[Objective] To investigate the effects of platycodin D(PD) on the proliferation and apoptosis of human stomach cancer SGC7901 and the related mechanism.[Methods] SGC7901 was cultured in virto and was treated with 5～20μm·L-1 concentrations of PD.Cell proliferation was examined by MTT assay.Cell apoptosis was detected by Annexin V FITC/PI double staining.The change of mitochondrial trans-membrane potential was measured by JC-1 staining.The potein expression of cleaved caspase-3,cleaved caspase-9,cleaved PARP,bcl-2,bax,p-ERK,ERK,p-JNK,JNK,p-p38 and p38 detected by Western blot.[Results] MTT results showed that PD inhibited the growth of SGC7901 cells in a dose-dependent manner at 24h and 48h.SGC7901 cells treated with PD for 24h showed significantly enhanced apoptosis and weakened mitochondrial membrane potential compared with the control cells.Western blot results showed that PD could up-regulate expression of cleaved PARP,cleaved caspase-3,cleaved caspase-9,bax,p-JNK,p-p38 protein,decreased bcl-2,p-ERK protein,the expression of ERK,JNK,p38 protein did not change significantly.[Conclusion] PD may inhibit the proliferation and induce the apoptosis of SGC7901 cells.These findings indicated that PD inhibited cell proliferation by inhibiting the ERK signaling.PD effect on bax and bcl-2 by activation of JNK and p38 signaling pathway resulted in the decrease of mitochondrial membrane potential and activation of caspase,which induced the apoptosis of cancer cells.

Objective To explore the effect of schisanhenol on adipokine expression in 3T3-L1 adipocyte and its related mechanism. Methods 3T3-L1 adipocyte was cultured in vitro and induced to differentiation and maturity. Glucokinase was added to culture medium to make an oxidative model. The expression of adipocytokines were detected under the circumstance of different doses and at different time points of schisanhenol. Results The expression of adiponectin, leptin, resistin and visfatin were decreased with the increase of glucokinase concentration. Concentration-dependent inhibition effect was most obvious in leptin (25 mU/ml Glucokinase vs Blank group, t =7.29, P＜0.01). With pretreatment of oxidative stress, the adipocytokines increased as the doses of schisanhenol increased (t=6.31,P＜0.01 in adiponectin;t=5.92, P＜0.01 in leptin; t=3.77, P＜0.05 in resistin; t=3.63,P＜0.05 in visfatin). With the extension of schisanhenol effect, the expression of four adipokines showed the process of first decrease-then increase'. The effects of schisanhenol on adipokines were parallel with the alteration of oxidative stress. Conclusions Schisanhenol increased adipocytokines expression in 3T3-L1 adipocyte by reducing oxidative stress, and the increase of leptin and adiponectin were most obvious, which indicated that schisanhenol could play a role in the treatment of diabetes by Chinese herb wuweizi.

Objective:To assess the role of EGFR mutations on pemetrexed response in patients with advanced lung adenocarcino-ma. Method: Forty pulmonary adenocarcinoma patients with evaluable lesions were retrospectively screened .They had been treated with pemetrexed-included chemotherapy and had EGFR gene test results. The evaluation endpoints were overall response rate,disease control rate and progression free survival. Result:No significant statistical difference was seen in overall response rate(ORR) (44.4%VS 31.8%, respectively) and disease control rate(DCR) (88.9%VS 81.8%, respectively ) between EGFR wild group and EGFR muta-tion group, but patients in EGFR wild group had longer progression free survival(PFS) ( 8.9 months VS 5.3 months;P=0.046). Conclu-sion:EGFR mutation status can influence the efficacy of pemetrexed.

Objective To evaluate the safety of mesohepatectomy for centrally located large hepatic tumors.Methods The clinical data of 37 patients who underwent hepatectomy for centrally located large liver tumors in our hospital from October 2010 to August 2015 were retrospectively analyzed.During the operation,the left and right hemilivers were mobilized.Slings for the improved liver hanging maneuver and for selective hepatic vascular occlusion were placed.These slings were used when necessary in order to minimize occlusion and ischemia time to the residual liver,and to maximize the volume of functional liver remnant.Mesohepatectomy was carried out using a microwave hemostatic separator.The feasibility,its effects on preventing hemorrhage,the degree of liver damage and the postoperative complications were evaluated.Results The mean diameter of the neoplasms was (12.6 ± 7.2) cm.The vascular inflow occlusion time of the left and right hemilivers were (12.2 ±3.5) min and (18.5 ±7.1) min,respectively.The blood loss was (487 ± 352) ml.The amount of red blood cell transfusion was (2.7 ± 1.9) U.The operation time was (215 ± 72) min.TBIL,ALT and AST reached their peak levels on the 1 st day after operation and they were higher than before surgery (P ＜ 0.01).The levels were then significantly decreased on the 3rd day after operation.However,the TBIL (P ＜ 0.05),ALT (P ＜ 0.01) and AST (P ＜ 0.05) were higher than the preoperative level,and only returned to normal or were close to the preoperative value on the 7th day after operation (P ＞ 0.05).The initial increase in ALT was quick and then it slowed down,while the initial increase in AST was slow but it decreased quickly.Conclusions Mesohepatectomy for centrally located large hepatic tumors could safely be carried out using the liver hanging maneuver combined with selective hepatic vascular occlusion and a microwave hemostatic separator.This method has the advantages of causing less bleeding,liver damage and rapid recovery.

Correspondinga uthor:Wan Chun, Email:mdchunwan@163.com
[Absrt act] Obj ective To summarize the clinical experience with isolated complete resection of he-patic caudate lobe in 14 patients. Mte hods The clinical data of 14patients with isolated complete resection of hepatic caudate lobe carried out in our hospital from December 2007 to March 2015 were retrospectively analyzed .During the operation , selective hepatic vascular occlusion slings , and supra-and infra-hepatic in-ferior vena cava slings were placed after full mobilization of the liver .Isolated complete resection of the he-patic caudate lobe was performed through the left and /or the right , the anterior liver-splitting or the retro-grade approaches .Results The mean operation time was (227 ±64) min.The mean amount of blood loss was (530 ±325) ml.The mean vascular occlusion time was (19.5 ±18.6) min.The mean diameter of ne-oplasm was (15 4.±9 .2) cm. All the operations were successfully carried out .There were no massive hem-orrhage, bile leakage or perioperative death .Hydrothorax occurred in 3 patients and ascites in 2.The mean stay in hospital was (21 ±9) days.All the patients were cured and discharged home .Conclusion Isolated complete resection of hepatic caudate lobe was feasible in clinical practice .

OBJECTIVE:To upgrade the management of the out-patient pharmacy and provide all the patients, doctors and nurses with good service. METHODS: HIS was applied to the real stock management of the out-patient pharmacy in our hospital. RESULTS: Due to the HIS, the amount of drugs was identical with the account; the overstock and stocktaking error rate were greatly decreased, and the account was clear & the supervision was easy. CONCLUSION: The work efficiency and quality of the out-patient pharmacy was greatly improved by the scientific normalized management.

Objective To explore the signal mechanism of proliferation stimulating effect of connec-tive tissue growth factor (CTGF) on hypertrophic scar (HS) derived fibroblasts. Methods <'3>H-TdR in-corporation technique was used to determine the proliferative effect of CTGF at different concentration. Western blot was applied to semi-quantitively analyze the expression of phosphorylated and total ERK1/2 protein after 0, 5, 10, 15, 30, and 60 min of CTGF stimulation, and the relative value of which was de-fined as AI to measure the activation of ERK1/2 signal pathway. PD98059 was admitted to specifically block the ERK1/2 pathway, and subsequently cell proliferation stimulated by CTGF was studied by MTT. Results CTGF could stimulate fibroblasts proliferation with a dose-dependant manner, and activa-ted the ERK1/2 signal pathway, and AI built up to 0.209±0.0201, reaching the apex at 15 min after stimulation performed. Inhibition of ERK1/2 activation by PD98059 suppressed CTGF-mediated HS fi-broblasts proliferation significantly, while OD significantly dropped. Conclusion CTGF induces a prolif-erative response in HS fibroblasts, and this action is mainly dependent on the activation of ERK1/2 signal pathway.

ObjectiveTo investigate the treatment and prevention of auricle reconstruction complications by Medpor framework and autoallergic rib cartilage framework implantation.Methods A total of 158 microtia were performed ear reconstructive operation,in which postoperative complications happened in 18 cases during January 2003 to June 2011,and studied retrospectively.Results There were three cases of dilator haematoma (incidence rate was 1.90 ％),and they were cured after treatment.There were two dilator infection cases (incidence rate was 1.27 ％).One case was cured after treatment,and another one revealed no effect after treatment and dilator implantation operation was done half a year later.There were thirteen cases of framework plantation exposure and infection after Ⅱ stage operation,in which there were seven rib cartilage framework cases (incidence rate was 5.79 ％),and they were cured after change dressings and operation; there were six Medpor framework cases (incidence rate was 16.22 ％),and the three cases were cured after change dressings and operation,and other three cases revealed no effects after change dressings and so the operation failed.ConclusionsPreoperative percise plan and fine manipulation can decrease the incidence of haematoma.The main reasons of framework exposure include the skin tension,thin skin flap or the effect of external force.On account of the high incidence of framework exposure and difficult treatemnt,it is better to use rib cartilage framework for uricle reconstruction.

Objective : To apply analytical flow chart method to building a model for forecasting the risk of influenza and providing preventive measures. Methods : Surveillance data of influenza in Zhoushan from 2015 to 2018 was collected. Analytical flow chart method was used to evaluate the real-time risk of influenza,which were stratified by the seasonality of influenza,the percentage of influenza-like patients （ILI%） and whether there were effective prevention and treatment measures. The trend-line,warning line and action line of the influenza in 2018 were fit and the risk grades of influenza forecast were defined,which were compared with the actual risk grands during the first 20 weeks in 2018,to evaluate the accuracy of influenza forecast index. Results : Through the analysis of the flow chart,the influenza index was divided into six grades,very high risk（gradeⅠ,n=0）,high risk （gradeⅡ,n=14,ILI%=12.61%±7.54%）,relative high risk （gradeⅢ,n=16,ILI%=7.76%±3.53%）,general risk（gradeⅣ,n=57,ILI%=6.31%±2.26%）,relative low risk （gradeⅤ,n=32,ILI%=5.37%±1.96%）and low risk （grade Ⅵ,n=37,ILI%=4.30%±1.40%）. The concordance rate between the forecast risk and actual risk was 70.00% （14/20）. Conclusion This influenza forecasting model could well forecast the levels of influenza risk each week.

SUMO4 Met55Val variation was shown to be related to type 2 diabetes susceptibility and the vascular complications in Asian people. To further examine the related mechanisms, this study was designed to evaluate the association of SUMO4 Met55Val polymorphism with insulin resistance and β cell function in newly diagnosed type 2 diabetic patients in a Chinese population. Four hundred and twenty seven newly diagnosed type 2 diabetic patients were selected for SUMO4 Met55Val polymorphism genotype analysis. All subjects underwent a 75-g oral glucose tolerance test (OGTT) to estimate the insulin sensitivity and β cell function. Anthropometrics and a metabolic profile were used for phenotyping analysis. The results showed that the SUMO4 Met55Val polymorphism was associated with higher insulin resistance (P<0.001) and lower insulin sensitivity (P<0.001). Patients with GG genotype had higher levels of plasma glucose, insulin and C peptide. Insulin sensitivity index (ISI) was closely correlated with body mass index (BMI) in patients with GG genotype in comparison to the counterparts with AG or AA genotype (r= -0.504 vs. r= -0.430 vs. r= -0.340). Multiple regression linear analysis showed that SUMO4 Met55Val polymorphism was an independent determinant for insulin sensitivity (P=0.001), which, along with triglyceride, BMI and sex, could account for 20.1% of the variation in ISI. The result remained the same after adjusting for BMI and sex. No association was found between SUMO4 Met55Val polymorphism and β cell function (all P>0.05). It was concluded that SUMO4 Met55Val variant was associated with increased insulin resistance in Chinese patients with newly diagnosed type 2 diabetes.