Objective To investigate the inhibitory effect of melatonin on the proliferation activity of murine foregastic carcinomac ( MFC) cells via melatonin membrane receptors MT 2 and its relationship with the signaling pathways of mitogen-activated protein kinases ( MAPKs), phosphatidylinositol 3-kinase ( PI3K)-Akt.Methods Using siRNA technology to silence MT2 expression, we examined the ability of melatonin to inhibit the proliferation activity of MFC cells and its influence on the phosphorylation of ERK 1/2 and Akt.Results We found two interesting effects of SiRNA-mediated silencing of MT2 expression.Firstly, it significantly antagonized the inhibitory effect of melatonin on the proliferation activity of MFC cells .Secondly , it partially blocked the inhibitory effect of melatonin on the phosphorylation of ERK 1/2 and Akt.Conclusion Our results suggest that melatonin can inhibit the phosphorylation of ERK 1/2 and Akt via MT2 receptors , thereby inhibiting the proliferation of gastric cancer cells .

OBJECTIVE: To investigate the clinical effect of nasal packing of pulmicort respules combined withnasopore after endoscopic sinus surgery. METHOD: A total of 30 CRSwNP and CRSsNP patients with bilateral functional endoscopic sinus surgery and finished following up visit were randomly choosed, conventionally select the left nasal cavity as the experimental group, the right nasal cavity as the control group. Experimental group to pack the nasal cavity with pulmicort respules union nasopore after surgery and control group to pack the nasal cavity with only nasopore after surgery. The differences were observed in patients with subjective symptoms and recovery of mucosa of operative cavity between the two groups after two weeks, one month and three months. RESULT: (1) The postoperative VAS symptoms score about nasal obstruction, nasal secretion, headache, dizziness and distending pain after two weeks,one month and three months in the experiment group were significantly better than those in the control group(P<0.05). (2) The postoperative Lund-Kennedy endoscopic mucosa morphology score after two weeks, one month and three months in the experiment group were significantly better than those in the control group(P<0.05); (3) After three months, the experiment group had 28 cases with clinic symptoms cured(93. 3%), Total effective rate was 96. 6%; The control group had 22 cases with clinic symptoms cured (73. 3%), total effective rate was 93. 3%. The cure rate of the experiment group was significantly higher than the control group(P<0.05), but there was no statistic difference between the two groups in the total effective rate (P>0.05). CONCLUSION The application of nasal packing of pulmicort respules combined with nasopore after functional endoscopic sinus surgery can effectively relieve postoperative uncomfortable symptoms, promote recovery of mucosa of perative cavity, which deserves clinical promotion.
Anti-Inflammatory Agents ; administration & dosage ; Bandages ; Budesonide ; administration & dosage ; Endoscopy ; Epistaxis ; Humans ; Nasal Cavity ; Nasal Obstruction ; Paranasal Sinuses ; surgery ; Postoperative Period

Objective To investigate the morphological characteristics and proliferation ability of diabetes mellitus-derived adipose-derived stem cells (ADSCs) by comparing with normal-derived ADSCs.Methods The ADSCs could be achieved from diabetes mellitus' adipose tissue by the similar method of normal ADSCs isolation and culture,and then the differnce was compared between the two groups about their morphologies under microscope,and the proliferation ability of two groups was determined by CCK-8.Results ADSCs in patients with diabetes were obvious hypertrophy and irregular in morphology.A values of ADSCs in diabetes and non-diabetes were 0.210+0.002 and 0.390+0.006 in 1st day;0.250+0.015 and 0.443+0.023 in 2nd day;0.368+0.014 and 0.726+0.033 in 3rd day;0.368+0.014 and 0.726+0.033 in 4th day;1.767+0.072 and 3.153+0.067 in 5th day and 1.810+0.072and 3.170+0.021 in 6th day,respectively.The difference was statstically significant at the beginning from 4th day (P＜0.05).Conclusions There is obvious difference of the microscopic morphology between the diabetes mellitus-derived ADSCs and normal-derived ADSCs.The proliferation ability of the diabetes mellitus-derived ADSCs is lower than normal-derived ADSCs.These difference could be closely related to ulcerous non-healing wounds in patients with diabetes mellitus.

OBJECTIVE:To prepare Zuojin gastric-mucoadhesive tablets and evaluate their drug release properties in vitro. METHODS:Zuojin gastric-mucoadhesive tablets were prepared with hydroxypropyl methyl cellulose K15M(HPMC-K15M),car-bomer 934P and HPMC-E50 as the bioadhesive and matrix materials,and basic magnesium carbonate(foaming material),95% al-cohol solution(adhesive)and aerosil(glidant and lubricant)as the adjuvants. With the accumulative release of total alkaloids from Coptis chinensis Franch. at 2,6 and 10 h(Q2 h,Q6 h and Q10 h)as the indexes,orthogonal design test was conducted to optimize the amounts of HPMC-K15M,carbomer 934P,HPMC-E50 and basic magnesium carbonate,and verification was carried out. Drug re-lease properties in vitro of the preparation and Zuojin conventional tablets were observed and in vitro adhesion thereof determined. RESULTS:The optimal formulation was as follows as that for 50 tablets,HPMC-K15M of 0.7 g,carbomer 934P of 0.2 g, HPMC-E50 of 3.5 g and basic magnesium carbonate of 0.4 g. The Q2 h,Q6 h and Q10 h of three batches of prepared samples were 24.32%,56.10% and 77.04% respectively. 1-12 h drug release in vitro of prepared samples was in conformity with Ritger-Peppas equation. The Q2 h of Zuojin conventional tablets and Zuojin gastric-mucoadhesive tablets were 80.46% and 24.04%,Q12 h thereof 92.15% and 95.83% and gastric adhesion thereof 24.2 and 74.0 g/cm2,respectively. CONCLUSIONS:Zuojin gastric-mucoadhesive tablets which have sustained-release effect and adhesive property have been prepared successfully.

Objective:To investigate the expression and clinical significance of 12-lipoxygenase (12-LOX) in glioma. Methods:12-LOX expression in 40 glioma cases and 10 normal human-brain tissues was assayed by immunohistochemistry. Clinicopathological data were analyzed to reveal the association between 12-LOX expression and prognosis of glioma patients. Results:12-LOX was weak-ly expressed in the normal human brain tissues, whereas 12-LOX was strongly expressed (72.5%) in glioma tissues (P<0.05). The strong 12-LOX expression was correlated with the histopathological grading of glioma (P=0.012), whereas 12-LOX expression was not correlated with factors such as patient gender and age, tumor size, and Karnofsky Performance Score. Median survival time was longer in the group with low 12-LOX expression (25.6 months) than in the group with high 12-LOX expression (13.2 months) (P<0.05). Con-clusion:Abnormal 12-LOX expression is implicated in glioma. 12-LOX expression was correlated with the histopathological grading of glioma and was closely associated with patient prognosis.

Objective To observe multiple metabolic changes within one year after Roux-en-Y gastric bypass (RYGB) surgery in obese patients with type 2 diabetes mellitus, and to evaluate the index of the gastric bypass surgery and the determination of applicable population. Methods The clinical and laboratory data before and after surgery in 112 patients diagnosed as type 2 diabetes mellitus by RYGB were included in this study. According to BMI, these patients were divided into two groups: normal group (≤ 25kg/m2), and the overweight group (> 25 kg/m2). The physiologic and biochemical indexes of the patients were followed up at 1, 3, 6, 12 months, respectively. The statistical analysis was performed by SPSS17.0 software. Results Compared with the preoperative period, the levels of HbA1c and HOMA-IR in the postoperative period were significantly increased in the two groups. Principal component analysis showed that the postoperatively contributions of BMI and HbA1c in 6 months was bigger than that of the other indexes, while HOMA-β, HOMA-IR had larger contributions after 6-month postoperative period. Conclusion Various metabolic indexes in patients with type 2 diabetes improve significantly within one year after surgery, and the complete remission rate is gradually increased. The indexes including weight, blood glucose, serum lipids, HOMA-βand HOMA-IR in overweight and obese group have more significant improvements than those in normal group. Obese patients are more appropriate for the surgical treatment. The indexes, such as BMI, HbA1c,HOMA-βand HOMA-IR, should help to evaluate the operating effectiveness and preoperative indications.

Objective To study the concentration of anti-cyclic citrullinated peptide antibody (CCP),rheumatoid factor (RF),immunoglobulin (Ig) in synovial fluid and serum of patients with rheumatoid arthritis (RA),and the positive rate of anti-keratin antibodies (AKA) and anti-perinuclear factor (APF) were also measured.The aim was to explore the diagnostic value of these antibodies in synovial fluid for RA.Methods Thirty RA patients were collected,synovial fluid were withdrawn from the inflamed joints and peripheral blood were collected at the same time.Anti-CCP antibody,AKA,APF and RF were measured.The cut-off value of CCP in synovial fluid was determined through operating characteristic curve (ROC curves) analysis.The antibody levels in serum and synovial fluid were compared.Statistical analyses were performed using t test,and Pearson's correlation test.Results The cutoff value of CCP in RA synovial was higher,which was 29.00 U/ml,with the sensitivity of 87.00％ and specificity of 94.10％.There were significant differences in the concentration among anti-CCP antibody [(326±313) U/ml,(496±454) U/ml,t=-2.399,P＜0.05],IgG [(57±39) mg/L,(173±86) mg/L,t=-7.4792,P＜0.05),RF [(53±36) U/ml,(149±104) U/ml,t=-2.402,P＜0.05] in synovial and blood serum respectively in RA patients.Conchsion The diagnosis of RA is enhanced if anti-CCP antibodies,RF and IgG in synovial fluid are examined.They are supplementary to RA diagnosis and are helpful for clinical practice,especially for patient with very recent-onset RA.

Objective:To compare the clinical effect of anterior and posterior resection,bone grafting and internal fixation on the spinal tuberculosis.Methods:82 cases of patients with spinal tuberculosis in our hospital from February 2014 to August 2015 were selected and randomly divided into the control group and the observation group with 41 cases in each group.Both groups received conventional anti tuberculosis treament and underwent debridement bone graft and internal fixation treatment,the control group underwent anterior internal fixation,while the observation group underwent posterior internal fixation.The operation time,intraoperative blood loss,low back pain relief time,ambulation time and hospitalization time were compared between two groups.All patients were followed up for 6 months,the Frankel grade and serum Thl7 cell related factors levels were compared between two groups before and after operation.Results:The low back pain relief time,ambulation time and hospitalization time of observation group were significantly shorter than those of the control group(P＜0.01).After operation,the Frankel classification grade A and B ratio of observation group were significantly higher than those of the control group (P＜0.05),the serum IL-10,IL-17,IL-23 and TGF-beta 1 levels were significantly lower than those of the control group (P＜0.01).Conclusion:Anterior resection combined with posterior bone graft inFixation could effectively promote the rehabilitation of spinal tuberculosis,reduce the severity of spinal injury,relieve the inflammatory response and promote the recovery of immune function.

Objective To investigate feasibility and early stage postoperative complications of lapa-roscopic radical cystectomy ( LRC) . Methods We retrospectively analyzed the data of 63 consecutive pa-tents (58 males and 5 females) who underwent LRC from Oct .2011 to Oct.2013 in our institute.Of these patients, 46 patients underwent ileal conduit , 9 patients underwent ureterocutaneostomy , and 8 patients un-derwent orthotopic ileal neobladder urinary diversion .The average age and body mass index of patients were 67.7±11.1 (33-84) years and 23.3±2.1 (18.8-28.7) kg/m2, respectively.The mean hemoglobin and al-bumin of patients were (130.7±20.3) g/L and (38.9±4.1) g/L, respectively.Comorbidities of hyperten-sion, diabetes, coronary heart disease and decompensated liver cirrhosis were found in 10, 6, 2 and 1 pa-tient, respectively.10 of 61 patients had a history of abdominal surgery .The indications for cystectomy were classified as muscle invasive bladder cancer for 30 patients, unresectable superficial bladder cancer for 19 patients and recurrent bladder cancer for 14 patients.Postoperative data and early stage postoperative compli-cations within 3 months after surgery were collected . Results The median operative time for LRC and uri-nary diversion was 390 (260-480) min, with a median estimated blood loss of 400 (100-1 500) ml.This was one patient converted to open surgery .The mean postoperative hemoglobin and albumin of patients was 108.5±14.7 g/L and 29.5±3.7 g/L, respectively, both of which significantly reduced compared with pre-operative data (P<0.01).The median duration of hospital stay was 15 days.The median time for liquid in-take, abdominal drainage removal and ureteral stent removal was 4 days, 9 days and 2 months after surgery , respectively.Catheter was removed 2 weeks after laparoscopic orthotopic cystectomy .21 (33.3%) of 63 pa-tients suffered from perioperative complications .15 of 46 patients (32.6%) in ileal conduit group had com-plications including ileus ( 5, 1 of 5 need re-operation ) , lymphatic fistulas ( 5) , pulmonary infection ( 1) , pyelonephritis (1), delirium (1), anastomotic leak (1, re-operation was needed) and pneumothorax (1). 2 of 9 patients (22.2%) in ureterocutaneostomy group had complications such as ileus (1) and lymphatic fistulas (1).4 of 8 patients (50.0%) in orthotopic ileal neobladder group suffered from complications like ileus (2, 1 of 2 required re-operation), lymphatic fistulas (1) and arrhythmia (1). Conclusions LRC is technically feasible and safe .It reduces the estimated blood loss and postoperative complications .It is noteworthy to surgeons that serum albumin significantly reduced after LRC , nutrition should be kept balanced after surgery.

Objective:To investigate the value of mean platelet volume-to-lymphocyte ratio (MPVLR) in assessing the prognosis of elderly patients treated with radiotherapy for esophageal cancer.Methods:A retrospective case series study was conducted. The clinical data of 102 elderly esophageal cancer patients who received radiotherapy from September 2015 to September 2020 in Zhongshan Hospital Affiliated to Xiamen University were retrospectively analyzed. After admission, all patients were tested for serum mean platelet volume and lymphocyte levels by using a fully automated hematology analyzer, and MPVLR was calculated. The optimal cut-off value of MPVLR was determined based on the receiver operating characteristic (ROC) curve. The patients were grouped according to the optimal cut-off value of MPVLR, and clinicopathological characteristics of the two groups were compared. The Kaplan-Meier method was used to analyze the overall survival of patients after radiotherapy, and the multivariate Cox proportional risk model was used to analyze the factors affecting the overall survival of patients after radiotherapy.Results:The age of 102 patients was (77±3) years; there were 58 male cases, 44 female cases; 67 cases of middle and high differentiation, 35 cases of low differentiation; 65 cases of TNM stage Ⅰ-Ⅱ, 37 cases of stage Ⅲ-Ⅳ. ROC curve analysis showed that the area under the curve of MPVLR predicting the overall survival of esophageal cancer patients after radiotherapy was 0.905 (95% CI: 0.855-0.955). The optimal cut-off value of MPVLR was 5.442. All patients were divided into the low MPVLR group (MPVLR ≤ 5.442, 60 cases) and the high MPVLR group (MPVLR > 5.442, 42 cases) according to the optimal cut-off value of MPVLR. The proportion of patients with low differentiation and stage Ⅲ-Ⅳ in the high MPVLR group was higher than that in the low MPVLR group (all P < 0.001). The 3-year overall survival rate after radiotherapy in the high-MPVLR group was lower than that in the low-MPVLR group (23.81% vs. 51.67%), and the difference in the overall survival of both groups was statistically significant ( P < 0.05). The differences in the overall survival of elderly esophageal cancer patients with different differentiation and TNM staging after radiotherapy were statistically significant (all P < 0.05). Univariate Cox regression analysis showed that TNM stage Ⅲ-Ⅳ ( HR = 3.034, 95% CI: 1.805-5.101), low differentiation ( HR = 2.872, 95% CI: 1.791-4.606), and MPVLR > 5.442 ( HR = 3.789, 95% CI: 2.000-7.178) were independent risk factors for overall survival in elderly patients with esophageal cancer after radiotherapy (all P < 0.001). Conclusions:MPVLR before radiotherapy is closely related to the prognosis of elderly patients with esophageal cancer, and patients with MPVLR > 5.442 may have poorer overall survival after radiotherapy.