AIM: To investigate the regulatory effect of the adenosine triphosphate binding cassette transporter A1 (ABCA1) on apolipoprotein E secretion from human THP1 macrophages.METHODS: Differentiation of THP1 macrophages from monocytes was stimulated with phorbol 12-myristate 13-acetate. The macrophages then were incubated with factors which regulate ABCA1 expression. After periods of incubation, apo E secreted in the medium and synthesized in the cell was determined with ELISA, and apo E mRNA espression was detected with Northern blot.RESULTS: An increase in apo E secretion from THP1 macrophages was observed by 8 h of incubation with 8-Br-cAMP, an activator of ABCA1 expression (P

ObjectiveTo evaluate the efficacy and safety of combination therapy of tamsulosin and solifenacin for benign prostatic hyperplasia ( BPH ) with overactive bladder ( OAB ).Methods82 patients with OAB and coexisting BPH were randomly divided into tamsulosin group ( n = 38 ) and combination group ( n = 44). The ages were from 50 to 75 y ( averaged, 56.8 ± 8.6). Inclusion criteria: the mean frequency of micturition ≥8 times per day, the frequency of nocturia ≥2 times per day, voiding volume ＜200 ml each time; for the overactive bladder symptom score ( OA BSS), the 3 rd score ＞ 2, total score ＞ 3. The tamsulosin group accepted tamsulosin 0.2 mg once daily, the combination group accepted tansulouxin 0.2 mg and solifenacin 0.2 mg once daily. Both groups were maintained the corresponding therapy for 12 weeks.The international prostate symptom score (IPSS), Qmax, residual urine volume, OAB score and adverse reactions were recorded.ResultsThe values of IPSS ( 19.5 ±2.2 vs 15.6 ±2.4, P =0.027), the voiding symptom score ( 15.6 ± 2.4 vs 3.4 ± 1. 7, P = 0. 022) and Qmax ( 13.7 ± 3.8 vs 16.6 ± 4.1, P = 0. 034 )improved significantly after treatment in tamsulosin group ( P ＜ 0. 05 ). The values of IPSS ( 19.7 ± 2.3 vs 9.7 ± 3.0, P ＜0. 001), the storage symptom score (13.8 ± 1.9 vs 5.6 ± 1.6, P ＜0. 001 ), OABSS (10.3 ±1.8 vs 5.3 ±1.3, P ＜0.001) and Qmax(14.1 ±4.1 vs 17.2 ±3.5, P=0.027) also improved significantly after treatment in combination group ( P ＜ 0. 05 ). The values of IPSS ( 9.7 ± 3.0 vs 15.6 ±2.4, P ＜ 0.001 ), the storage symptom score (5.6 ± 1.6 vs 12.0 ± 1.6, P ＜ 0.001 ) and OABSS ( 5.3 ±1.3 vs 9.7 ± 2.7, P ＜ 0. 001 ) improved significantly in combination group than those in tamsulosin group ( P ＜0.001 ). There were no difference between two groups in values of the voiding symptom score, Qmax and residual urine volume ( P ＞ 0.05 ). The incidences of adverse reactions in tamsulosin group and combination group were 7.9％ (3/38) and 20.5％ (9/44) without significant difference. There was no acute urinary retention in both groups.ConclusionsIt is effective and safe for patients with BPH and OAB to accept combination therapy of tamsulosin and solifenacin.

Objective To explore the clinical application of adaptive support ventilation (ASV) in elderly patients with acute respiratory failure.Methods A total of 46 mechanically ventilated patients aged over 65 years with acute respiratory failure admitted from January 2013 to June 2015 were enrolled.Comparison between the ASV mode and synchronized intermittent mandatory ventilation (SIMV) mode was carried out in respects of the impacts of both modes on respiratory mechanics, hemodynamics, oxygen availability and comfort rate.Results Difference between ASV and SIMV in respiratory rate was [(20.84 ±4.04) vs.(24.50 ±4.60) cycles/min, t =4.04, P ＜0.05], in inspiratory resistance was [(13.24 ±4.76) vs.(16.54±5.25) cmH2O/ (L·s), t=3.16, P＜0.05], in mean airway pressure was [(13.58±2.58) vs.(16.63 ±1.57) mmHg, t =6.84, P＜0.05], in peak airway pressure was [(25.96 ± 3.69) vs.(27.87 ± 2.45) mmHg, t =2.92, P ＜ 0.05], and tidal volume was [(378.41 ± 85.61) vs.(341.52 ± 86.84) mL, t =2.05, P ＜ 0.05], and comfort rate of patients was increased in ASV mode.There were no statistically significant differences in arterial oxygen partial pressure, carbon dioxide partial pressure, lactate, heart rate, mean arterial pressure and central venous pressure between the two modes (PP ＞ 0.05).Conclusions Compared with the synchronized intermittent mandatory ventilation mode, the adaptive support ventilation mode can improve the respiratory mechanics and can increase the comfort rate in the elderly patients with mechanical ventilation.

OBJECTIVE:To establish a method for the determination of related substances in bisacodyl raw material and enteric-coated tablet. METHODS:HPLC was performed on the column of Hibar C18 with mobile phase of acetonitrile-20 mmol/L ammonium acetate (acetic acid adjust pH to 5.0)(55∶45,V/V),detection wavelength was 265 nm,flow rate was 1.0 ml/min, column temperature was 30℃,and the injection volume was 20 μl. RESULTS:The linear range of bisacodyl was 0.25-5.0 mg/ml (r=0.999 9);the limits of detection and quantification were 19-25 ng and 61-68 ng for bisacodyl and impurity A,B,C,D and E;RSDs of precision,stability and reproducibility tests were lower than 2%;recovery was 99.50%-101.00%(RSD=0.5%,n=9). CONCLUSIONS:The method is specific, sensitive and reproducible, and can be used for the determination of related substance in bisacodyl raw material and enteric-coated tablet.

Objective Compare the clinical efficacy between anterior cervical decompressions, internal fixation with steel plate and zero profile interbody fusion system (Zero-P) in the treatment of cervical spondylotic myelopathy.Methods From October 2010 to May 2013, a total of 47 patients with cervical myelopathy were included in prospective randomized controlled study.All patients were randomly divided into two groups, respectively using plate fixation (screw plate system group, 26 cases)and Zero-P (Zero-P group, 21 cases).Compared operation time, intraoperative blood loss, postoperation flow and the incidence of postoperative discomfort swallowing.Evaluated the Japanese Orthopaedic Association (JOA) score of nerve function and calculated improvement rate;measured cervical Cobb Angle on X-ray film, observed abnormal activity of surgical clearance, evaluated degree of bone graft fusion and related internal fixation complications.Results The average operation time of screw plate system group was 71.2±26.8 min, which was 53.4±28.6 min in Zero-P group, significant difference was found in two groups.The average bleeding volume was 78.1 ±46.7 ml, and average volume of postoperation drainage was 63.3±37.7 ml in screw plate system group;the average bleeding volume was 77.5±50.4 ml, and the average volume of postoperation drainage was 60.7±28.6 ml in Zcro-P group, no significant difference was found.5 cases in screw plate system group remained swallowing discomfort 3 weeks after operation, but non in Zero-P group.Followed-up lasted for 24-42 months, an average of 23±2.16 months, nerve function were significantly improved at the end of the follow-up of both two groups, the JOA score of screw plate system group was 14.28±2.96, the improvement rate was 68.91％±7.9％, and Zero-P group was 14.32±2.87, the improvement rate was 69.79％±11.2％, there were no significant difference;curvature of cervical vertebrae of screw plate system group was 15.2°±5.7° at the end of follow-up;Zero-P group was 18.1°±7.9°, which with significant difference.Bone graft fusion were found in all patients at the end of follow-up, and no abnormal activities and fixation loosening was found during follow-up period.Conclusion Zero-P compared with traditional fracture-fixation techniques in treating single or double segments of cervical spondylotic myelopathy, can shorten operation time, reduce the incidence of postoperative chronic discomfort swallowing, and maintain in favour of cervical curvature.

Objective:To discuss the effect of sarcopenia (Sa) on the prognosis of transjugular intrahepatic portosystemic shunt (TIPS) in patients with portal hypertension (PHT).Methods:Totally 131 PHT patients treated with TIPS were retrospectively collected from August 2013 to December 2017 in the First Affiliated Hospital of USTC, and were divided into the Sa group [maximum transverse diameter of the psoas major muscle/height (TPMT/H) ≤16.8 mm/m, n=60] and the control group (TPMT/H>16.8 mm/m, n=71). The patients were followed up with a median time of 42 months. The Kaplan-Meier method was used to calculate the incidence of hepatic encephalopathy, recurrence rate of PHT-related complications and survival rate of PHT patients after TIPS, and the differences were compared by Log-rank test. Results:The incidences of hepatic encephalopathy within 6 months after TIPS and severe hepatic encephalopathy requiring hospitalization in the Sa group [36.7% (95%CI 24.5%-48.8%) and 15.0% (95%CI 6.0%-24.0%)] were higher than those of the control group [15.7% (95%CI 7.3%-24.1%) and 2.8% (95%CI 0-6.7%)], with statistically significant differences (χ2=7.843, 16.442, P=0.005, 0.001). The 5-year overall recurrence rate of PHT-related complications of the Sa group after TIPS [15.8% (95%CI 6.4%-25.2%)] was higher than that of the control group [5.7% (95%CI 0.2%-11.2%)], with a statistically significant difference (χ2=4.431, P =0.035. The 1, 3 and 5-year survival rates in the Sa group were 88.3% (95%CI 80.3%-96.3%), 86.7% (95%CI 78.1%-95.3%) and 77.8% (95%CI 65.1%-90.5%) respectively, which were all lower than those of the control group [97.2% (95%CI 93.3%-100%), 95.8% (95%CI 91.1%-100.0%) and 93.7% (95%CI 87.6%-99.87%) respectively], and the difference was statistically significant (χ2=5.055, P=0.025). Conclusion:Sa has a higher incidence in PHT patients, which can increase the incidence of hepatic encephalopathy and recurrence rate of PHT-related complications, and can decrease the survival rate in PHT patients after TIPS. Hence, the Sa is an indicator of the poor prognosis in PHT patients with TIPS.

Objective To measure and compare the expression profdes of plasma miRNA between Tibetan and Han nationality.Methods Plasma samples were taken from 246 healthy Tibetans and 128 Han individuals.The randomly selected 50 Tibetan and Han plasma samples were pooled respectively and the levels of 754 miRNAs were examined using a TaqMan Low Density Array.Two markedly differentially expressed miRNAs,miR-130a-3p and miR-629-5p,were verified in all the plasma samples by individual qRT-PCR.Results The Low Density Array results showed that the correlation coefficient of expression profiles of plasma miRNA for the Tibetan and Han population was 0.592.Compared with Han population,the expression levels of 139 miRNAs were distinctly different,in Tibetan (62 up-regulated and 77 down-regulated).The levels of miR-130a-3p and miR-629-5p were further verified to be significantly higher in the plasma from Tibetans than those in the plasma from Han population [(467 ± 27.30) × 10-5 vs (236 ± 9.69) × 10-5,p ＜ 0.01;(14.67 ±0.94) × 10-5 vs(7.58 ± 0.52) × 10-5,P ＜ 0.01] by qRT-PCR assay.Conclusion There may be marked difference of plasma miRNA expression profile between Tibetan and Han nationality.The influence of the nationality factors on miRNA profiles should be taken into account in the application of miRNAs in clinical detection in the future.

ObjectiveTo explore the relationship between flash visual evoked potentials (fVEP) and intracranial pressure (ICP), and the effect of fVEP on monitoring ICP treatment.MethodsICPs of 37 patients with large area cerebral infarction and intracranial hypertension were measured before and at 10 min, 20 min, 30 min, 40 min, 50 min and 60 min after mannitol treatment.ResultsThe mannitol effect to cure the large area cerebral was not well.ConclusionfVEP can monitor ICP exactly and harmless, and has importance value to instruct therapy of ICP in clinic.

OBJECTIVETo investigate the safety, feasibility and long-term outcomes of laparoscopic complete mesocolic excision for the transverse colon cancer.

METHODSClinical data of 61 patients who underwent laparoscopic complete mesocolic excision for transverse colon cancer (transverse group) in our department from January 2011 to January 2014 were retrospectively analyzed, which were compared with those of 155 patients undergoing laparoscopic complete mesocolic excision for ascending colon cancer (ascending group) and 230 patients undergoing laparoscopic complete mesocolic excision for sigmoid colon cancer (sigmoid group). Differences in operative details, postoperative recovery, postoperative complications and long-term survival among 3 groups were evaluated.

RESULTSNo significant differences in the baseline information were found among 3 groups(all P>0.05). The average operative time was significantly longer in transverse group as compared to ascending group and sigmoid group [(192.1±58.7) min vs. (172.2±54.7) min and (169.1±53.6) min]( P<0.05), while the blood loss [(89.7±63.6) ml, (86.3±66.3) ml, (82.6±61.5) ml], conversion rate [3.3%(2/61), 2.6%(4/155), 2.2%(5/230)], number of harvested lymph node (13.0±4.7, 14.4±6.5, 13.4±5.6), time to flatus [(2.7±1.1) d, (2.6±1.1) d, (2.5±1.0) d], time to liquid diet [(3.0±1.7) d, (2.8±1.5) d, (2.7±1.4) d], incidence of postoperative complication(6.6%, 9.0%, 11.7%), and hospital stay [(11.6±5.8) d, (10.7±5.8) d, (10.6±5.7) d] among 3 groups were not significantly different (all P>0.05). A total of 436 patients received postoperative follow-up of median 36 (5 to 67) months. The overall 5-year survival rate was 73.1%, 73.7% and 74.8%, and the 5-year disease-free survival rate was 71.5%, 71.1% and 72.7% in transverse, ascending and sigmoid colon cancer groups respectively, whose differences were not significant among 3 groups (all P>0.05).

CONCLUSIONLaparoscopic complete mesocolic excision for transverse colon cancer is safe and feasible with slightly longer operation time, and has quite good long-term oncologic efficacy.

Colectomy ; methods ; Colon, Ascending ; surgery ; Colon, Sigmoid ; surgery ; Colon, Transverse ; surgery ; Colonic Neoplasms ; surgery ; Comparative Effectiveness Research ; Disease-Free Survival ; Humans ; Laparoscopy ; methods ; Length of Stay ; Lymph Node Excision ; Lymph Nodes ; Mesocolon ; surgery ; Operative Time ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Survival Rate ; Treatment Outcome

Objective To evaluate the effect of islet transplantation for patients with type 2diabetes mellitus (DM). Methods Since December 2007, 4 cases of islet transplantations were performed on 3 patients with type 2 DM and end-stage renal disease (ESRD). Two patients received simultaneous islet-kidney transplant from single-donor (SIK), and one received 2 consecutive islet transplants 5 months following kidney transplantion (IAK). All recipients given insulin with a dose of percutaneous transhepatic portal catheterization. Anti-CD25 monoclonal antibody was used as induction. For SIK, low-doses of Tacrolimus and sirolimus were used as maintenance immunosuppression protocol. For IAK, the maintenance protocol included cyclosporine and MMF.Insulin dose, the level of blood glucose, C-peptide and the value of HbA1 were observed. Results The first patient of SIKhad normal glucose level 3 days after surgery and became insulin independent within the first month, but insulin was administered gradually and the dose reduced to 1/3. The second patient of SIK died of bleeding and secondary infection of liver puncture site 5 days following operation, the blood glucose level recovered to normal 24 h after operation. The insulin dose of the patient of IAK was reduced to 1/2 after the first transplant. The patient became insulin free after the second operation. The level of fasting and postprandial C-peptide of the surviving recipients increased by 600 pmol/L. The value of HbA1 of the SIK was 6.7 %～7.3 %, while that of the IAK was 5. 5 %～ 5. 9 %. Conclusion Islet transplantation is an effective treatment for patients with type 2 DM.