Objective To investigate the expression and clinical significance of P-selectin in colorectal cancer cells. Methods The protein expression of P-selectin was detected by immunohistochemistry in colorectal cancer tissues ( n=116) and corresponding non-tumor normal mucosa(n=57). The differences of P-selectin expression in colorectal cancer tissues, corre?sponding non-tumor normal mucosa and the clinical pathological significance were compared and analysed in two groups. Results The expression of P-selectin protein was found not only in vascular endothelial cells but also in colorectal cancer cells. The positive rate of P-selectin expression was apparently higher in colorectal cancer cells (77.6%, 90/116) than that in normal mucosa (17.5%, 10/57,χ2=56.49, P<0.05). However, there were no significance in positive rates of P-selectin in colorectal cancer cells between tumors with different diameters, different degrees of differentiation, different depths of infiltration and with or without lymph node metastasis (80.6%vs. 74.1%, 79.0%vs. 74.3%, 78.4%vs. 76.9%, 82.7%vs. 73.4%, P>0.05). Conclusion The high expression of P-seletin in colorectal cancer cells is an important characteristic of colorectal cancer.

Objective To synthesize a lipophilic prodrug of triptolide (TP) and improve its druggability .Methods Trip-tolidestearate (TP-SA)was synthesized via the DMAP-catalyzed DCC method and identified by MS ,1H-NMR and 13C-NMR. The shake-flask method was used to study the oil/water partition coefficient .The preparations of TP and TP-SA liposomes and emulsions were compared .Their encapsulation efficiency and stability were investigated .Results TP-SA was synthesized suc-cessfully .Its log P in octanol/water system was 2 .33 .It was difficult to prepare TP liposome or emulsion .By contrast ,TP-SA liposome and emulsion can be prepared successfully with the same formulation process .The particle size of TP-SA lipo-somes were about 90 nm and TP-SA emulsions were about 110 nm .The encapsulation efficiency was above 95% .Their stabili-ty were studied at 4℃ and 25℃ .The preparation parameters ,such as particle size and encapsulation efficiency ,had no signif-icant change in a week .Conclusion Triptolide stearate enhanced drug lipophilicity .Its druggability was improved significant-ly .These data can be used for the TP related drug design and development .

24 patients with chronic hepatitis B were treated with interleukin-2 activated human peripheral blood lymphocytes (IAPBL). 23 patients served as control. The results showed that HBeAg disappeared in 54.2% of IAPBL group, in comparison with 17.4% of the controls (P

Colorectal cancer is a malignant tumor with increasing incidence in China. Chemotherapy or neoadjuvant therapy are needed when the patients have deep tumor invasion of distant metastasis due to the hidden clinical manifestations and limited screening methods for the colorectal cancer. With many side effects of the current chemo-medications and the drug resistance, researchers are actively exploring new chemotherapy drugs for colorectal cancer. Paclitaxel is a first-line chemotherapy drug for the treatment of breast cancer, ovarian cancer, pancreatic cancer and other malignant tumors. Colorectal cancer cells are prone to become resistant to paclitaxel and the treatment efficiency was limited. However, new drug delivery systems and the combination drug therapy can enhance the treatment efficiency. This article reviews the effective treatment strategies of paclitaxel for colorectal cancer with the hope for new ideas and more effective chemotherapy.

Objective:To investigate the effect of enhanced recovery after surgery (ERAS) in percutaneous pedicle screw internal fixation treating thoracolumbar fracture patients.Methods:A retrospective case-control study was conducted to analyze the clinical data of 62 patients with thoracolumbar fracture treated by percutaneous pedicle screw internal fixation at Second Hospital of Soochow University from October 2018 to April 2019. There were 42 males and 20 females, aged 27-59 years (mean, 43.9 years). Fracture site included T 11 in 4 patients, T 12 in 28, L 1 in 23 and L 2 in 7, and AO type contained type A1 in 40 patients, type A2 in 3, and type A3 in 19. Thirty-one patients were treated with ERAS nursing mode (ERAS group), and other 31 patients with routine nursing mode (control group). The postoperative recovery time of intestinal function, first time of expelling flatus and dejection time, hospitalization time, preoperative and postoperative pain visual analogue scale (VAS), Kolcaba comfort scale (GCQ), Oswestry disability index (ODI), incidence of abdominal distension, incidence of urinary tract infection, first wake up dizziness, urinary retention, and wound healing were compared between the two groups. Results:Period of follow-up for all patients was 3-6 months (mean, 4.5 months). Postoperative recovery time of intestinal function, first time of expelling flatus and dejection time in ERAS group were (7.2±2.0)hours, (10.7±3.7)hours and (26.7±6.4)hours, respectively, which were significantly decreased compared to control group [(19.2±5.6)hours, (22.5±5.1)hours, (72.5±12.4)hours] ( P<0.05). Hospitalization time was (4.7±1.3)days in ERAS group, shorter than that in control group [(5.9±1.5)days]. There was no significant difference in VAS preoperatively between the two groups ( P>0.05). VAS in ERAS group was (3.6±1.5)points, (2.8±0.8)points, (1.7±0.6)points at postoperative 1, 3 and 7 days, lower than that in control group [(4.6±1.3)points, (4.0±1.3)points, (2.7±0.9)points] ( P<0.05). GCQ score in ERAS group was (72.0±6.5)points, (75.0±11.1)points, (88.4±5.1)points and (89.3±4.5)points at 2 hours before operation and 2 hours, 1 days and 3 days after operation, which were higher than that in control groups [(54.0±7.2)points, (59.5±6.3)points, (62.7±5.9)points, (76.0±5.7)points] ( P<0.05). ODI in ERAS group was 37.3±5.8, 28.9±6.3 and 23.1±2.7 at 3 days, 1 month and 3 months after operation, which was markedly decreased compared to control group (44.9±7.9, 33.9±8.7, 30.3±5.3) ( P<0.05). Moreover, the incidence of abdominal distension, urinary tract infection and first wake up dizziness in ERAS group was 7%, 5%, 3%, respectively, reduced from that in control group (26%, 35%, 16%) ( P<0.05). No significant difference was observed in urinary retention wound healing of the two groups, but there was no difference in wound healing ( P>0.05). Conclusion:For thoracolumbar fracture patients treated with percutaneous pedicle screw internal fixation, ERAS has advantages over traditional nursing in attenuating pain, shortening hospitalization time, reducing postoperative abdominal distension and urinary tract infection, and accelerating functional recovery.

OBJECTIVETo evaluate the restoration of function after spinal cord injury (SCI) in patients of different ages who have underwent intraspinal transplantation of olfactory ensheathing cells (OECs).

METHODSOne hundred and seventy-one SCI patients were included in this study. Of them, 139 were male and 32 were female, with age ranging from 2 to 64 years (mean, 34.9 years). In all SCI patients the lesions were injected at the time of operation with OECs. According to their ages, the patients were divided into 5 groups: 51 years group (n = 14). The spinal cord function was assessed based on the American Spinal Injury Association (ASIA) Classification System before and 2 - 8 weeks after OECs transplantation. One-way ANOVA and q test were used for statistical analysis, and the data were expressed as mean +/- SD.

RESULTSAfter surgery, the motor scores increased by 5.2 +/- 4.8, 8.6 +/- 8.0, 8.3 +/- 8.8, 5.7 +/- 7.3 and 8.2 +/- 7.6 in 5 age groups respectively (F = 1.009, P = 0.404); light touch scores increased by 13.9 +/- 8.1, 15.5 +/- 14.3, 12.0 +/- 14.4, 14.1 +/- 18.5 and 24.8 +/- 25.3 respectively (F = 1.837, P = 0.124); and pin prick scores increased by 11.1 +/- 7.9, 17.2 +/- 14.3, 13.2 +/- 11.8, 13.6 +/- 13.9 and 25.4 +/- 24.3 respectively (F = 2.651, P = 0.035). Restoration of pin prick in > 51 years group was better than other age groups except 21 - 30 years group.

CONCLUSIONOECs transplantation can improve the neurological function of spinal cord of SCI patients regardless of their ages. Further research into the long-term outcomes of the treatment will be required.

Adolescent ; Adult ; Age Factors ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Olfactory Bulb ; cytology ; transplantation ; Spinal Cord ; physiology ; Spinal Cord Injuries ; surgery ; Treatment Outcome

Objective To establish an UPLC-MS/MS method for determinating content of three paclitaxel fatty acid esters such as paclitaxel myristate （PTX-MA）, paclitaxel palmitate （PTX-PA） and paclitaxel myristate （PTX-SA） in mouse plasma, and preliminarily investigate the pharmacokinetic characteristics of their liposomes in mice. Methods Eclipse Plus C8 chromatography column （2.1 mm×50 mm, 1.8 μm） was used with different proportions of 0.2% formic acid aqueous solution （A） and methanol （B） mixture as mobile phase for gradient elution at a flow rate of 0.3 ml/min. The collum temperature was 30℃. The sample injection volume was 10 μl. The triple quadrupole mass series spectrometer was used as multi-reaction monitoring （MRM）. Results PTX-MA, PTX-PA and PTX-SA all exhibited a good linear relationship in the range of 5.0~500.0 ng/ml （r>0.9950）. Their RSD of precision, stability, extraction recovery rate and matrix effect test results was all less than 10%. The half-lives （t_1/2） for liposomes of three paclitaxel fatty acid esters PTX-MA-L、PTX-PA-L and PTX-SA-L in mice were 14.78 h, 44.49 h and 69.32 h individually, and their clearance rates （CL） were 29.06 L·kg/h, 24.94 L·kg/h and 13.74 L·kg/h, respectively. Conclusion This method had high specificity, sensitivity, easy operation and good stability, which could be used for the determination of paclitaxel fatty acid esters in mouse plasma. The results of pharmacokinetic studies in mice showed that t_1/2 for paclitaxel fatty acid esters were significantly prolonged, and the clearance rate were significantly reduced with the length of fatty acid carbon chains increasement, which indicated that esterification of paclitaxel with different chain length saturated fatty acids could obviously alter its in vivo pharmacokinetic properties, which provided scientific basis for the research and development of nano formulations of paclitaxel fatty acid ester prodrug.

To present the clinical characteristics and the misdiagnosis rate of acute coronary syndrome manifested primarily as throat discomfort, we conducted a multicentric and retrospective study in the cardiology and otorhinolaryngology departments. Records of patients with primary complaint of throat discomfort, absence of chest pain at onset, and an ultimate diagnosis of acute coronary syndrome, as well as patients with pharyngitis (as controls) were collected from May 2015 to April 2016. The patients' main manifestations were compared. Logistic regression results showed that chest tightness, dyspnea, perspiring, and exertional throat symptoms were significantly associated with acute coronary syndrome, with odds ratios of 8.3 (95% CI 2.2-31.5), 10.9 (95% CI 1.8-66.9), 25.4 (95% CI 3.6-179.9), and 81.2 (95% CI 13.0-506.7). A total of 25 (56.82%) out of 44 acute coronary syndrome patients, who were first admitted to the otorhinolaryngology department, were misdiagnosed, with a 12% (3/25) mortality rate. Throat discomfort can be the principal manifestation of acute coronary syndrome. Such patients exhibit high misdiagnosis and mortality rates. Exertional throat symptoms, chest tightness, perspiring, and dyspnea were important indicators of acute coronary syndrome in patients whose main complaint was throat discomfort. The awareness of this condition will result in prompt diagnosis and reduce morbidity and mortality.
Acute Coronary Syndrome/etiology* ; Dyspnea/etiology* ; Humans ; Pharyngitis/diagnosis* ; Pharynx ; Retrospective Studies