Objective To observe the anti-atherosclerosis effects of Guizhi Fuling Capsule. Methods 50 healthy SD male rats were randomly divided into 2 groups: normal group (n=12) and AS model group(n=38). The model of experimental AS rats was established by feeding high cholesterol diet and intraperitoneal injecting VitD3. The normal control group was fed by ordinary diet. AS model group was further divided into 3 groups randomly: AS group(n=12), control group (n= 12), and therapy group(n= 12). The therapy group was given Guizhi Fuling Capsule by intragastric administration.The control group was given simvastatin and captopril by intragastric administration. 0.9% NaCl was given to the AS group instead of Guizhi Fuling Capsule. The rats were killed at the 16th weekend, and their aorta arch and breast aorta were observed.Blood fat and serum levels of Endothelin-1 (ET-1), Nitric oxide (NO), high-sensitivity C-reactive protein (hs-CRP) were detected respectively. Immunohistochemistry technology was used for observing the expression of intercellular adhesion molecule- 1 (ICAM- 1 ) in breast aorta. Results The values of ET- 1, NO, hs-CRP and the amount of ICAM- 1 were (142.61 ±25.67)ng/ml, (66.05 ± 8.63) μmol/L, (2.86±0.40)mg/L, (0.29±0.05) in the normal group; (182.38±22.96)ng/ml, (28.70±4.49)μmol/L, (5.60±0.49)mg/L, (0.58±0.06)in the AS group; (154.37±21.11)ng/ml, (45.88±11.36)μmol/L, (3.66±0.34)mg/L, (0.37±0.04)in the control group and (152.13±23.23)ng/ml, (57.67±8.96)μmol/L, (3.70±0.40)mg/L, (0.36±0.04) in the therapy group respectively. The levels of ET-1, NO, hs-CRP and the amount of ICAM-1 have significant difference between the AS group and the normal group(P=2.47E-4, 6.02E-19, 1.11E-12, 2.51E-18). There was also significant difference between the control group and the AS group(P=0.005, 1.59E-14, 1.87E-5, 3.87E-14). The level of NO in the therapy group was higher than that in the control group (P=0.002). The levels of ET-1, hs-CRP and the amount of ICAM-1 did not have significant difference between the therapy group and the control group(P=0.81, 0.81, 0.48) Conclusion Guizhi Fuling Capsule has effects of Anti-atherosclerosis on rats with AS.

Objective To evaluate the effect of lipopolysaccharide (LPS) on the expression of ATP-binding cassette transporter A1 (ABCA1) in alveolar macrophage cells of rats.Methods The alveolar macrophage cells of rats NR8383 were seeded in 6-well plates at a density of 1 × 106 cells/ml (2 ml/well) and randomly divided into 6 groups:control group (group C,n =24),0.2 μg/L LPS group (group L0.2,n =12),2.0 μg/L LPS group (group L2.0,n =12),20.0 μg/L LPS group (group L20.0,n =60),200.0 pg/L LPS group (group L200.0,n =12),and 20.0 μg/L LPS + ABCA1 siRNA group (group L20.0 + siRNA,n =12).The cells were routinely cultured in group C.LPS with the final concentrations of 0.2,2.0,20.0 and 200.0μg/L was added to the culture medium in L0.2,L2.0,L20.0 and I200.0 groups,respectively.In group L20.0 + siRNA,siRNA 50 nmol/L was added to the culture medium and 12 h later LPS 20.0 μg/L was added.In group C,6 wells were chosen for determination of ABCA1 mRNA and protein expression.At 24 h of incubation with LPS 0.2,2.0 and 200.0 μg/L,or at 2,6,12 and 24 h of incubation with LPS 20.0 μg/L,6 wells were chosen and the cell suspension was obtained for measurement of ABCA1 mRNA expression (by real-time fluorescent quantitative PCR),and ABCA1 expression (by flow cytometry).At 12 h of incubation with 20.0 μg/L LPS or with 20.0 μg/L LPS + 50 nmol/L siRNA,6 wells were chosen and the cell suspension was obtained for measurement of TLR4 mRNA expression (by real-time fluorescent quantitative PCR) and TLR4 expression (by flow cytometry).Results Compared with group C,the expression of ABCA1 mRNA and protein was significantly down-regulated in L0.2,L2.0,L20.0 and L200.0 groups,and the expression of ABCA1 mRNA and protein was up-regulated in L20.0 and L20.0 + siRNA groups.In L20.0 group,the expression of ABCA1 mRNA and protein was gradually down-regulated with the prolonging time of incubation with LPS.Compared with group L20.0,the expression of TLR4 mRNA and protein was significantly up-regulated in group L20.0 + siRNA.Conclusion LPS can down-regulate the expression of ABCA1 in alveolar macrophage cells of rats,however,ABCA1 can inhibit the synthesis of TLR4.

Objective To investigate the effects of penehyclidine hydrochloride(PHC)precon-ditioning on hepatic ischemia-reperfusion injury (HIRI)in rats.Methods Fifty-four male Sprague-Dawley rats,weighing 230-250 g,were randomly divided into three groups (n =18 each):sham op-eration group (group S),HIRI group (group HR)and penehyclidine hydrochloride group (group PHC).In group S,the hepatoduodenal ligaments of rats were only pulled and separated,then abdo-mens were closed.In group HR,an atraumatic vascular clip was placed on the vessels blocking the portal venous blood supply to the median and left lateral lobes of the liver for 45 minutes,which re-sulted in approximately 70% rat liver ischemia injury.In group PHC,the rats were treated with 0.45 mg/kg penehyclidine hydrochloride at 30 minutes before the portal venous and hepatic arterial were blocked like group HR.Animals were killed at 2 h (T1 ,n =6),4 h (T2 ,n =6),24 h (T3 ,n =6) after HIRI or sham surgery.Liver tissues and blood samples were taken for analysis.The serum con-centration of ALT and AST were measured as the markers of hepatic functional damage.The TNF-a and IL-1βconcentration were measured by the enzyme linked immunosorbent assay (ELISA)tech-nique.The endothelial nitric oxide synthase (eNOS ) and hypoxia-inducible factor (HIF-1α) expression were measured by immunohistochemical staining.Results Compared with group S,the expressions of ALT,AST,TNF-αand IL-1βin groups HR and PHC increased at T1-T3 (P <0.05), which were similar to the change trend of HIR-1αand eNOS expressions (P <0.05).Compared with group HR,the expression of ALT,AST,TNF-αand IL-1βin group PHC decreased at T1-T3 (P <0.05).Nevertheless expression of HIF-1αand eNOS of groups HR and HPC were increased than that of group S,and experssion of HIF-1αand eNOS of group HPC were increased than that of group HR at T1 and T2 (P < 0.05 ).Conclusion PHC preconditioning can protect the liver from HIRI.The mechanism may be associated with the up-regulation of eNOS and HIF-1α,as well as reducing the in-flammatory response.

BACKGROUNDWith the improvement of the surgical and anesthetic techniques, there are increasing numbers of elderly surgical patients with lung cancer. The purpose of this study is to examine the prognostic factors of surgical resection in patients more than 70 years of age.

METHODSData were retrospectively analyzed from 192 patients aged ≥70 years who underwent lung cancer surgery. Of these patients, 48.4% were in stage I, 20.8% in stage II, 19.3% in stage III, and 2.1% in stage IV. Patient demographics were the following: 79.2% male and 20.8% female; 21.9% ≥75 years older; and 11.5% had significant co-morbidities. Tumor characteristics: squamous cell carcinoma 49.0%, adenocarcinoma 35.9%, adenosquamous carcinoma 8.3%, small cell lung cancer 4.7%, others 2.1%.

OPERATIONSexploration 2.1%, wedge resection 8.3%, lobectomy 72.4%, more than lobectomy 12.5%, pneumonectomy 4.7%. Of these operations, 91.1% were radical surgery. The significance of prognostic factors was assessed by univariate and multivariate COX regression analyses.

RESULTSThe total 5-year survival rate was 33.5% in this series. Age, sex, symptom and co-morbidity had no impact on survival. Multivariable COX analysis demonstrated that incomplete resection (P=0.003), advanced surgical-pathological stage (P < 0.001) and other type of the tumor (P=0.016) were significant, independent, unfavorable prognostic determinants in patients.

CONCLUSIONSThoracic surgery is a safe and feasible approach in elderly patients with lung cancer. Every effort should be made to detect early stage patients who might benefit from surgical treatment. Lobectomy is still the ideal surgical option for elderly patients who are able to tolerate the procedure. More limited lung surgery may be an adequate alternative in patients with associated co-morbidities.

Intrahepatic cholangiocarcinoma (ICC) is the second most common primary hepatic malignancy with an increasing incidence and mortality in recent years.Despite advanced improvements in its diagnosis and therapy,the prognosis for ICC patients remains poor.High heterogeneity and malignant biological behavior are the main factors determining the prognosis of ICC.An in-depth study of the mechanism of ICC invasion and metastasis is expected to help optimizing clinical decision-making.The application of advanced technologies such as next-generation sequencing has enhanced the researchers' understanding of heterogeneity of ICC and characteristics of invasion and metastasis.Studies have found that ICC gene expression abnormalities (gene mutations,fusion gene formation,and abnormalities in gene expression regulatory pathways) and microRNA expression disorders are closely related to ICC cell proliferation,invasion and metastasis.In addition,ICC is usually characterized by a dense desmoplastic stroma,in which cancer-associated myofibroblasts are the major cellular components and play an important role in inducing epithelial-mesenchymal transition,promoting malignant cell invasion and metastasis,and even accelerating ICC progression.