Objective To investigate the effect of MicroRNA-9 (miR-9) on cell proliferation and collagen synthesis in hepatic stellate cells (HSCs),and to explore the potential mechanism.Methods HSC-T6 cells were cultured and transfected with miR-9 mimics with lipofectamine 2000.After incubation 48 h,the cells were collected and total proteins and RNAs were extracted.The expression of miR-9 was detected by quantitative real time polymerase chain reaction (qRT-PCR).The protein expression of type Ⅰ collagen and type Ⅲ collagen were measured by Western blot.The methyl thiazolyl tetrazolium (MTT) method was used to asses the proliferation of HSC-T6 cells.The expression of transforming growth factor-β1 receptor 2 (TGFBR2) was detected by qRT-PCR and Western blot.Results Compared to the control group,miR-9 expression in HSCs was increased in the miR-9 mimics group (P ＜ 0.05),type Ⅰ and type Ⅲ collagen protein expression was reduced by (44 ± 2) ％ and (50 ± 3) ％ (P ＜ 0.01),respectively.The proliferation activity of HSCs was decreased by (48 ± 4)％ (P ＜ 0.05).The expression of TGFBR2 was inhibited in the miR-9 mimics group.Conclusions Upregulation of miR-9 plays a role on suppressing cell proliferation and collagen synthesis in HSCs.This process might be mediated by downregulation of TGFBR2.

Objective To summarize the clinical experienee in surgical treatment for hepatocellular carcinoma (HCC). Methods The clinical data of 7566 HCC patients who had been admitted to Research Institute of Liver Cancer of Fudan University from January 1988 to Deeember 2007 were retrospectively analyzed. The overall survival and recurrence free survival (RFS) rates were eaeulated with Kaplan-Meier survival curve. All the data were analyzed using Log-rank test and Cox regression model. Results The 3-, 5-, 10-year overall survival and RFS rates of 7164 patients with HCC resection were 56.29%, 41.76%, 26.70%, and 63.92%, 56.12%, 42.97%, respectively, and the perioperative mortality was 1.54%. The 5- and 10-year overall survival rates of patients with small HCC (diameter<5 era) were 58.20% and 38.47%, which were significantly higher than 31.42% and 20.43% of patients with large HCC (diameter >5 cm) (X2 =535. 568, P <0.01). The 5-year overall survival rotes of HCC patients with resection after down-staging (n = 110), re-resection after recurrence (n = 515), and tumor thrombus in portal vein (n = 168) were 51.26%, 67.28% and 26.81%, respectively; nd the 5-year DFS rotes were 77.44%, 13.01% (calculated from the first operation) and 34.90%, respectively. The 3- and 5-year overall survival and DFS rates of 402 patients who had undergone liver transplantation were 60.81%, 55.63% and 64.47%, 58.52%. The independent prognostic factors influencing the overall survival and DFS rates were the size, number and differentiation of HCC and intrahepatic vessel invasion (X2 = 200.539, 27. 536, 96.964,216. 156, P <0.01). Conclusions Early screening, improved safety of surgery, combined therapy and breakthrough in the reseaeh of preventing HCC metastasis and reeurrenee will significantly improve the treatment outcome of HCC.

This study was aimed to explore the suppression of nitric oxide (NO) production in RAW264.7 cells by total lactones fraction from Andrographis paniculata. The inflammatory model in vitro was established by stimulating the RAW264.7 cells with lipopolysaccharide (LPS). The NO production and inhibitory rate were determined by Griess assay. Cytotoxicity was evaluated by MTT method. The results showed that total lactones fraction ofA. paniculata suppressed NO production in a concentration-dependent manner in the concentration range from 5 to 50μmol·L-1 and their IC50 values were 8.58μmol·L-1, 11.52μmol·L-1 and 8.94μmol·L-1, respectively. In this condition, major constituents were andrographolide (5-60μmol·L-1), dehydroandrographolide (5-100μmol·L-1) and neoandrographolide (5-100μmol·L-1) inhibited NO production in a dose-dependent manner with an IC50 values of 17.54μmol·L-1, 49.54μmol·L-1 and 41.80μmol·L-1, respectively. It was concluded that the NO inhibitory activity of total lactones fromA. paniculata was better than three active ingredients, which may be able to provide a theoretical foundation and scientific basis for the preparation and clinical application of total lactones fraction fromA. paniculata.

OBJECTIVETo evaluate the effect of beta irradiation on intimal proliferation and apoptosis in vein grafts.

METHODSAutogenous vein graft model was established in 80 rats by transplanting the internal branch of the jugular vein to the carotid artery by end to end anastomosis. The veins were irradiated by (32)P solution before anastomosis. Two dose schedules were studied: control group (graft, nonirradiated) and radiation group (20 Gy). The grafted veins were harvested at 3, 1, 2 and 4 week respectively after the operation. intimal hyperplasia (IH), smooth muscle cell (SMC), proliferation, p53, bcl-2 and bax were observed pathologically and immunohistochemically. They were analyzed by a computerized system. The presence of apoptotic VSMC was demonstrated by TUNEL method.

RESULTThere was a significant decrease in the average intimal thickness at 7, 14 and 28 days (t = 15.694, P < 0.05) in the radiation group. Immunohistochemical analysis of PCNA indicated decreased positive cells in the radiation group compared with the controls at 1 and 2 weeks (t = 60.157, P < 0.01). Apoptosis of VSMC was higher in the radiation group than in the control group at 2 weeks (t = 56.176, P < 0.01). There was no significant difference in expression of P(53) between the two groups, and there was a significant increase in bax/bcl-2 in the radiation group at 2 weeks (t = 9.783, P < 0.05).

CONCLUSIONThese preliminary results demonstrated that low dose of beta irradiation in the vein graft inhibits SMC proliferation and induces the apoptosis of VSMC in rats.

Animals ; Apoptosis ; Beta Particles ; Brachytherapy ; Disease Models, Animal ; Graft Occlusion, Vascular ; metabolism ; pathology ; In Situ Nick-End Labeling ; Male ; Muscle, Smooth, Vascular ; pathology ; radiation effects ; Proliferating Cell Nuclear Antigen ; metabolism ; Rats ; Tumor Suppressor Protein p53 ; metabolism ; Tunica Intima ; pathology ; radiation effects

Objective To evaluate the diagnosis and treatment of focal nodular!hyperplasia of the liver (FNH). Methods Retrospective analysis was made on 60 FNH cases in terms of clinical findings, images, pathologic examination and surgical treatment. Results Of the 60 FNH patients in our hospital from 1993 to 2003, 41 were male and 19 female. The average age was 37 year′s old. Fifty-five cases had single focus, the other five were of multiple lesion, with tumor diameter 10cm in one. Correct preoperative diagnosis was made in 33 cases (55%). The correct diagnostic rate of BUS, CT and MRI was 33.3%, 58.3% and 72.0%, respectively. All 60 cases underwent operation with an uneventful recovery and without recurrence at follow-up. ConclusionsCT and MRI are mandatory for the diagnosis of FNH. Definite preoperative diagnosis is usually difficult even in cases of typical type of FNH. Surgical resection is the treatment of choice when a patient becomes symptomatic or when malignancy could not be excluded.

OBJECTIVETo demonstrate the feasibility of extralevator abdominoperineal excision (ELAPE) for locally advanced low cancer in China.

METHODSA prospective multicenter clinical trial was carried out by 7 general hospitals across China from August 2008 to October 2011. A total of 102 patients underwent ELAPE for primary locally advanced low rectal cancer. There were 60 male and 42 female patients. The patients' characteristics, complications and prognosis were recorded.

RESULTSAll patients underwent the ELAPE procedure successfully. The median operating time was 180 minutes (range 110-495 minutes) and median intraoperative blood loss was 200 ml (range 50-1000 ml). The rates of sexual dysfunction, perineal complications, urinary retention, and chronic perineal pain were 40.5%, 23.5%, 18.6% and 13.7%, respectively. Chronic perineal pain was associated with coccygectomy (12 months postoperatively, t = 8.06, P < 0.01), and the pain might gradually ease over time. Reconstruction of pelvic floor with biologic mesh was associated with lower rate of perineal dehiscence (χ(2) = 13.502, P = 0.006) and overall perineal wound complications (χ(2) = 5.836, P = 0.016) compared with primary closure. A positive circumferential margin (CRM) was demonstrated in 6 (5.9%) patients, and intraoperative perforations occurred in 4 (3.9%) patients. All CRM involvement and intraoperative perforation located at anteriorly and anterolaterally. The local recurrence was 4.9% at a median follow-up of 35 months (range, 18-58 months).

CONCLUSIONSELAPE performed in the prone position for low rectal cancer leads to a reduction in CRM involvement, intraoperative perforations, and local recurrence, but it might result in a little high rate of perineal wound related complications. Reconstruction of pelvic floor with biologic mesh might lower the rate of perineal wound complications.

Adult ; Aged ; Digestive System Surgical Procedures ; methods ; Female ; Humans ; Male ; Middle Aged ; Perineum ; surgery ; Postoperative Complications ; Prognosis ; Prospective Studies ; Rectal Neoplasms ; surgery ; Treatment Outcome

Objective To summarize the preliminary experience of extraperitoneal laparoscopic radical prostatectomy (C.R.P.C.four-step) for localized prostate cancer and the outcomes based on early follow-up.Methods A total of 102 prostate cancer patients were screened by prostate specific antigen (PSA) and diagnosed by prostate magnetic resonance imaging and prostatic puncture biopsy with cT1c-cT3b,with average age of (67 ±5) years old,average preoperative total PSA value of (45.32 ± 18.33) ng/ml,and average prostate volume was (42 ± 12)cm3.All these patients underwent extraperitoneal laparoscopic radical prostatectomy by the four-step technique,abbreviating as C.R.P.C.[C:control DVC (dorsal deep venous complex).R:recognize three anatomical layers (prostate and bladder junction,seminal vesicle,and Denonvilliers' fascia surface).P:preserve urethral sphincter and bladder neck.C:continuous anastomosis between urethra and bladder neck (4 key needles at 3,5,7 and 9 o'clock)].The operative time,estimated blood loss,length of hospital stay and postoperative complications were recorded,and the postoperative PSA was followed up.Results All the 102 cases were successfully treated by iaparoscopic radical prostatectomy.The operative time was from 55 to 156 min (mean 92 min),and the estimated blood loss was from 55 to 185 ml (mean 105 ml).There was no case converted of open surgery,only one case received blood transfusion for postoperative hemorrhage (0.98％),and positive surgical margin was found in 15 case (14.70％) by pathological examination.Postoperative urinary extravasation within one week occurred in 2 (1.96％) cases,and resolved after tensioning the catheter and prolonging the indwelling time.During the follow-up period of 12 to 45 months,2 cases were incontinent (grade I-II),and the other cases(98.04％) had no incontinence or dysuria.However,11 cases (10.78％) developed to biochemical recurrence within 6 months after the operation.Conclusions The C.R.P.C.four-step technique of lparoscopic radical prostatectomy is easily to be grasped and performed by the greenhand urologists,and was efficient and safe.