Objective To study the effect of non steroidal anti inflammatory drug(NSAID) on apoptosis of hepatocellular carcinoma (HCC)cell lines(SMMC7721) and explore its anti tumor mechanism. Methods HCC line SMMC7721 was treated with different concentration of indomethacin(IN). Apoptosis was identified by terminal deoxynucleotidyl transferase mediated dUTP biotin nick end labeling(TUNEL)method. The expression of cyclooxygenase (COX) 2,p53,p27 kipl , C myc protein and Fas antigen was identified by immunocytochemical SP staining method. Results ①The apoptosis index was (2.4?1.4)%,(4.2? 1.5)% ,(8.0?3.2)%,(14.3?5.1)%,(14.9?4.3)% and (19.0?6.1)%( P0.05 ). Conclusion IN could induce apoptosis of HCC cell line in vitro by down regulating the expression of COX 2 and up regulating the expression of p27 kipl , p53 and c myc.

Objective To increase the awareness of the incidence trend of ischemic colitis and improve the level of diagnosis and treatment.Methods From January 2004 to December 2013,the clinical data of 89 in patients with ischemic colitis were retrospectively analyzed.At the same period,100 patients diagnosed as chronic colitis were enrolled as control group.The laboratory findings of patients with ischemic colitis were compared with those of control group.Non normal distribution data were analysed by non parametric test.Results The annual person-times of patients with ischemic colitis and the percentages accounted in the whole hospital annual person-times increased year by year in recent 10 years,which was one person time and 0.01％ in 2004 increased to 41 person-times and 0.11％ in 2013.The average age of the 89 patients was (63.5±12.7) years,and the male to female ratio was 1∶2.18.The most common underlying disease in the 89 patients was hypertension,accounted for 43.8％.Thirty-eight patients had a history of abdominal surgery,and eighteen patients with appendectomy,accounted for 20.2％.Seventy-eight patients had abdominal pain and defecation desire.Seventy-four patients complained of hematochezia.Compared with control group,there was no statistically significant difference in fasting blood glucose,triglyceride,total cholesterol,blood platelet levels and prothrombin time (all P＞0.05).While the levels of C reactive protein and Ddimer were higher than those of control group (89.21 mg/L vs 61.29 mg/L,90.13 μg/L vs 59.39 μg/L; Z=-3.959,-4.377; both P＜0.05).The images of computed tomography (CT) indicated thickened bowel wall in lesion segment.The results of colonoscopy showed that in the left colon and rectum were the predilection sites,accounted for 93.88％ (138/147).The average hospital stay was (10.59 ± 5.97) days and t he recurrence rate was 3.37 ％ (3 / 89).The percentage of chronic cases was 2.25 ％ (2/89),and no death was reported.Conclusions The incidence of ischemic colitis significantly increased in recent years.Patients with abdominal pain and/or hematochezia should be considered,especially those over 60 years old.Receiving colonoscopy as earlier as possible was helpful for the diagnosis.

Objective To explore the differential expression of microRNAs (miRNAs) in Burkitt lymphoma (BL) and their potential use as biomarkers for BL diagnosis.Methods The different miRNAs in BL from reactive hyperplasia of lymph node cases were screened by miRNA chip.The potential targets of miRNAs were predicted using miRWALK.MAS3 program was used to determine the putative functions of potential miRNA target genes by annotation using Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses.Results A total of 46 miRNAs (36 upregulated and 21 downregulated) were dysregulated in BL compared with reactive hyperplasia of lymph node.Interestingly,members of the let-7 family (let-7f-1-3p) was downregulated in BL.The target genes of let-7f-1-3p were predicted,and the GO enrichment analysis revealed their functions were mainly related with multicellular organismal development and regulation of transcription from RNA polymerase Ⅱ promote.KEGG pathway analysis was also carried out among the predicted target genes,which showed that they were mainly involved in TGF-beta signaling pathway and related with chronic myeloid leukemia.Conclusions The set of differentially expressed miRNAs identified here expands the range of potential diagnostic markers for BL.

Objective To investigate the effect of propofol on the brain injury in children undergoing open heart surgery under cardiopulmonary bypass (CPB).Methods Thirty children aged 4-10 yr undergoing repair of ventricular septal defect or atrial septal defect under CPB were randomly divided into 2 groups ( n = 15 each):control group (group C) and propofol group (group P). Anesthesia was induced with iv injection of sufentanil 1 μg/kg, propofol 2.5 mg/kg (midazolam 0.2 mg/kg in group C) and pipecuronium 0.1 mg/kg in group P. Anesthesia was maintained with iv infusion of 1％ propofol 6 mg·kg-1 ·h-1 (0.05％ midazolam 0.2 mg·kg-1 ·h-1 in group C) until the end of operation. Isoflurane ( 1％-2％ ) were inhaled during the operation in all patients. Sufentanil 1 μg/kg and pipecuronium 0. 1 mg/kg were injected intravenously after the start of CPB. A catheter was inserted into right internal jugular vein and advanced cephalad until jugular bulb for blood sampling before CPB, at 30 min of CPB, at the end of CPB, at 30 min after termination of CPB, at the end of operation, and at 24 h after termination of CPB to detect the plasma concentrations of 8-iso-PGF2 and S-100β by ELISA. Arterial and jugular bulb venous blood samples were collected for determination of SjvO2 before CPB, when naso-pharyngeal temperature was reduced to 30 ℃, when naso-pharyngeal temperature returned to 36 ℃ and at the end of CPB. Cerebral arterial venous oxygen content differences ( Da-jvO2 ) and cerebral oxygen extraction rate of oxygen ( CEO2 ) were calculated. Results Plasma concentrations of 8-iso-PGF2α and S-100β were significantly lower, SjvO2 was significantly higher, Da-jvO2 and CEO2 were significantly lower in group P than in group C (P ＜ 0.05＝. ConclusionPropofol can reduce the brain injury in children undergoing open heart surgery during CPB and the mechanism is related to decrease in cerebral oxygen metabolic rate and lipid peroxidation.

Objectives To analyze the diagnosis and management of steroid-resistant nephrotic syndrome (SRNS) accompanied with irreversible leukoencephalopathy in children. Methods The clinical, laboratory and imaging data were retrospectively analyzed in a SRNS child accompanied with irreversible leukoencephalopathy. A literature review was performed. Results After clinical diagnosis of SRNS, glucocorticoid, immunosuppressant, and hemodialysis were administrated for 10 months. During the course of treatment, the seizures, visual problems, and hypertension were repeatedly occured. The cranial MRI showed bilateral occipital parietal lobe hyperintensity and right frontotemporal lobe hyperintensity on T2-weighted imaging and bilateral occipital parietal lobe hypointensity on T2-Flair imaging, which indicated that encephalomalacia was accompanied with gliosis. Conclusions A variety of reasons may induce leukoencephalopathy in children. The accompanied irreversible leu-koencephalopathy should be strongly considered in management of SRNS.

Objective To discuss the efficacy of laparoscopic ureteroureterostomy for upper pole hydronephro-sis and ureteral dilatation in children with complete duplex kidney.Methods The clinical data of 14 patients (15 units in total)who underwent laparoscopic ureteroureterostomy from April 2016 to October 2017 were retrospectively analyzed. Nine out of 14 cases had repeated urinary tract infections(UTI)and other symptoms[6 cases in group A:patients without vesicoureteral reflux(VUR)but presenting urinary tract infection (UTI)symptoms,3 cases in group C:patients diagnosed with VUR];5 cases of asymptomatic patients were selected as group B.All the 14 cases had upper pole hydronephrosis and ureteral dilatation.Preoperative examinations included ultrosonograpy,urinary magnetic resonance urography(MRU), intravenous pyelography (IVP),voiding cystourethrogram(VCUG),and nuclear renal scanning.It was found that 4 cases had ureterocele;3 cases had recurrent cystoureteral reflux (group C)before operation,and 1 case had cystoureteral re-fluxed after replantation.Results Laparoscopic surgery was successful in all of 14 children.None of them were shifted to open surgery because of abdominal viscera injury bleeding.The operation duration was 85－140 min.The average posto-perative hospital stay was 5.58 days.There was neither urinary anastomotic leakage nor UTI.Fourteen cases were followed up and the postoperative follow－up period was 7－23 months.No cases developed urinary tract infection except 2 cases with vescioureteral reflux.Ultrasound examination showed that the upper renal parenchyma of 5 children was thicker,ul-trasonography showed that upper pole hydronephrosis was better and ureteroceles were smaller.There was no complication such as lower pole hydronephrosis.The symptoms of urinary tract infection disappeared after operation.Conclusions Laparoscopic ureteroureterostomy can treat renal duplication with less trauma,and it is safe and effective.It can be one of therapeutic regimen to treat low－functional upper pole hydronephrosis and ureteral dilatation in renal duplication.Howe-ver,this procedure cannot be used for vescoureteral reflux cases because of high rate of stump infection.

Objective:To investigate the effect of pirfenidone (PFD) on the proliferation of human glomerular mesangial cells (HMC) stimulated by serum IgA1 in patients with IgA nephropathy (IgAN) and its possible mechanism.Methods:Serum IgA1 of IgAN patients was purified by Jacalin affinity chromatography combined with Sephacryl S-200 gel filtration, and then heated to aggregated form (aIgA1). CCK8 method was used to confirm the concentration and time of PFD. The cells were divided into blank control group, IgA1 (0.5 mg/ml) group and IgA1 (0.5 mg/ml)+PFD (2 mmol/L) group. The CCK8 method was used to detect proliferation of mesangial cells. The cell cycle was detected by flow cytometry, and the proliferation index of mesangial cells was calculated. The expression levels of transforming growth factor β1 (TGF-β1), Smad4, Smad7, fibronectin (FN) and collagen Ⅳ protein and mRNA were detected through Western blotting and real-time PCR.Results:Compared with blank control group, the proliferation of HMC was promoted significantly by aIgA1 ( P<0.05). After PFD treatment, the proliferation of HMC was significantly inhibited ( P<0.01). Compared with the blank control group, the number of G1 phase cells decreased, the number of S phase cells and cell proliferation index increased in IgA1 group (all P<0.05). Compared with IgA1 group, the number of cells in G1 phase increased significantly, the number of cells in S phase and G2/M phase decreased significantly, and the cell proliferation index decreased in IgA1+PFD group (all P<0.05). Western blotting and real-time PCR results showed that compared with the blank control group, the protein and mRNA expressions of collagen Ⅳ, FN and Smad4 in HMC stimulated by aIgA1 were significantly increased, while TGF-β1 protein expression was increased and Smad7 protein expression was decreased (all P<0.05). After PFD treatment, the protein and mRNA expression of collagen Ⅳ, FN and Smad4 in HMC was significantly decreased, while TGF-β1 protein expression was obviously decreased, and Smad7 protein was up-regulated (all P<0.05). There was no significant difference in the mRNA expression of TGF-β1 and Smad7 in each group before and after PFD treatment (all P>0.05). Conclusions:PFD can increase the arrest of HMC in G1 phase, inhibit the proliferation of HMC induced by aIgA1 of IgAN patients, and reduce the production of extracellular matrix. The mechanism may be related to up-regulation of Smad7 expression and down-regulation of TGF-β1/Smad4 pathway.

Objective:To analyze the effects of a novel type of polydopamine (PDA)-coated porous titanium alloy scaffolds loaded with zoledronic acid-gelatin nanoparticles (ZOL-GNPs) for topical sustained drug release on osteoclasts in vitro. Methods:After porous titanium alloy scaffolds were fabricated using electron beam melting technique and ZOL-GNPs with different ZOL concentrations (0, 1, 10, 50, 100, 500 μmol/L) were prepared by desolvation method, PDA-coated porous titanium alloy scaffolds loaded with ZOL-GNPs were constructed by combining the two. The characteristics of the scaffolds were analyzed. The biomechanics of 3 different scaffolds (bare porous titanium alloy scaffolds, PDA-coated porous titanium alloy scaffolds, and PDA-coated porous titanium alloy scaffolds loaded with ZOL-GNPs) were investigated. Drug release detection was carried out by high performance liquid chromatography on the 1st, 4th, 7th, 14th, 21st, and 28th days respectively. The osteoclasts were inoculated into the novel scaffolds with different ZOL concentrations. The expression of osteoclast-related genes was detected by real-time quantitative (RT)-polymerase chain reaction (PCR); the expression of osteoclast-related proteins was detected by Western-blot.Results:The PDA-coated porous titanium alloy scaffolds loaded with ZOL-GNPs were successfully constructed. Electron microscope scanning showed that the GNPs were well spheroidized, smooth in surface, and uniformly dispersed, with a particle size of (243.6±63.4) nm. The ZOL-GNPs were uniformly compounded on the surface and in the pores of the scaffolds, and the spheres were regular in shape with no adhesion. The biomechanical experiments showed that the elastic moduli of the porous titanium alloy scaffolds under 3 different conditions were (1.81±0.12) GPa, (1.80±0.23) GPa and (1.81±0.15) GPa, showing no significant difference ( P> 0.05). The drug release percentage in the porous titanium alloy scaffolds was obviously high on the first day, and increased gradually and slowly in the subsequent 27 days. In the scaffolds with a low concentration ZOL, more osteoclasts adhered and proliferated; in the 50 μmol/L scaffolds, spheroid cells appeared; the spheroid cells increased and even apoptosis occurred with an increase in the ZOL concentration. RT-PCR showed that the expression of Ctsk gene and TRAP gene increased with the increased ZOL concentration, peaked in the 50 μmol/L scaffolds, and then decreased with the increased concentration, showing statistically significant differences ( P < 0.05). Western-blot showed that the expression pattern of Ctsk and TRAP was similar to that of their related genes. Conclusions:The novel PDA-coated porous titanium alloy scaffolds loaded with ZOL-GNPs demonstrate good mechanical properties and an anti-osteoporosis effect via their topical sustained drug release. The scaffolds with a ZOL concentration of 50 μmol/L may exert the best effect on inhibition of osteoclasts.

Objective:To investigate the efficacy and safety of retroperitoneal soft tissue sarcoma resection combined with nephrectomy.Methods:The clinical data of 27 cases undergoing retroperitoneal soft tissue sarcoma resection combined with nephrectomy at the Gastrointestinal Tumor Center , Guangdong Provincial Hospital , Traditional Chinese Medicine from Jun 2017 to Aug 2022 were retrospectively analyzed for the indication of nephrectomy, postoperative progression of renal insufficiency and survival rate.Results:Twenty-six cases (96%) achieved R 0/R 1 resection and 1 case nderwent R 2 resection. Six cases underwent combined unilateral nephrectomy and 21 patients underwent combined multi-organ resection with a median number of resections of 4 (2,5). Postoperative pathology suggested that the combined resected kidney was positive for tumor infiltration in 17 cases. Five cases had Clavien-Dindo grade 3 or higher complications and no deaths occurred within 30 days after surgery. At the 90th day after surgery, 19 cases (70%) had decreased renal function ( Z=2.88, P=0.04), with a median decrease of -3.96 (-30.36, 0.31)ml·(min·1.73 m 2) -1, including 8 cases of preoperative Chronic Kidney Disease(CKD)1 stage progression (6 cases of CKD 2 stage, 2 cases of CKD 3 stage); 2 cases of CKD 2 stage progressed to CKD 3 stage; 1 case of preoperative CKD 3 stage progressed to CKD 4 stage. During the follow-up period of 3-38 months, no patient progressed to CKD 5 stage and no patient required dialysis treatment. Conclusion:Retroperitoneal soft tissue sarcoma resection combined with nephrectomy is safe and feasible while improving tumor radicality.

Objective To analyze the prognostic factors of adrenal tumor in children under 12 years of age. Methods A total of 90 children with 97 adrenal tumors admitted from June 2006 to August 2017 were selected in Children's Hospital of Nanjing Medical University.The age distribution,tumor type,biochemistry and tumor indicators, treatment,stage classification and prognosis were analyzed.Results There were 46 males and 44 females in 90 cases. Ages ranged from 4 days to 11 years and 1 month,with an average of (38.1 ± 31.3)months.The main clinical mani-festations were abdominal mass,fever and abdominal pain.Eighty cases (82.5%)underwent surgery,while 17 cases (17. 5%)did not.Open resection was performed in 48 cases,open partial resection in 11 cases,laparoscopic surgery in 10 cases,and just biopsy in 11 cases.The pathological examination showed 43 cases with neuroblastoma,13 cases with ganglioneuroblastoma,8 cases with ganglioneuroma,5 cases with adrenocortical carcinoma,3 cases with teratoma,1 case with pheochromocytoma,1 case with malignant rhabdoid tumor.Statistical analysis revealed that neuron－specific eno-lase(NSE)value of neuroblastoma and lactate dehydrogenase(LDH)value of cortical cancer increased significantly. The age was correlated with tumor stage,and patients had older age on stage Ⅳ.Complete resection in surgery was correlated with the stage of the tumor,as tumor in lower tumor stage seemed easier to be completely removed.Fifty－three cases (58.9%)were followed up for 2 months up to 11 years and 4 months.Forty－four cases survived and 9 ca-ses died.Higher tumor stage predicated worse prognosis.Conclusions Adrenal gland tumors need early diagnosis and active treatment.Earlier onset of age,complete surgical resection with patients have better prognosis.Complete resection of the disease was a key factor in the prognosis.