Objective To investigate the clinical effect of acellular allograft dermal tissue patch used in transvaginal rectovaginal fistula repair.Methods From Jan.2008 to Dec.2011,22 patients with rectovaginal fistula undergoing treatment in Chinese People's Liberation Army General Hospital were studied retrospectively.Twelve patients treated by tissue patch were classified into study group matched with 10 patients with general surgery as controls.Results In study group,11 patients were successfully repaired by their first surgery; one patient was successfully fixed by the second surgery.The successful rate of first operation was 11/12 in study group and 4/5 in recurrent transvaginal rectovaginal fistula.In control group,7 patients were fixed successfully in their first surgeries,the successful rate of first surgery was 7/10.Two primary patients and 1 recurrent patient were successfully fixed by their second surgeries.All of the patients were followed up for (9.0 ± 2.0) months,and no recurrence diseases were observed.Conclusion The transvaginal rectovaginal fistula fixed using acellular allografi dermal tissue patch could get less trauma and higher cure rate.

Objective To investigate the clinical significance of CD55,CD59 and Aeromonas hydrophila toxin variant (FLAER) in the diagnosis of anemia and paroxysmal nocturnal hemoglobinuria (PNH).Methods Collected 30 healthy controls,22 cases of PNH,33 cases of aplastic anemia (AA),37 cases of iron deficiency anemia (IDA),45 cases of megaloblastic anemia (MA),30 cases of hemolytic anemia (HA) and 31 cases of myelodysplastic syndrome (MDS) from January 2009 to March 2017,CD55,CD59 and FLAER negative cell ratio of peripheral blood neutrophil of them were detected by multipa rameter flow cytometry.Results The detection rates of FLAER in PNH,AA and MDS groups were higher than those of CD55 and CD59,but there was significant difference in AA (x2 =7.759,5.518,P=0.005,0.019＜0.05).The average CD55,CD59 and FLAER deletion rate in PNH and AA group were significantly higher than those in normal control group and other groups (t=2.163～17.890,P=0.000～0.038＜0.05).The number of FLAER in PNH group was higher than CD59 and CD59 was higher than CD55 with the statistically significant difference (t=2.503 ～ 6.308,P=0.000 ～0.016＜ 0.05).Conclusion CD55,CD59 and FLAER have important value in the diagnosis of PNH and differential diagnosis with other anemia diseases,and can also be used to detect the presence of MDS and AA in patients with PNH.FLAER outperforms CD59,CD59 outperforms CD55.

This study examined the expression of cell adhesion molecule 1 (CADM1) in pancreatic cancer and the possible mechanism. The expression of CADM1 was detected by immunohistochemistry in tissues of pancreatic cancer, pancreatitis, and normal pancreas. The plasmid pcDNA3.1-Hygro(+)/CADM1 was transfected into PANC-1 cells (a pancreatic cancer cell line). The expression of CADM1 in the transfected cells was determined by RT-PCR and Western blotting. Cell growth was measured by the MTT method and cell apoptosis by flow cytometry. The results showed that CADM1 was weakly expressed in tissues of pancreatic cancer in contrast to its high expression in normal pancreatic and pancreatitis tissues. The expression level of CADM in pancreatic caner was intensely correlated with the differentiation degree, lymph node metastasis and TNM stages. The growth of CADM1-transfected PANC-1 cells was significantly suppressed in vitro by a G1 cell cycle arrest and apoptosis occurrence. It was concluded that re-expression of CADM1 inhibits the growth of pancreatic cancer cells and induces their apoptosis in vitro. As a tumor suppressor gene, CADM1 plays an important role in the occurrence, progression and metastasis of pancreatic cancer.

Objective To investigate the expressions of PI3K, AKT and MRP protein in pancreatic carcinoma and to determine the clinicopathological significance and the correlation among three protein expressions. Methods The immunohistochemical method was used to detect the expressions of PI3K, AKT and MRP in forty three pancreatic carcinoma, nine chronic pancreatitis and eight normal pancreatic tissue samples. Results The positive expression rates of PI3K, AKT and MRP were 46.51%, 55.81% and 39.53%, respectively in pancreatic carcinoma, which were remarkably higher than those in normal pancreatic tissue and in chronic pancreatitis (P<0.01 and P<0.05, respectively). The aberrant expression of PI3K, AKT and MRP were associated with lymph node metastasis and TNM stages (P<0.05). The abnormal expression rate in both MRP and PI3K was 32.56%, the normal expression rate of both MRP and PI3K was 46.51%, and there was positive correlation between the expression of MRP and PI3K(r=0.581, P<0.01). The abnormal expression rate of both MRP and AKT was 32.56%, the normal expression rate was 37.21%, and there was a positive correlation between MRP and PI3K (r=0.432,P<0.05). The abnormal expression rate of both MRP and PI3K was 37.21%, the normal expression rate of both MRP and PI3K was 32.56%, there was also a positive correlation between MRP and PI3K (r=0.306,P<0.05). Conclusions The expressions of PI3K, AKT and MRP were up-regulated in pancreatic carcinoma. The expressions of PI3K and AKT may be related to the lymph node metastasis and TNM staging.

One hundred and thirty seven pafients diagnosed by coronary angiography were recruited in the study and divided into coronary heart disease group(CAD)and control group.Relationship between serum apolipoprotein M levels and the severity of stenosis of coronary arteries was analyzed.In covariate analysis,serum apolipoprotein M levels were significantly lower in CAD group than those in control group adjusted for sex,age,body mass index(BMI)(P＜0.05).By stepwise muhiple regression,serum levels of apolipoprotein M were correlated positively with BMI(r=0.65,P＜0.01),and correlated negatively with total cholesterol(TC)(r=-0.53,P＜0.01)and low density lipoproteins(LDL-C)(r=-0.42,P＜0.01).Serum levels of apolipoprotein M were correlated negatively with the score of coronary stenosis(r=-0.62,P＜0.01).The results suggest that apolipoprotein M might be related to the development of coronary artery disease.

BACKGROUNDTo investigate the expression of survivin and its relation with apoptosis in non-small cell lung cancer.

METHODSSurvivin expression was examined in sixty paraffin-embedded NSCLC samples and 16 benign pulmonary disease tissues by immunohistochemistry methods.Apoptosis of NSCLC cells was detected by TUNEL technique.

RESULTSSurvivin was expressed in 38 of 60 (63.3%) NSCLC tissues.In contrast, benign pulmonary disease tissues did not express survivin. The expression of survivin protein was closely related to TNM stages (P < 0.05), lymph node involvement (P < 0.05) and cell differentiation (P < 0.01), but not to histological classification, gender and ages (P > 0.05). A correlation coefficient test showed a negative correlation between the AI and survivin expression (r=-0.231,P < 0.05).

CONCLUSIONSApoptosis inhibition caused by abnormal survivin expression may participate in the oncogenesis and progression of NSCLC. The over-expression of survivin suggest the bad prognosis in NSCLC. Survivin gene may be indentified as a potential therapeutic target in NSCLC.

BACKGROUNDTo evaluate the response, adverse effects and survival of MVP regimen and TVP regimen.

METHODSSixty six patients with advanced non-small cell lung cancer were randomized into two groups:MVP arm (32 patients, mitomycin C 6-8 mg/m² d1, vindesine 2-3 mg/m² d1 and d8, cisplatin 70-80 mg/m² d1) and TVP arm (34 patients, pirarubicin 40-50 mg/m² d1, vindesine and cisplatin were the same as arm MVP). Characteristics of the patients were similar in two arms. All patients received two to four cycles of chemotherapy.

RESULTSThe overall responses were 34% (11/32) in the MVP arm and 56% (19/34) in the TVP arm. There were 1 complete response, 10 partial responses in the MVP arm and 1 complete response, 18 partial responses in the TVP arm. TVP regimen appeared to have a higher objective response, but no statistically significant difference in the response was observed between two regimens (Chi-square=2.269, P=0.132). Main side effects were hematological toxicities. Grade III+IV hematological toxicities were significantly higher in the patients of arm TVP than arm MVP, especially neutropenia (79% vs 44%, Chi-square=7.458, P=0.006). Median survival time was 12 months vs 8 months, and 1-, 2-, 3-year survival rates were 53% vs 24% (Chi-square=4.943, P=0.026), 17% vs 6%, 6% vs 0, for arm TVP and arm MVP, respectively..

CONCLUSIONSMVP regimen has a lower response rate and longer survival time but less hematological toxicities than TVP regimen. The results suggest MVP regimen is a safe and active regimen for advanced non-small cell lung cancer.

OBJECTIVETo prepare and identify the capsaicin-hydroxypropyl-beta-cyclodextrin (capsaicin-HP-beta-CD) inclusion compound the mol ratio between capsaicin and HP-beta-CD and the thermodynamic constants in inclusion were studied simultaneously.

METHODThe capsaicin-HP-beta-CD inclusion compound was prepared with the method of saturation aqueous solution. Meanwhile, the inclusion compound was identified by differential scanning calorimetry methods (DSC), infrared spectrometry (IR), and X-ray diffraction (XRD), respectively. The mol ratio between host and guest molecular and the thermodynamic constants during the inclusion process were also researched by phase solubility method.

RESULTAn 1 : 1 molar ratio inclusion compound of capsaicin with HP-beta-CD could form at 25, 35 and 45 degrees C. The phase diagram was A(L) type.

CONCLUSIONThe solubility of capsaicin-HP-beta-CD inclusion compound can be increased obviously.

2-Hydroxypropyl-beta-cyclodextrin ; Calorimetry, Differential Scanning ; Capsaicin ; chemistry ; Drug Compounding ; Drug Stability ; Solubility ; Spectrophotometry, Infrared ; Spectroscopy, Fourier Transform Infrared ; Technology, Pharmaceutical ; methods ; Thermodynamics ; X-Ray Diffraction ; X-Rays ; beta-Cyclodextrins ; chemistry

Objective To investigate the effects of high energy enteral nutrition (EN) on nutritional status and immune function in patients with heart failure caused by pulmonary cardiac disease. Methods Eighty-six patients with heart failure caused by pulmonary heart disease were continuously collected from March 2017 to March 2018 in the Department of Critical Care Medicine of Taizhou First People's Hospital, and they were divided into a high-energy EN group and a standard EN group according to the different use of EN preparations, each group with 43 cases. The high-energy EN group were treated with high energy EN solution TPF-T (Ruineng), and the standard EN group were treated with standard EN solution TP (Ruisu); the initial EN infusion velocity in all the patients was 25 mL/h, the calorific calorie would reach the target to 104.6-125.5 kJ·kg-1·d-1, and the protein would target to 1.5-2 g·kg-1·d-1 within 3 days;the blood glucose was controlled within the scope of 7.8-11.1 mmol/L. The differences in rates of calorie and protein goal targeting situations, nutritional status, inflammatory response and immune function were compared between the two groups. Results From the 3rd day to 7th day after EN application, the rates of calorie and protein goal targeted in the high-energy EN group were significantly higher than those in the standard EN group [calorie targeted rate: 69.77% (30/43) vs. 41.86% (18/43), protein targeted rate: 25.58% (11/43) vs. 11.63% (5/43), all P < 0.05]. With the extension of EN application, nutritional indexes such as albumin (Alb), prealbumin (PA), transferrin (TRF), etc. and the immune indexes such as human leucocyte antigen (HLA)-DR positive rate, immunoglobulins (IgA, IgG), etc. were persistently increased in both groups, reaching the peak values on the 7th day, and the indexes in high-energy EN group were significantly higher than those in the standard EN group [Alb (g/L): 36.43±5.81 vs. 33.79±5.34, PA (mg/L): 278.83±47.56 vs. 251.67±41.92, TRF (mg/L): 3.58±0.64 vs. 3.26±0.81, HLA-RD positive rate: (53.22±6.11)% vs. (50.21±5.69)%, IgA(mg/L): 165.34±40.13 vs. 141.54±38.76, IgG (mg/L): 4 990.68±881.66 vs. 4 211.75±861.54, all P < 0.05]. However, the levels of inflammatory factors such as C-reactive protein (CRP) and tumor necrosis factor-α (TNF-α) in both groups were gradually decreased, reaching the valley values on the 7th day, and the indexes in high-energy EN group were significantly lower than those in the standard EN group [TNF-α(ng/L): 14.43±8.69 vs. 20.59±9.45, CRP (mg/L): 21.33±6.35 vs. 27.36±7.83, all P < 0.05]. Conclusion High energy EN not only can improve the nutritional status in patients with pulmonary heart failure, but also can reduce patients’ inflammation response and elevate their immune function.

Objective:To investigate the effects of video-assisted anal fistula treatment (VAAFT) on stress indicators and anal function in patients with anal fistula.Methods:Ninety-nine patients with anal fistula who received treatment in Lishui City People's Hospital from March 2020 to February 2022 were included in this study. They were randomly divided into a control group ( n = 48, undergoing fistulotomy) and an observation group ( n = 51, undergoing VAAFT). Clinical efficacy and the levels of various indexes during the perioperative period were compared between the two groups. Anal function [anal maximal contraction pressure, anal canal rest pressure, anal longest contraction time, anal incontinence Wexner score], and the levels of serum stress indicators [norepinephrine (NE), β-endorphin (β-EP), nerve growth factor (NGF), substance P (SP), and cortisol (Cor)] were determined before and after treatment. Postoperative complications were recorded. All patients were followed up for 3 months after surgery. Recurrence of anal fistula was compared between the two groups. Results:The total effective rate in the observation group was 94.12% (48/51), which was significantly higher than 79.17% (38/48) in the control group ( χ2 = 4.84, P < 0.05). The operative time, intraoperative blood loss, wound healing time, and length of hospital stay in the observation group were (34.78 ± 4.01) minutes, (34.48 ± 3.86) mL, (19.46 ± 2.05) days, and (12.76 ± 1.50) days, which were significantly shorter or less than those in the control group [(54.86 ± 6.05) minutes, (36.88 ± 4.01) mL, (25.61 ± 2.92) days, (21.05 ± 2.46) days, t = -19.57, -3.03, -12.18, -20.67, all P < 0.05). On the first day after surgery, the Visual Analogue Scale score in the observation was (1.88 ± 0.28) points, which was significantly lower than (3.55 ± 0.41) points in the control group ( t = -23.78, P < 0.05). At 3 months after surgery, anal maximal contraction pressure and Wexner scores in the observation group were (171.86 ± 18.68) mmHg and (0.39 ± 0.07) points, which were significantly lower than (180.37 ± 19.56) mmHg and (0.52 ± 0.09) points in the control group ( t = -2.21, -8.04, both P < 0.05). Anal canal rest pressure in the observation group was (50.77 ± 5.68) mmHg, which was significantly higher than (48.34 ± 5.23) mmHg in the control group ( t = 2.21, P < 0.05). There was no significant difference in anal longest contraction time between the two groups before and after treatment (both P > 0.05). At 3 days after surgery, NE and Cor levels in each group increased compared with those before surgery (both P < 0.05). At 3 days after surgery, NE and Cor levels in the observation group were (252.67 ± 29.16) μg/L and (281.34 ± 31.27) nmol/L, respectively, which were significantly lower than (304.03 ± 32.28) μg/L and (308.72 ± 34.18) nmol/L in the control group ( t = -8.31, -4.16, both P < 0.05). At 3 days after surgery, β-EP, SP, and NGF in each group were decreased compared with those before treatment (all P < 0.05). At 3 days after surgery, β-EP, SP, and NGF in the observation group were (62.37 ± 6.83) ng/L, (1.87 ± 0.23) ng/L, (30.82 ± 4.03) mg/L], respectively, which were significantly higher than (51.09 ± 5.74) ng/L, (2.59 ± 0.51) ng/L, and (38.19 ± 4.24) mg/L in the control group ( t = 8.86, 8.95, 8.85, all P < 0.05). There was no significant difference in the incidence of complications between the two groups ( P > 0.05). The recurrence of anal fistula in the observation group was 1.96% (1/51), which was significantly lower than 12.50% (6/48) in the control group ( χ2 = 4.18, P < 0.05). Conclusion:VAAFT exhibits a significant therapeutic effect on anal fistula, with a small surgical incision and minimal intraoperative bleeding. This procedure greatly shortens operative time and the length of hospital stay, alleviates postoperative pain, improves anal function, reduces postoperative stress response indicators, and has a low postoperative recurrence rate.