ObjectiveTo determine the relationship between the expression of bax and bcl-2 gene in mucous adenocarcinoma of rectum and patient′s prognosis.MethodsImmunohistochemical method was used to evaluate monoclone antibody of bax and bcl-2 protein in 38 cases of mucous adenocarcinoma of the rectum. ResultsThe positive-staining rate of bax was 77.8% in Dukes′ A and B stage compared to 45.0% in Dukes′ C stage( ? 2=4.260,P=0.039).The intensity of positive-staining of bax over bcl-2 was significantly correlated with tumor stage(P=0.04) and the survival (P=0.001).ConclusionThe expression rate of bax and bcl-2 gene was very high in mucous adenocarcinoma of large bowel, and it might have a prognosis implications in patients with colonic mucous adenocarcinoma.

BACKGROUND:Pretreatment is a dominant way to increase the histocompatibility of biomaterials,but many pretreatments are not satisfactory due to some reactions,such as calcification,cytotoxic reaction and reducing the tension resistance.OBJECTIVE:To investigate the effect of immunogenicity,scaffold tension and cell growth factor on the non-pretreated scaffold biomaterials,and to prepare the homograft decellularized scaffolds.DESIGN:Contrast observation for the histomorphology.SETTING:The experiments were carried out in the Department of General Surgery,Affiliated Hospital of Nantong University from June 2006 to March 2007.MATERIALS:Wistar rats of SPF grade were adopted in this study.Sodium dodecyl sulfate from BioteehGrade Company(U.S.A.);basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF) from Peprotech Company(UK);dynamometer from Suzhou Electrical Element First Factory (China).METHODS:The vena cava inferior from rats were selected as experimental materials,we decellularized the epithelial cells from vein according to the improved Booth's methods with low osmotic Tris buffer containing sodium dodecyl sulplate,and then reserved the extracellular matrix.After fixing,the decellularized scaffold was stained by hematoxylin and eosin,the collagen fibers were observed and photographed by light microscope and scanning electron microscope.Changes of the intensity of the scaffolds were measured before and after decellularization.The deceilularized scaffolds were transplanted subcutaneously at homogeneity rats to observe whether the scaffolds had induced immunological rejection.In combination with bFGF and/or VEGF,the scaffolds were transplanted subcutaneously at homogeneity rats and took out two weeks later,in order to exam the new vessels in the scaffolds by immunohistochemistry.Dynamometer was applied to compare the change of the intensity of the scaffolds before and after transplantation.MAIN OUTCOME MEASURES:Change of the intensity of the scaffolds after decellularization and transplantation.Formation of new vessels in scaffolds.Local rejection of the scaffold subcutaneously transplanted into rats.RESULTS:The endothelial cells of the vein were completely removed when incubated with Tris buffer containing 0.03% sodium dodecyl sulfate for 48 hours.Results of hematoxylin and eosin staining,light microscope and scanning electron microscope showed that,the main components of extracellular matrix (collagen fiber) were reserved.There was no significant difference in the morphological structure and the intensity of collagenous scaffolds before and after decellalarization (P＞0.05).There was no apparent reject reaction at the embedded site,local incisions healed well.New vessels could be observed in the scaffolds two weeks later.There was no significant difference in the intensity of collagenons scaffolds before and after inoculation (P＞0.05).CONCLUSION:The low osmotic Tris buffer containing 0.03% sodium dodecyl sulfate is suitable for decellularizing the vein.The homograft collagenous scaffolds exhibit no rejection after transplantation,and the intensity of the scaffolds does not descend.VEGF and bFGF can improve the growth of new vessels in the decellularized scaffolds,and have a synergistic effect.

Objective To evaluate the therapeutic efficacy of hook plate and fascia lata graft in management of chronic acromioclavicular joint dislocation.Methods From May 2012 to March 2014,a total of 16 cases of chronic acromioclavicular joint dislocation (Rockwood type Ⅲ) were treated with hook plate and fascia lata graft.They were 10 men and 6 women,from 19 to 57 years of age (mean,34.7 years).Seven cases were at the left side and 9 at the right side.All injuries resulted from direct violence.The time from injury to surgery ranged from 8 to 54 weeks (mean,12.4 weeks).At the final follow-ups,the shoulder function was assessed using the Quick Version of the Disabilities of the Arm,Shoulder and Hand Score (DASH) and visual analogue scale (VAS),and the efficacy using Karlsson's evaluation system.Results All surgical wounds primarily healed.The dislocation of acromioclavicular joint was corrected,without any vascular or neural damage.The patients were followed up for an average of 12 months (from 6 to 18 months).No plate breakage,screw loosening or redislocation was observed.The DASH and VAS scores of the shoulder at the final follow-ups (25.42 ± 8.34 and 2.22 ± 1.70,respectively) were significantly improved,compared with the preoperative ones (43.72 ± 12.35 and 6.33 ± 1.37,respectively) (P ＜ 0.05).According to the Karlsson's criteria,10 cases were excellent,4 good and 2 moderate.Conclusion In management of Rockwood type Ⅲ chronic acromioclavicular joint dislocation,hook plate and fascia lata graft can restore dynamic balance and stability of the acromioclavicular joint,resulting in solid fixation,early joint motion and limited complications.

Objective To explore the methods of surgical treatment of patients with tumors in the body and tail of pancreas. Methods We analyzed the clinical data from 45 patients with tumors in the body and tail of pancreas who underwent surgical excision between 1984 and 2002 in our hospital. The 45 cases consisted of malignant tumors(n=33) and benign tumors(n=12). Operations performed included resection of the body and tail of pancreas(17 cases), combined-organ excision (24 cases) and local tumor resection(4 cases ). Results Pathological classification:carcinoma (33 cases), islet cell tumors (8 cases ), cystic adenoma (8 cases), epithelioid fibroma (1 case) and cystic teratoma (1 case). The average diameter-size of excised tumor was determined as follows: carcinoma in the body or tail of pancreas was(8.0?2.6)cm, and that of islet cell tumors was(6.5?2.4)cm. There were no operative deaths, but operation resulted in the following complications: pancreatic fistula (2 cases), subdiaphragmatic abscess (2 cases), pancreatic pseudocyst (1 case ), upper gastrointestinal bleeding(1 case) and infection or poor healing of incisional wound (3 cases). All of the complications were cured with conservative therapy. Conclusions Excision of the body and tail of pancreas is an effective method for the treatment of patients with tumors in the distal half of pancreas.Before operation, it is necessary to be routinely prepared to perform combined organ excision. Regarding the surgical handling of pancreatic stump, we select the use of ligation of main pancreatic duct plus mattress suture, which we believe could effectively prevent pancreatic fistula.

Objective To survey on the prevalence of schistosomiasis among floating population in Zhejiang province. Methods A survey on prevalence of schistosomiasis among floating population was conducted from September to November 2008, and the stratified cluster sampling method was adopted in the survey. Totally 129 villages of 19 counties or districts were selected as survey sites, and 100 samples of migrants aged 6 to 65 from schistosomiasis-endemic areas were taken in each selected village. All selected individuals were surveyed by questionnaire and underwent serum indirect hemagglutination (IHA) test. For individuals with positive serum IHA testing the fecal examination was carried out to detect the eggs by nylon sedimentation method. SPSS 13.0 software was used for data processing. Results The number of migrants in survey sites was 3 357 420, among whom 303 219 were from schistosomiasis-endemic areas (9.03%).The positive rate in serum IHA test was 2.06% (286/13 898), 276 IHA-positives individuals received fecal examination, and 7 cases were positive (2.52%). Based on above data it was estimated that there would be potentially about 33 500 serum IHA-positive cases and 845 egg-positive cases among floating population in Zhejiang province. Conclusion The risk of schistosomiasis transmission still exists in Zhejiang province due to the infected migrants from endemic areas, and a surveillance system and quick response are required for prevention of re-emergence of the disease.

Objective To study the effect of α-lipoic acid on the retinal expression level of VEGF and diabetic retinopathy in rats with diabetes mellitus and mechanism.Methods Totally 72 Wistar rats were divided into 4 groups:12 (control group)in group A,24 in modeling group(group B),24 in group treated withα-LA(group C)and 12 in high-glucose(group D).Group B to group D were given 60 mg/kg STZ through intraperitoneal injection,rats in group C were given 100 mg/kg α-LA and rats in group D were given 5.0% glucose-solution.The body mass,FPG,FINS,HOMA-IR,expression level of VEGF,activity of SOD,GSH and IL-6 of 4 groups were compared by statistics.Results After 72 h,the FPG of group A was(4.57 ±0.1 5 )mmol/L,that of group B was (21.72±4.28)mmol/L,that of group C was(21.54±4.96)mmol/L and that of group D was(21.83±4.77)mmol/L,the difference had statistical significance (P <0.05).The body mass of group A was(210.5±5.2)g,that of group B was(21 1.2 ±5.7)g,that of group C was(209.8±5.8)g and that of group D was(208.7±3.4)g,the difference had no statistical significance (P >0.05).The body mass,FPG,FINS,HOMA-IR,expression level of VEGF,activity of SOD,GSH and IL-6 among 4 groups at 4 w,8 w and 12 w had statistical difference (P <0.05).After 12 w,the difference of GR stage among group B to group D had statistical significance (P <0.05).Conclusion α-LA can inhibit the expression of VEGF in rats with diabetes mellitus,which is related to its ability to re-duce the oxidative stress and inflammation reaction,as well as to alleviate the insulin resistance.

BACKGROUND:Reports have demonstrated that cytotoxicity produced by ferric oxide (Fe2O3) nanoparticles is associated with cellular lipid peroxidation. Whether Fe2O3 nanoparticles have toxicity to macrophages, and what is the association of toxic mechanism and oxidization?OBJECTIVE: To observe the effects of different concentrations of Fe2O3 nanoparticles on the oxidative damage of macrophages.DESIGN: A controlled observation experiment.SETTING: School of Public Health, Southeast University.MATERIALS: RAW264.7 cells were peritoneal macrophages of mouse and purchased from Shanghai Institute of cells, Chinese Academy of Sciences. Fe2O3 nanoparticles (30 nm) suspension was provided by Department of Biomedical Engineering, Southeast University). Fe2O3 nanoparticle suspension was placed in 60 ℃ water for 10 hours,then in 37 ℃ water overnight. This procedure was repeated 3 times for germicidal treatment. Then, the suspension was packed into small bottles and stored at 4 ℃ for later use. DMEM high glucose culture fluid (Gibco Company,USA); trypsinase (Difco Company, USA, imported); new-bom calf serum(Sijiqing Company, Hangzhou); hydrogen dioxide (H2O2, Gibco Company); Kits for measuring hydrogen dioxide(H2O2), hydroxy radical (·OH), superoxide anion radical (O2·-), lactic acid dehydrogenase, ultramicro ATP enzyme and Coomassie brilliant blue protein levels (Jiancheng Biotechnique Co., Ltd.,Nanjing).METHODS: This experiment was carried out in the laboratory of Department of Labor and Environmental Health, School of Public Health, Dongnan University between March 2006 and July 2006. RAW264.7 cells (Abelson murine leukemia virus-induced tumor) were cultured in DMEM (Gibco Company) containing 100 g/L fetal bovineserum, 100 000 U/L penicillin and 100 mg/L streptomycin in the environment of 5% CO2. Cell growth was observed under an inverted radical in the cells: 1.5×108 L-1 macrophages were inoculated to 24-well plate, 1 mLa well. After the macrophages were cultured for 24 hours in incubation at 37 ℃ in a humidified atmosphere containing 5% CO2. 1.070 0, 0.5350 and 0.2675 g/L Fe2O3 nanoparticles (30 nm) suspension-intervened macrophages were set as Fe2O3 nanoparticle group, and normal saline group was set as control group. Following the intervention of nanoparticles, macrophages were disrupted with Determination of the activities of lactate dehydrogenase (LDH), Na+-K+-ATPase and Ca2+-Mg2+-ATPase: Macrophages in the Fe2O3 nanoparticle group and control group were treated as above. The activities of LDH in culture medium were determined according to the instruction of reagent kit (Nanjing Jiancheng Bioengineering Co., Ltd). And the activities of Na+-K+-ATPase and Ca+-Mg2+-ATPase were also determined according to the instruction of reagent kit (Nanjing Jiancheng Bioengineering Co., Ltd) at low temperature. MAIN OUTCOME MEASURES: ①Effects of different concentrations of Fe2O3 nanoparticles on the production of H2O2, ·OH and O2·- in RAW264.7 cells.②Effects of different concentrations of Fe2O3 nanoparticles on the activities of LDH ,Na+-K+-ATPase and Ca2+-Mg2+-ATPase in RAW264.7 cell culture fluid.RESULTS: ① Level of ·OH free radical in Fe2O3 nanoparticle 0.267 5, 0.535 0, 1.070 0 g/L groups was higher than that in control group, respectively [(0.605±0.066), (0.410±0.080), (0.764±0.051), (0.285±0.057)mkat/g, P ＜ 0.05]; Level of respectively [(9.935±1.159), (8.912±0.131), (13.479±0.752), (5.635±0.475)μkat/g,P ＜ 0.05]; Level of H2O2 in Fe2O3 nanoparticle 1.070 0 g/L group was higher than that in the control group [(14.695±2.815), (2.397±0.399) mmol/L, P ＜increased (P ＜ 0.05). Fe2O3 nanoparticles had effects on the activities of Na+,K+-ATPase and Ca2+,Mg2+-ATPase. With the increase of dose of Fe2O3 nanoparticles, the activities of Na+-K+-ATPase and Ca2+-Mg2+-ATPase were gradually decreased. There were significant differences as compared with control group (P ＜ 0.05)CONCLUSION:Increasing dose of Fe2O3 nanoparticles wouldcause more H2O2,·OH and O2·- free radicals in the cells, increase cell membrane permeability and inhibit the activities of LDH, Na+-K+-ATPase and Ca2+-Mg2+-ATPase.

【Objective】 To analyze the viability of 2 different blood screening strategies against SARS-CoV-2 in low risk populations, so as to provide references for the formulation of blood screening strategy. 【Methods】 Two screening strategies for antibodies against SARS-CoV-2 were adopted: 1) the total antibody were initially screened for all samples, and the antibody IgG and IgM were retested in those primary positive samples; 2) only antibody test of IgG and IgM for all samples. And SARS-CoV-2 nucleic acid was detected in parallel. Reactive samples was confirmed by neutralization test. The sensitivity, specificity and true positive rate of two strategies were calculated. 【Results】 None was positive for SARS-CoV-2 nucleic acid among 880 samples. Four truly positive samples were implicated in 9 (1.02%, 9/880) initially reactive samples in total antibody test; 3 in 26 (2.95%, 26/880) initially IgG or IgM reactive samples. 【Conclusion】 The first strategy is superior to the second strategy in the sensitivity and specificity, and is recommended for the detection of SARS-CoV-2 antibody in low risk populations.

Objective To establish the model of goat intervertebral disc degeneration （IDD） induced by controllable axial compressive stress and evaluate its imaging and pathological characteristics. Methods Twenty goats were randomly divided into 4 groups (control group, 4-week pressure group, 8-week pressure group, 12-week pressure group, n=5, 40 N pressure). Disc height index (DHI) was used to evaluate the change of intervertebral disc height by X-ray, Pfirrmann classification method was used to observe the degree of intervertebral disc degeneration by magnetic resonance imaging (MRI), and histopathological observation and evaluation for intervertebral disc were conducted by HE staining and immunohistochemistry. Results DHI in control group showed no significant changes with the extension of pressure time, while DHI in the experimental group gradually decreased. There was no significant change in Pfirrmann classification in control group. In experimental group, with the extension of time, the higher the degeneration aggravated with the Pfirrmann classification increasing. In experimental group, HE staining showed that the disc nucleus pulposus decreased in volume and nucleus pulposus cells, which were gradually replaced by fibrous tissues. Immunohistochemical staining showed that type I collagen in the nucleus pulposus gradually increased, type Ⅱ collagen gradually decreased, and intervertebral disc degeneration occurred. Conclusions A certain axial compressive stress can lead to degeneration of goat lumbar intervertebral disc, and the degree of degeneration is gradually increased with the extension of time.

OBJECTIVETo investigate the factors which may influence the imatinib plasma concentration in Chinese patients with gastrointestinal stromal tumor(GIST), and to illuminate the significance of monitoring imatinib plasma concentration in adjuvant therapy for patients with GIST.

METHODSA cross-sectional study with 60 GIST patients who accepted the imatinib therapy after surgery was conducted. They were respectively administrated in 10 domestic hospitals from December 2014 to April 2016, including The First Affiliated Hospital of Nanjing Medical University(n=28), The Affiliated Hospital of Nantong University(n=9), The Affiliated Hospital of Xuzhou Medical College(n=6), Nanjing Drum Tower Hospital(n=5), The Second Affiliated Hospital of Nanjing Medical University (n=2), Jingling Hospital (n=2), The Second People's Hospital of Lianyungang(n=2), Shandong Provincial Hospital(n=2), Jiangsu Province Tumor Hospital(n=2), and The First Affiliated Hospital of Zhejiang University(n=2). Some specific time points for collecting blood sample before and after taking imatinib were determined, then liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was used for monitoring imatinib plasma concentration in patients with GIST. Linear regression analysis was used for the correlation analysis of imatinib plasma concentration with dosage, clinicopathologic feature and side effect.

RESULTSPatients who could not tolerate 400 mg imatinib per day(n=3) received 300 mg per day. There was no significant difference in imatinib plasma concentration between patients with 300 mg and those with 400 mg imatinib(n=53)(P=0.527). However, the imatinib plasma concentration in patients with 600 mg imatinib per day (n=4) was significantly higher as compared to those with 400 mg(P=0.000). Linear regression analysis indicated a negative correlation between the imatinib plasma concentration in patients with 400mg imatinib per day for 90 days continuously and body surface area(R=0.074, P=0.035), but no significant correlations of with age, creatinine clearance and serum albumin concentration were observed (all P>0.05). The differences in imatinib plasma concentration were not statistically significant between patients of different gender and those taking proton-pump inhibitor (PPI) or not (both P>0.05). Difference in imatinib plasma concentration between patients with different surgery was significant (P=0.026). Compared to patients who underwent wedge resection, enterectomy and other surgeries, the imatinib plasma concentration of patients with subtotal gastrectomy or total gastrectomy decreased significantly (all P<0.05). After 90 days of taking imatinib continuously, linear regression analysis revealed a negative correlation between imatinib plasma concentration in patients with 400 mg imatinib per day and white blood cell count (R=0.103, P=0.013), and a positive correlation with serum alanine aminotransferase (ALT) concentration (R=0.076, P=0.033).

CONCLUSIONSThe imatinib plasma concentration in patients with larger body surface area, subtotal gastrectomy or total gastrectomy may be lower. For these patients, dosage of imatinib should be considered to increase in order to achieve effective plasma concentration. Excessive imatinib plasma concentration can result in some side effects, such as decrease of white blood cells and liver damage. Therefore, it is significant for receiving optimal clinical therapeutic efficacy to monitor imatinib plasma concentration, adjust imatinib dosage timely and keep imatinib plasma concentration in effective and safe range.

Adult ; Antineoplastic Agents ; administration & dosage ; pharmacokinetics ; Benzamides ; Combined Modality Therapy ; Cross-Sectional Studies ; Female ; Gastrectomy ; Gastrointestinal Stromal Tumors ; drug therapy ; surgery ; Humans ; Imatinib Mesylate ; administration & dosage ; pharmacokinetics ; Male ; Middle Aged ; Piperazines ; Pyrimidines ; Tandem Mass Spectrometry