Objective To evaluate the safety and efficacy of the technique of transoral Orvil EEA stapler (OrVil) for laparoscopic gastrectomy of gastric cancer in our hospital.Methods Between Sep 2012 and Aug 2013,73 patients at our department underwent open (n =36) or laparoscopic (being reconstructed by OrVil,n =37) gastrectomy.Early surgical outcomes of the two groups were compared to assess the effectiveness,security and postoperative complications of OrVil procedure.Results The two groups had similar mean numbers of dissected lymph nodes (29 ± 10 vs.31 ± 14,t =-0.697,P =0.488),lengths of postoperative hospital stay (14 ± 5 vs.12 ± 3 d,t =1.933,P =0.057) and postoperative complications (11 vs.11,P =0.939).Intraoperative blood loss was significantly less (189 ± 79 vs.343 ± 90 ml,t =-7.782,P =0.000) and time to first flatus significantly shorter (2.9 ±0.5 vs.3.5 ±0.6 d,t =-4.714,P =0.000) with the use of OrVil.Operation time of laparoscopic group was significantly longer than that of open group (266 ± 97 vs.204 ± 39 min,t =3.607,P =0.001).There was one each anastomotic leakage in both groups.Conclusions With the suitable approach and skillful technique,OrVil is a technically safe and feasible surgical procedure for the treatment of gastric cancer.

Objective To investigate the effect of intensive insulin therapy on long-term remittance of the islet β-cell function in newly diagnosed type 2 diabetic patients. Methods 120 newly diagnosed type 2 diabetic patients were randomly divided into four groups, and intensive insulin therapy was given for 15 days, 30 days, 60 days and 90 days respectively. The islet β-cell function were measured before and 1 or 2 years after treatment, and the differences were compared among each group. Results The plasma glucose was controlled well and the islet β-cell function was significantly improved in each group after treatment. The ratio value of △I30/△G30 in groups of 30 days,60 days and 90 days were higher than group of 15 days[(1.48±0.43 )mmol/L vs (1.25±0.40) mmol/L, t＝2.40,P＜0.05, (1.83±0.37) mmol/L vs (1.25±0.40) mmol/L, t＝2.85,P＜0.01, (1.90±0.41) mmol/L vs (1.25±0.40) mmol/L, t＝2.97,P＜0.01]. The indexes of the islet β-cell secretion function all gradually declined in each group after treatment for 2 years, but still higher than before treatment, the ratio value of △I30/△G30 in groups of 60 days and 90 days were higher than group of 15 days and 30 days[(1.44±0.51)mmol/L vs (0.87±0.47) mmol/L,t＝2.92, P＜0.01, (1.44±0.51)mmol/L vs (1.09±0.55) mmol/L, t＝2.44,P＜0.05, (1.52±0.44) mmol/L vs (0.87±0.47) mmol/L, t＝2.86, P＜0.01, (1.52±0.44) mmol/L vs (1.09±0.55) mmol/L, t＝2.50, P＜0.05], there was no difference between group of 60 days and 90 days. The ratio of remittance in groups of 60 days and 90 days was very high. Conclusions Intensive insulin therapy can significantly improve the islet β-cell function of newly diagnosed type 2 diabetic patients,anddelay the natural process. An appropriate extension of treatment can further prevent the descending rate of islet β-cell function, and easily get the long-term remission.

Objective To investigate the effect of STAT3 knockdown on the sensitivity of breast cancer cells with drug-resistant to adriamycin (MCF-7/ADR). Methods Levels of STAT3 and p-STAT3 in MCF-7/ADR and MCF-7 cells were detected by Western Blot. The MCF-7/ADR cells were infected with lentivirus expressing STAT3-shRNA and the negative control vectors in the STAT3-RNAi group and NC group, respectively, wihle the cells in the blank group received no treatment. The transfection efficiency was observed with fluorescence microscope, the mRNA level of STAT3, protein levels of STAT3 and p-STAT3 were detected by qRT-PCR and Western Blot, respectively. MCF-7/ADR cells were treated with different concentrations of adriamycin for 48 hours, cell proliferation was detected by MTT assay and cell apoptosis was detected by flow cytometry. Results Levels of STAT3 and p-STAT3 in MCF-7/ADR cells were significantly higher than those in the MCF-7 cells (P < 0.05). The levels of STAT3 mRNA, STAT3 and p-STAT3 in the STAT3-RNAi group were significantly lower than those in the Con group and the NC group (P<0.05, respectively). The Adriamycin IC50 in the Con group, NC group and STAT3-RNAi group was (56.1 ± 3.00)ug/mL,(54.9 ± 11.9)ug/mL and (7.6 ± 0.2)ug/mL, respectively. The flow cytometry results showed that the cell apoptosis in the Con group, the NC group and the STAT3-RNAi group was (10.5+0.7)%, (11.7+0.7)%and (34+3.1)%, respectively. Conclusion LV-shRNA-STAT3 can significantly inhibit STAT3 expression and enhance the sensitivity of breast cancer cells to adriamycin, and the underlying mechanism may be related to cell apoptosis.

Objective The article was to observe the clinical efficacy of the application of terbinafine and mizolastine in com -bined treatment of chronic eczema ( CE) with dermatophytes infection , so as to define the etiology role of dermatophytes in allergic dis-eases. Methods All subjects were randomly divided into experiment group and control group .The experiment group was treated with the combination of terbinafine and mizolastine , while the control group took mizolastine orally alone .EASI grading , recovery rate and effective rate were evaluated at 2, 3 week after the treatment and EASI grading and recurrence rate were evaluated at 4 weeks after the treatment. Results 79 patients had finished the experiment .Significant difference was found in the effective rates between two groups at 3 weeks after treatment (P<0.05).At 4 weeks after the treatment, EASI value and recurrence rate in experiment group were obviously lower than those in control group (P<0.05). Conclusion Good therapeutic effect has been achieved through the ap-plication of terbinafine and mizolastine in combined treatment of CE with dermatophytes infection , which implies dermatophytes plays an important role in the etiology of CE .

Objective To investigate the relationship between C-reactive protein (CRP) and carotid intima-media thickness in pa-tients with impaired glucose tolerance (IGT). Methods Senan CRP was measured with immunoturhidimetry and the carotid intima-media thickness (CAIMT) was measured using color Doppler in 108 patients with impaired glucose tolerance (IGT) and 80 subjects with normal glucose tolerance(NGT).Then we observed all IGT patients for 3 years using prospective follow-up method, Oral Glucose tolerance test (OGGT) and every index were measured in follow-up 1.5 year and 3 year. Results 2 objects were lost to follow-up. IGT group showed a significant higher CAIMT and CRP compared with NGT group. After follow-up 1.5 year and 3 year, the patients with impaired glucose toler-ance (IGT) were divided into type 2 diabetes (T2DM) group and IGT group based on the level of blood glucose. Both T2DM group and IGT group showed a significant higher CAIMT and CRP, compared with NGT group. The level of serum CRP of T2DM group was higher than that of IGT group, and the level of serum CRP of IGT group was higher than that of NGT group. There were great differences between each group.Linear correlation showed that the level of blood glucose was positively correlated with CRP and CAIMT in T2DM group after follow-up 3 year. CAIMT was positively correlated with the level of blood glucose and CRP. Mulfivariant stepwise regression showed that CRP was signifi-canfly correlated with the level of blood glucose and CAIMT. Conclusion Inflammation played an important role in the development of dia-betes, and it had great vessels complication. The patients with impaired glucose tolerance, who have high level of CRP, were facilitated to be diabetes, and they were at risk of getting great vessels complication during the phase of impaired glucose tolerance. So it would be helpful to prevent IGT patients with high CRP or CAIMT with anti-inflammatory therapy.

The study on tumor metabolism has been gradually be-come a hot spot in recent years .A lot of proteins involved in the regulation of tumor metabolism especially the glucose transporter protein 1(GLUT1).As a key regulatory factor mediating energy metabolism within tumor cells , GLUT1 can regulate the glucose intake and maintain the basic level of metabolism in tumor cells . More importantly, the abnormal expression of GLUT1 was asso-ciated with many kinds of tumors , of which GLUT1 was used to meet the energy requirement for the fast growth of tumor .Thus GLUT1 also played a crucial role in growth , differentiation and metastasis of tumor cells and prognosis of tumors .Meanwhile , as three-dimensional crystal structure of GLUT 1 was determined , it is possible to design the small molecular inhibitors of GLUT 1, which can realize “starve to death” tumor cells.GLUT1 can be a particularly attractive target for tumor treatment and interfer-ence.The relationship between abnormal expression of GLUT 1 protein and tumor metabolism was reviewed . Moreover , the mechanism of tumor metabolism regulated by GLUT 1 protein ex-pression and treatment of cancers were discussed , which may provide references for future research and clinical treatment .

AIM: To investigate the effect of peritoneal vibration on the peritoneal permeability and the peritoneal surface layer. METHODS: Peritoneal transport rate was examined in twelve male SD rats. Six (S group) were put on an electronic shaker and the other six were used as control (C group). After that, the peritoneum was examined by electron microscopy (EM). RESULTS: The net ultrafiltration volume (NUF) in the S group was lower than that in the C group. This difference in NUF was due to both a significantly higher peritoneal fluid absorption rate and a significantly lower transcapillary ultrafiltration rate in S group as compared to C group. The peritoneal direct lymphatic absorption rate was higher in S group. The transport rates of small solutes were also significantly higher in S group. EM showed that the thickness of the peritoneal surface layer was significantly decreased in S group. CONCLUSION: Our results suggest that the peritoneal surface layer may be an important layer in modulating the peritoneal transport rate.

Aim To discuss the impact of important ac-tive ingredient of garlic diallyl sulfide———DATS on platelet activating factor (PAF ) mediated melanoma metastasis and its mechanisms.Methods ①MTT was used to test the effect of different concentrations of DATS on B16F10 and A375 melanoma cell growth number;②Scratch test and transwell were employed to test the effect of different concentrations of DATS on B16F10 and A375 melanoma cell migration;③ West-ern blot was used to test the effect of DATS on expres-sion of MMP-2,ERK,p38 induced by PFA;④Intrave-nous injection of tumor metastasis model was used to check the inhibition of DATS in PAF-mediated melano-ma metastasis.Results B16F10 cells relative growth rate fell to 73.21% and 48.78%,respectively,when DATS concentration reached 50 and 100 μmol·L-1 . DATS inhibited the levels of PAF-induced migration of melanoma cells B16F10 and vertical migration signifi-cantly,and inhibited B16F10 cells migration induced by PAF through inhibiting the expression of MMP-2, paxillin protein,FAK and other proteins.Conclusion DATS can significantly inhibit PAF-induced tumor metastasis, which is related to the inactivation of MAPKs.

Tumor metastasis is one of the important biological characteristics of malignant tumor,which is closely related with the prognosis of the cancer patients.High expression of ADAM8 in varieties of tumors was revealed in many recent studies,and such aberrant expression played a crucial role in regulating of tumor metastasis.Studies showed that overexpression of ADAM8 attenuated the intercellular adhesion effect,promoted tumor angiogenesis,and enhanced the degradation of ECM as well as the releasing of cytokines.Therefore,suppression of ADAM8 may lead to inhibition of tumor metastasis,which makes ADAM8 a particular attractive target as it can be used as a prognostic indicator and a potential therapeutic target of malignant tumor.A review about the relations between ADAM8 protein′s abnormal expression and tumor occurrence was discussed in this paper,also include discussion about the mechanisms of ADAM8 protein′s disorder-induced tumor formation,as well as therapeutic strategies based on ADAM8-targeted,which may provide references for follow-up research and clinical treatment.

Objective: To study the pharmacokinetics and brain/plasma concentration ratio of nortriptyline at multiple doses in mice which were pre-treated with physiological saline, piperine and verapamil. Methods: A total of 216 male Kun Ming mice[(25±3) g] were equally divided into 4 groups randomly. Each group was intragastrically administered physiological saline (B), piperine (170 μg/kg), piperine (5 mg/kg) and verapamil (5 mg/kg) for 8 days. On the 8th day, 1 h atfer giving the above drugs, each mice was intraperitoneally injected nortriptyline (13 mg/kg). The mice were sacriifced by picking off eyeballs at the time intervals of 5, 15, 30 min, and 1, 2, 4, 6, 8 and 12 h, andthe cerebra were collected and weighted. Nortriptyline in mouse plasma and brain was determined by HPLC-MS/MS. The pharmacokinetic properties of the plasma, brain and brain/plasma were calculated. Results: hTe AUC0-12 h of brain/plasma concentration ratio in the 170 μg/kg piperine group was significantly lower than that in the other groups (P<0.05), while the AUC0-12 h of brain/plasma concentration ratios in the 5 mg/kg piperine group and the verapamil group were not signiifcantly different from those of untreated mice. Conclusion: Piperine (170 μg/kg) may induce P-glycoprotein expression in the blood-brain barrier, while piperines at 5 mg/kg has no influence on P-glycoprotein expression in the blood-brain barrier.