enhanced and cystic component was not enhanced on contrast enhancement.6 patients presented the main pancreaticduct dilation.Conclusion Pancreas SMCA has certain imaging features.It is always manifested as lobulated mass with multiple small capsules(<2 cm) and fiber separations.The fiber separation enhance significantly,but lower than normal pancreatic tissue.Central scar is the characteristic manifestation of SMCA, and it manifests iso or slightly lower signal on T1WI and T2WI.Typical SMCA can be diagnosed according to the CT and MR imaging manifestations.

AIM: The goal of the present study was to evaluate the possibility about enterogenous endotoxemia in pathogenesis of hepatopulmonary syndrome. METHODS: The rat model of cirrhosis was prepared with compound factors. A small dose of lipopolysaccharide (LPS) was administered intraperitoneally once to aggravate endotoxemia of animal with cirrhosis. The normal rats injected with LPS or injected with LPS combined with glycine (LPS antagonist) were designed as controls. RESULTS: Hepatopulmonary syndrome of rats with cirrhosis had occurred in the end of eighth weeks. Pulmonary pathological changes of cirrhosis rats were exacerbated after administration of a given dose of LPS. Glycine sharply antagonized the biological effect of LPS in vivo and in vitro, inhibited the production of TNF-? by LPS and alleviated various pathological changes of hepatopulmonary syndrome. CONCLUSIONS: Enterogenous endotoxemia in cirrhosis rats might be an important mechanism in the development of hepatopulmonary syndrome. Endotoxin and its mediating effect by way of cytokines (TNF-?) may play a role in the pathogenesis of hepatopulmonary syndrome.

Objective To evaluate the diagnosis and treatment of duodenal neuroendocrine tumors.Method We retrospectively analyzed data of 15 patients with duodenal neuroendocrine tumors admitted between August 1999 and July 2012.Result In all the 15 cases accurate and definitive diagnosis were achieved via pathological examination and immunohistochemistry.Clinical diagnostic methods included ultrasound,endoscopy,upper gastrointestinal imaging,abdominal CT,MRI,etc.7 cases underwent pancreaticoduodenectomy,2 cases were treated by local excision,4 cases by endoscopic excision,and total gastrectomy and distal gastrectomy was performed in one each case.Conclusions The diagnosis of duodenal neuroendocrine tumors is established mainly by endoscopy and diagnostic imaging.Surgical resection is the treatment of choice.Pancreatoduodenectomy and local excision is applicable for G2 and G3 patients while endoscopic excision can be used for G1 patients.

Objective To evaluate the clinical efficacy of Clostridium butyricum tablets in treatment of diarrhea in patients with hepatitis B-related liver cirrhosis.Methods Eighty-seven patients with hepatitis B-related liver cirrhosis and diarrhea were collected from Pujiang People' s Hospital in Zhejiang province during January 2011 and May 2013.According to random number table,patients were divided into Clostridium butyricum treated group (n =44) and control group (n =43).Both groups were given antiviral,liver support,jaundice-relieving and fluid infusion treatments,while patients in Clostridium butyricum group were given Clostridium butyricum tablets (2 tables per time,3 tables per day for 4 weeks) additionally.Diarrhea remission time,improvements in liver function and the complications were observed.Differences in measurement data were compared with t test,and enumeration data were compared with x2 test or rank-sum test.Results The total effective rate in Clostridium butyricum group was 95.45％ (42/44),while that in control group was 74.4％ (32/43) (Z =2.82,P ＜ 0.05).After 4 weeks of treatment,the improvements of alanine aminotransferase (ALT),aspartate transaminase (AST),total bilirubin (TBil),albumin (Alb) and Child-Pugh (CTP) score in Clostridium butyricum group were more marked than those in control group (t =2.13,2.57,4.83,5.93 and 3.30,P ＜ 0.01).Hepatic encephalopathy occurred in 2 patients in control group and none in Clostridium buayricum group.Conclusion Clostridium butyricum has significant curative effect on diarrhea in patients with hepatitis B-related liver cirrhosis,and it can also improve liver function and reduce the incidence of hepatic encephalopathy.