Objective To study the function of ginsenoside Rg3 on proliferation in human breast cancer cell line MCF-7 and effect of ginsenoside Rg3 on Cx26 gene expression and gap junctional intercellular communication (GJIC) in MCF-7, cultured in vitro. MethodsHuman breast cancer cells MCF-7 was exposed to ginsenoside Rg3 at differential concentrations for 24 h, respectively. The cell proliferation inhibition was measured by 3-[4,5-dimethylthiazo-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assay. The expression of Cx26 mRNA was measured by RT-PCR in experimental groups and control goup. The GJIC function of MCF-7 cell was examined with scrape-loading dye transfer assay.ResultsHuman breast cancer cell line MCF-7 was exposed to ginsenoside Rg3 at a concentration of 10, 20, 40, 80, 160 μg/ml, respectively.The inhibition ratio was 3.1%, 5.2 %, 16.0 %, 26.3 %, 29.1% respectively after 24 h. Compared with control group, the concentration of 40 μg/ml above could significantly inhibit MCF-7 cell proliferation (P ＜0.05), so the experimental groups were exposed to ginsenoside Rg3 at a concentration of 40, 80, 160 μg/ml,respectively. The expression of Cx26 mRNA in every experimental group compared with control group was enhanced when MCF-7 cell was exposed to ginsenoside Rg3 at a higher concentration. It was observed that Lucifer yellow fluorescent staining was limited to a single cell in control group through fluorescent microscope,but Lucifer yellow fluorescent transfered through gap junction cells to neighboring cells, then came into being flake fluorescent staining in experiment groups. ConclusionGinsenoside Rg3 can enhance the expression of Cx26 mRNA in MCF-7 cell and restore the gap junctional intercellular communication, which may be one of important mechanisms of ginsenoside Rg3 in antitumor.

Objective To evaluate the imaging manifestations in diagnosis lipoma of upper alimentary canal.Methods 8 cases with lipoma of upper alimentary canal were performed by barium meal and dual-contrast gastrointestinography(n=8),ultrasound(n=1),computed tomography(n=2)and endoscopy(n=5).Results (1)Barium meal and dual-contrast gastrointestinography could diagnose benign space-occupation of upper alimentary canal.(2)Ultrasound and endoscopy could diagnose benign space-occupation.(3)The density of fat of lesion could well be displayed by computed tomography and contrast-enhenment computed tomography and lipoma could be diagnosed before opertion.Conclusion The combination of gastrointestinography,endoscopy and computed tomography can be regarded as the first procedure for diagnosis lipoma of upper alimentary canal.

Objective To study the effect and toxicity ofgefitinib combined with selected radiotherapy in the treatment of patients with advanced non-small-cell lung cancer (NSCLC). Methods From March 2006 to February 2009,10 of 13 advanced NSCLC patients who got benefit from gefitinib were enrolled to treatment group (gefitinib concurrent selected radiotherapy) and control group (gefitinib only), with 5 cases in each group. The response was evaluated as progression free survival (PFS) and overall survival (OS).Results No patient got complete remission (CR). Ten of 13 patients got partial remission (PR) and stable disease (SD). The 1 year and 2 years survival rate was 53.8%(7/13) and 46.2%(6/13) respectively. The median PFS in treatment group and control group was 24 months and 8 months respectively(P= 0.0019). The median OS was 32 months and 10 months respectively (P= 0.0062). The main toxicities were reversible skin rash and diarrhea,and 3 patients developed asymptomatic radiation pulmonary fibrosis. Conclusions Gefitinib combining with selected radiotherapy is effective and tolerated in patients with advanced NSCLC. It may prolong PFS and OS. It may be a rational choice for the standard and individualized treatment of NSCLC.

Objective To analyse the X-ray and CT manifestations of sacral primary tumor.Methods 10 cases with sacral primary tumors verified by pathology,including sacral chordoma(n=5),giant cell tumor(n=2),chondrosarcoma(n=2),neurilemmomas(n=1),were analysed retrospectively.Results (1)The manifestations of CT and X-ray of sacral chordoma presented as a midline destructive lesion,involving prominently at sacrum 3～5,with flocculent calcification and irregular bone crests.(2)Giant cell tumor involved predominately sacrum 1～3 with expansile destructive area and commonly in young adults.(3)Chondrosarcoma and neurilemmomas had difference characteristic on X-ray film and CT.One case with chondrosarcoma had bone destruction in sacrum 1～3 and giant mass grow into pelvis.Conclusion CT combined with X-ray film is helpful in diagnosis and differential diagnosis of sacral primary tumors.

Objective To discuss the feasibility of neuroendoscopic third ventriculostomy for chronic posttraumatic hydrocephalus (PTH).Methods Nineteen cases of chronic PTH treated with neuroendoscopic third ventriculostomy between October 2010 and October 2014 were analyzed retrospectively.There were 13 males and 6 females, aged 11-57 years (mean, 36.3 years).Trauma resulted from traffic accidents in 14 cases, falls in 4 cases and blunt object hitting in 1 case.Of the 19 cases analyzed, 5 had Glasgow Coma Scale (GCS) score of 13-15, 5 had score of 9-12 and 9 had score of 5-8 at admission.Results of operation were assessed with the Canada multicenter evaluation criteria.Prognosis was analyzed with the Glasgow Outcome Scale (GOS).Results All cases were followed up for mean 13.6 months (range, 6-26 months).Improvement of symptoms was achieved in 17 cases, but was not seen in 2 cases.Of the 2 cases, one required ventriculoperitoneal shunt two weeks after ineffective ventriculostomy, and one required second ventriculostomy one month after the presence of stoma blockage.No serious complications occurred.At follow-up, 9 cases had GOS score of 5, 8 cases had score of 4 and 2 cases had score of 3.Conclusions Neuroendoscopic third ventriculostomy is in line with the physical characteristics in cerebrospinal fluid circulation, which implies no shunt implantation, less operative trauma and less complications.The procedure is an effective approach for chronic PTH.

OBJECTIVE Toobservetheeffectoftemozolomide(TMZ)incombinationwithtetran-drine(TET)on cell viability,colony formation,migration and cell apoptosis of human glioblastoma U87 cells.METHODS TheviabilityofU87cellstreatedwithTET(8-64μmol·L-1),TMZ(50-400 μmol·L-1 )and TMZ combined with TET (3.2,6.4 μmol·L-1 )was detected by cytotoxicity assays with Cell Counting Kit-8 (CCK-8),the colony formation was detected by Giemsa staining,cell migration ability was detected by Transwell migration assay,cell apoptosis was assayed by flow cytometry using Annexin Ⅴ /PI double staining,and the expression of apoptosis-related proteins expression was detec-tedbyWesternblotting.RESULTS ThedataofCCK-8showedthatTET(r=0.903,P<0.05)orTMZ (r=0.995,P<0.05)could inhibit U87 cell viability alone in a concentration-dependent manner.The cell viability inhibition rate of U87 cells by TMZ co mbined with TET was higher than by TMZ or TET alone. Data showed that the effect of TMZ combined with TET was additive.TMZ 100 μmol·L-1 inhibited U87 cell colony formation and migration ablility compared with normal control.The inhibition rate of U87 cells by TMZ 100 μmol·L-1 combined with TET (3.2 and 6.4 μmol·L-1 )was more significant than by TMZ alone (P<0.05).Compared with TMZ alone,TMZ combined with TET (3.2 and 6.4 μmol·L-1 )signifi-cantly down-regulated the expression of anti-apoptotic protein Bcl-XL,but significantly up-regulated the expression of cleaved caspase 3 protein and cleaved poly(ADP-ribose)polymerase.CONCLUSION TET combined with TMZ can inhibit U87 cell viability,colony formation and migration by activating caspase-dependent apoptotic pathway,resulting in apoptosis.

OBJECTIVETo investigate the effect of glucagon-like peptide-1 (GLP-1) on glycolipid metabolism in 3T3-L1 adipocytes and explore the mechanism.

METHODS3T3-L1 adipocytes were treated with GLP-1, insulin, or both for 24 h, and Western blotting was used to analyze the expression levels of adipose triglyceride lipase (ATGL), glucose transporter type 4 (GLUT4), Akt1, Akt2 and phosphorylated Akt in the cells. Immunofluorescence was used to observe lipid content in 3T3-L1 adipocytes.

RESULTSAkt1 and Akt2 were not activated by insulin stimulation in 3T3-L1 adipocytes. Akt was phosphorylated by GLP-1 stimulation, which inhibited the expression of ATGL and increased the translocation of GLUT4 from the intracellular membranes to plasma membranes. These changes were more obvious under the synergistic effect of insulin in 3T3-L1 adipocytes.

CONCLUSIONGLP-1 decreases lipolysis by inhibiting the expression of ATGL and improves insulin resistance by increasing the translocation of GLUT4 in 3T3-L1 adipocytes.

3T3-L1 Cells ; Adipocytes ; cytology ; metabolism ; Animals ; Cell Membrane ; metabolism ; Down-Regulation ; Drug Synergism ; Glucagon-Like Peptide 1 ; pharmacology ; Glucose Transporter Type 4 ; metabolism ; Insulin ; pharmacology ; Insulin Resistance ; Intracellular Membranes ; metabolism ; Lipase ; metabolism ; Mice ; Phosphorylation ; Protein Transport ; drug effects ; Proto-Oncogene Proteins c-akt ; metabolism

Objective:To investigate the safety of minimally invasive liver resection for resectable hepatocellular carcinoma (HCC) complicated with portal hypertension.Methods:The propensity score matching and retrospective cohort study was conducted. The clinicopathological data of 807 patients with resectable HCC who underwent minimally invasive liver resection in 8 medical centers, including Sir Run Run Shaw Hospital, Affiliated with the Zhejiang University School of Medicine et al, from June 2011 to November 2022 were collected. There were 670 males and 137 females, aged 58(50,66)years. Of the 807 patients, 173 cases with portal hypertension were divided into the portal hypertension group, and 634 cases without portal hypertension were divided into the non-portal hypertension group. Observation indicators: (1) propensity score matching and comparison of general data of patients between the two groups after matching; (2) intraoperative and post-operative situations; (3) subgroup analysis. Propensity score matching was done by the 1:1 nearest neighbor matching method, with the caliper setting as 0.001. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the rank sum test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data was constructed using the non-parameter rank sun test. Results:(1) Propensity score matching and comparison of general data of patients between the two groups after matching. Of the 807 patients, 268 cases were successfully matched, including 134 cases in the portal hypertension group and 134 cases in the non-portal hypertension group. The elimination of the tumor diameter and robot-assisted surgery confounding bias ensured comparability between the two groups after propensity score matching. (2) Intraoperative and postoperative situations. The occlusion time of porta hepatis, cases with intraoperative blood transfusion, cases with postoperative complication, cases with complication >Ⅱ grade of Clavien-Dindo classification, cases of Clavien-Dindo classification as Ⅰ grade, Ⅱ grade, Ⅲ grade, Ⅳ grade, cases with liver related complication were 27.0(15.0,43.0)minutes, 33, 55, 15, 13, 29, 14, 1, 37 in the portal hypertension group, versus 35.0(22.0,60.0)minutes, 17, 25, 5, 14, 9, 4, 1, 13 in the non-portal hypertension group, showing significant differences in the above indicators between the two groups ( Z=-2.15, χ2=6.30, 16.39, 4.38, 20.72, 14.16, P<0.05). (3) Subgroup analysis. Results of subgroups analysis showed that in cases with major live resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 243.5(174.6,296.3)minutes, 200.0(150.0,600.0)mL, 7.5(6.0,13.0)days in the portal hypertension group, versus 270.0(180.0,314.5)minutes, 200.0 (75.0,450.0)mL, 7.0(5.5,10.0)days in the non-portal hypertension group, showing no significant difference in the above indicators between the two groups ( Z=-0.54, -1.73, -0.92, P>0.05). In cases with non-major live resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 170.0(120.0,227.5)minutes, 100.0(50.0,200.0)mL, 8.0(5.0,10.0)days in the portal hypertension group, versus 170.0(120.0,227.5)minutes, 100.0(50.0,200.0)mL, 7.0(5.5,9.0)days in the non-portal hypertension group, showing no significant difference in the above indicators between the two groups ( Z=-1.39, -0.10, 1.05, P>0.05). In cases with anatomical liver resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 210.0(150.0,285.0)minutes, 150.0(50.0,200.0)mL, 8.0(6.0,9.3)days in the portal hypertension group, versus 225.5(146.3,306.8)minutes, 100.0(50.0,250.0)mL, 7.0(6.0,9.0)days in the non-portal hypertension group, showing no significant difference in the above indica-tors between the two groups ( Z=-0.75, -0.26, -0.91, P>0.05). In cases with non-anatomical liver resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 173.5(120.0,231.5)minutes, 175.0(50.0,300.0)mL, 7.0(5.0,11.0)days in the portal hyper-tension group, versus 186.0(123.0,262.5)minutes, 100.0(50.0,200.0)mL, 7.0(5.0,9.5)days in the non-portal hypertension group, showing no significant difference in the above indicators between the two groups ( Z=-0.97, -1.12, -0.98, P>0.05). Conclusion:Minimally invasive liver resection or even major liver resection is safe and feasible for screened HCC patients complicated with portal hyper-tension, but attention should be paid to the prevention and treatment of postoperative complications.

Objective To illustrate the clinical and pathological features of Chinese upper tract urothelial carcinoma (UTUC) patients and to investigate the regional difference and the possible prognostic factors.Methods A retrospective study was performed on 2 628 patients from 9 centers of three different regions (Beijing:2 centers with 1 022 cases,Shanghai:1 center with 814 cases,Sichuan:6 center with 792 cases).The median age was 68 (range 20 to 93) and the mean age was 66.3.There were 1 447 male patients (55.1％) and 1 181 female patients (44.9％).The clinical information,pathological outcomes and prognosis were collected and analyzed based on South (Shanghai and Sichuan) and North (Beijing)region.Results The distribution of Ta + T1,T2,T3 and T4 was 914 (34.8％),715 (27.2％),857(32.6％) and 142(5.4％).Patients from North were more likely to be female (55.9％ vs.38.0％,P＜0.001) and suffer from ureteral tumors (43.4％ vs.35.9％,P ＜ 0.001);while in patients from South higher tumor stage(T3 or T4,42.5％ vs.31.0％,P ＜ 0.001),high grade(72.0％ vs.34.0％,P ＜0.001) and larger tumor size [(3.73 ±2.17) cm vs.(3.36 ±2.02) cm,P＜0.001] were more prevalent.Subgroup indicated that female patients in North had obviously lower tumor stage (T3 or T4,27.2％ vs.35.9％,P =0.014),while relatively higher tumor stage were noticed in female patients in South (T3 or T4,48.2％ vs.38.9％,P =0.004).The median follow-up was 41 (1-206) months,and 963 patients (36.6％) died including 815 (31.0％) died from cancer.In North female patients had better 5-year overall survival (75.5％ vs.62.2％,P ＜0.001) and cancer-specific survival (78.3％ vs.65.0％,P＜0.001),but in South gender had no impact on overall survival (58.5％ vs.60.1％,P =0.927) or cancer-specific survival (62.0％ vs.65.8％,P =0.345).Conclusions This study demonstrated that in Chinese patients with UTUC,those from North were featured for lower tumor stage and grade,higher proportion of females and females had better survival.High age,high tumor stage and grade,large tumor diameter,and the presence of lymph node metastasis or lymphovascular invasion were risk factors for poor prognosis in Chinese UTUC patients.

According to the pathological characteristics of symptomatic chronic thoracic and lumbar osteoporotic vertebral fracture (SCOVF), the different clinical treatment methods are selected, including vertebral augmentation, anterior-posterior fixation and fusion, posterior decompression fixation and fusion, and posterior correction osteotomy. However, there is still a lack of a unified understanding on how to choose appropriate treatment method for SCOVF. In order to reflect the new treatment concept and the evidence-based medicine progress of SCOVF in a timely manner and standardize its treatment, the clinical guideline for surgical treatment of SCOVF is formulated in compliance with the principle of scientificity, practicability and advancement and based on the level of evidence-based medicine.