AIM: To investigate the application of biological amniotic membrane soaked in pirfenidone(PFD)and to evaluate its anti-scarring effect and toxic side effects on glaucoma model of rabbit eyes.METHODS: The right eyes of 72 healthy New Zealand white rabbits were randomly divided into 0.5%PFD+ biological amniotic membrane group, biological amniotic membrane group, mitomycin C(MMC)group and blank control group after the glaucoma model was established by anterior chamber injection of compound carbomer solution, and 18 rabbits in each group underwent trabeculectomy, in which the 0.5% PFD+ biological amniotic membrane group was placed with 0.5% PFD solution-soaked biological amniotic membrane under the scleral flap, and the biological amniotic membrane group was placed with normal saline-soaked rehydrated biological amniotic membrane under the scleral flap. In the MMC group, a cotton pad soaked in MMC was placed under the scleral flap for 3 min and immediately rinsed with normal saline, while the blank control group received no implant after the scleral flap was made. The intraocular pressure(IOP), filtration blebs, toxic side effects and complications were evaluated, and the histopathological changes in the filtration area were observed by hematoxylin-eosin(HE), Masson staining and immunohistochemical staining.RESULTS: The mean IOP at 14, 21 and 28 d after trabeculectomy were 0.5%PFD+ biological amniotic membrane group<MMC group<biological amniotic membrane group<blank control group(all P<0.05). At 28 d after trabeculectomy, 0.5%PFD+ biological amniotic membrane group had the best effect of anti-inflammatory hyperplasia and inhibition of collagen formation, the highest survival rate of filtration blebs, and the inflammatory reaction was mild.CONCLUSION: Biological amniotic membrane soaked in pirfenidone has more obvious anti-scarring effect on glaucoma model, with less toxic side effects and good safety.

OBJECTIVETo explore the effect of nano carbon tattooing on the lesion localization in the early colon cancer for additional surgical procedure after endoscopic resection.

METHODSThirty-five patients with early colon cancer accepted additional surgical procedures after endoscopic resection in Fuzhou General Hospital of PLA from May 2014 to November 2016. All the patients underwent nano carbon tattooing before the end of endoscopic resection: 0.1 ml carbon nanoparticles suspension was respectively injected into the normal intestinal submucosa from 1 cm outside the 4 sites (upper, lower, left and right) of the lesion border by colonoscopy, marking the original lesion location and guiding the subsequent additional surgery. Data of these 35 cases were summarized.

RESULTSAll the 35 cases, including 22 males and 13 females, with a mean age of 46.5 years(range 35-70), completed the endoscopic disposable carbon nano marking, and the mean operative time was 7.5 minutes(range 5-10). No bleeding, no perforation and no adverse reaction occurred. Four to 21(10±3.5) days after endoscopic resection, the patients received the additional surgery as a result of pathological specimens of endoscopic resection in 10 cases of vascular invasion, 7 cases of severe submucosal infiltration, 7 cases of more than grade G2 in tumor budding, 6 cases of poorly differentiated adenocarcinoma and undifferentiated carcinoma, and 5 cases of positive margin. All the patients underwent laparoscopic surgery. The mean time of intraoperative detection and lesion location was 3.0 minutes(range 1-5). All tattooings were clearly visible under the naked eye. The colon wedge resection were performed in 5 cases, colon segment resection in 14 cases, and radical resection of colon cancer in 16 cases. The operative time was 45 to 180(120±30) min, and the blood loss was 50 ~ 200(50±15) ml. There was no intraoperative complications. The first gas passage time was 12 to 48(24±8) h. The postoperative hospital stay was 10 to 3(6.5±2.5) d. There was no postoperative complication and no perioperative mortality.

CONCLUSIONNano carbon tattooing is helpful for the accurate location of primary lesions in the additional surgical operation after endoscopic resection of early colon cancer, and it can improve the safety and precision of surgical procedures, especially for laparoscopic surgery.

The mesoporous silica nanoparticles (MSN) in different pore size and sirolimus (SRL) loaded self-microemulsifying drug delivery system (SMEDDS) were prepared. The results in morphology were collected by scanning electron microscope, transmission electron microscope, small-angle X-ray diffraction, and N₂ adsorption-desorption. The results showed that the prepared MSN has ordered nanochannels with a pore size of 6.3, 8.1, 10.8 nm, respectively. The particle size of SRL-SMEDDS were measured by particle sizing system, which was 20.6±1.3 nm. The stirring method was developed to prepare SRL-SMEDDS-MSN. It was found that the optimal ratio of SRL-SMEDDS to MSN was 2:1, while the drug loading rate was near 0.83%, and the flow properties of SRL-SMEDDS-MSN were of good condition. The differential scanning calorimetry results proving a molecular or amorphous dispersed state of SRL in MSN while the suspension experiment has shown great reconstitution properties of SRL-SMEDDS-MSN. There is no significant influence on maximum drug release rate of different pore size of SRL-SMEDDS-MSN in 250 mL water within 2 h, while the results of the first 40 min have an obvious difference. Above all, MSN might provide a new strategy for the solidification of SMEDDS.

Adult ; Aged ; Female ; Gastric Mucosa ; drug effects ; pathology ; Gastrointestinal Agents ; adverse effects ; therapeutic use ; Gastrointestinal Hemorrhage ; drug therapy ; etiology ; Humans ; Hypertension, Portal ; complications ; drug therapy ; Male ; Middle Aged ; Octreotide ; adverse effects ; therapeutic use ; Pituitary Hormones, Posterior ; adverse effects ; therapeutic use ; Treatment Outcome ; Vomiting ; chemically induced

OBJECTIVETo investigate the expression of focal adhesion kinase (FAK) in breast carcinoma tissues and its association with microvessel density (MVD), and explore the relationship between FAK-mediated cell signaling and angiogenesis in breast carcinoma.

METHODSFAK and CD34 expressions were examined by immunohistochemistry with SP method in 88 breast carcinoma tissues and 30 tissues of benign breast disease. The correlations of FAK protein expression with MVD marked with CD34 and clinicopathological parameters were analyzed in breast carcinoma.

RESULTSIn the 88 breast carcinomas, the positivity rate of FAK was 68.2% (60/88) with MVD of (34.52-/+13.11) /HPE, showing significant differences from those of the benign disease group (P<0.01). FAK expression and MVD in breast carcinoma tissues were positively related to tumor size, axillary lymph node metastasis and clinical stage (P<0.05), but not to the patients' age or histopathological grade of the tumors (P>0.05). In breast carcinoma, the expression of FAK was positively related to MVD (P<0.01).

CONCLUSIONSFAK protein expression and MVD are closely correlated with the invasion and metastasis of breast carcinoma. FAK expression can promote angiogenesis of breast carcinoma.

Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; genetics ; metabolism ; pathology ; physiopathology ; Cytoplasm ; metabolism ; Female ; Focal Adhesion Protein-Tyrosine Kinases ; metabolism ; Gene Expression Regulation, Neoplastic ; Humans ; Immunohistochemistry ; Middle Aged ; Neoplasm Invasiveness ; genetics ; Neovascularization, Pathologic ; metabolism

Objective: Preliminary study on the clinical effect of preoperative ultrasound endoscopy combined with staining labeling technique to locate the actual boundary of esophageal and gastric cancer Methods: From September 1, 2015 to October 30, 2017, 18 patients with esophageal adenocarcinoma were enrolled in this study. The actual boundaries of esophageal and gastric-derived adenocarcinoma lesions were localized by endoscopic ultrasonography and staining. There were 10 males and 8 females. After completing the preoperative examination, 1-2 days before operation, endoscopic ultrasonography was used to locate the edge of the lesion. Two point injection of carbon nano suspension was used to mark the location of 1cm at the longest distance from the longitudinal axis of the tumor. According to the length of longitudinal axial staining, the thoracotomy was performed. Intraoperative proximal margin resection was used to send frozen pathology. According to the results of freezing, the operation was decided. After the operation, the specimens from the margin of the tumor were segmented into paraffin section, which was about 0.5cm in each segment, and the tumor cells were observed under the electron microscope at all levels of the paraffin sections. Results: The average time of preoperative endoscopic ultrasonography staining was(10.16±1.38) min, and the diameter of nano carbon diffusion was(1.43±0.41)cm. All patients in the operation could clearly see the nano carbon staining area under the naked eye. In the field, the average time of locating lesions was(1.27±0.53)min. 5 patients underwent thoracoabdominal surgery and 13 underwent abdominal surgery. The average length of the cut margin of the tumor was(4.74±1.12)cm, and the frozen pathology of the incision margin was negative, and no additional operation was performed. The routine pathology confirmed that all the specimens were negative. Conclusion The staining and labeling technique for adenocarcinoma of the esophagogastric junction under endoscopic ultrasonography can detect the tumor edge and the scope of invasion accurately. It provides guidance and guarantee for the smooth implementation of AEG precision surgery. It is a safe, rapid and effective positioning technique.

OBJECTIVE: To evaluate the preliminary clinical effective of open decompression, microwave ablation combined with open vertebroplasty and pedicle screw rod system in the treatment of spine metastases. METHODS: The clinical data of 12 patients with spine metastases were retrospectively analyzed, they were treated with open decompression, microwave ablation combined with open vertebroplasty and pedicle screw rod system between January 2014 and January 2016. Six males and 6 females were included, aged from 30 to 75 years old with an average of 55.6 years. There were 5 cases with spine metastases from lung cancer, 2 from breast cancer, 2 from thyroid cancer, 2 from renal cancer and 1 from liver cancer. Sevencases were thoracic metastases and 5 cases were lumbar metastases. Tomita score were mainly arranging from 3 to 6 points. According to ASIA neurologic grading system, 3 patients were grade C, 1 was grade D, 8 were grade E. Preoperative VAS score was 8.3±0.4. VAS was used to evaluate the clinical effect at 1, 3, 6 months after operation and final follow-up. RESULTS: All operations were successful and the amount of blood loss during surgery was 500 to 2 050 ml (average of 850 ml), operation time was 3.5 to 5.5 h (average of 4.5 h). There was no nerve root injury during surgery. Cerebrospinal fluid leakage occurred in 3 cases after surgery, which were healed after conservative treatment. Superficial infection of the incision occurred in 2 cases, which were healed after dressing change. There was one case of pulmonary infection. No deep infection, lower limb thrombosis or other complications were found. All 12 patients were followed up for 9 -40 months with an average of 28.6 months. The clinical symptoms of all patients were significantly improved, and the motor function of the lower limbs was recovered to varying degrees. According to ASIA grade, 2 cases of grade C were improved to grade B;1 case of grade C did not recover significantly;1 case of grade D was improved to grade E. One patient died of primary liver cancer 10 months after surgery. Local tumor recurrence occurred in 1 patient during follow up period. The VAS scores were 2.7±0.6, 2.5±0.4, 2.6±0.5, and 2.5±0.5 at 1, 3, 6 months after surgery and at final follow-up, which were significantly improved compared with the score before surgery(<0.05). CONCLUSION Open decompression, microwave ablation combined with open vertebroplasty and pedicle screw rod system in the treatment of spine metastases show some effects, with less intraoperative blood loss, shorter operation time, significant postoperative pain relief, and low tumor recurrence rate.
Adult ; Aged ; Female ; Humans ; Lumbar Vertebrae ; Male ; Microwaves ; Middle Aged ; Pedicle Screws ; Retrospective Studies ; Thoracic Vertebrae ; Treatment Outcome ; Vertebroplasty

Objective To investigate the clinical efficacy of low-frequency transcranial magnetic stimulation (rTMS) on post-stroke upper limb spasticity and its mechanism. Methods From September, 2015 to December, 2017, 23 patients with post-stroke upper limb paralysis were randomly divided into control group (n=13) and experimental group (n=10). Both groups received routine rehabilitation, and the experimental group received 1 Hz rTMS at primary motor area (M1) for eight weeks. They were assessed with modified Ashworth Scale (MAS), modified Barthel Index (MBI) and Fugl-Meyer Assessment-Upper Extremities (FMA-UE) before and after treatment, while the activation under fMRI in the task state was observed and the laterality index (LI) was calculated. Results The scores of MAS, FMA-UE and MBI improved after treatment in both groups (Z>2.121, t=6.248, P<0.05), and improved more in the experimental group than in the control group (Z>2.084, t=-2.095, P<0.05). The ipsilateral M1, ipsilateral sensory motor cortex and bilateral supplementary motor area were activated more in the control group than in the experimental group during the movement of affected hand. LI in the M1 increased after treatment in both groups (Z>2.366, P<0.05), and was more in the experimental group than in the control group (Z=-2.430, P<0.05). There was a positive correlation between the change of LI in the M1 and the improvement of the MAS and FMA-UE (r>0.612, P<0.05). Conclusion Low-frequency rTMS may improve the motor function and spasticity of upper limb after stroke by promoting reorganization of the cortex and inducing normalization of cortical function.

Objective To investigate the therapeutic effectiveness of endoscopic self-expandable metal stent implantation for hilar cholangiocarcinoma. Methods The clinical data of 73 patients with hilar cholangiocar-cinoma who had received endoscopic metal stent implantation at the General Hospital of PLA Chengdu Command from July 2004 to July 2009 were retrospectively analyzed. The success rate of stent implantation, effective rate of jaundice release, duration of patency of the stent, survival time and postoperative complications were analyzed. Results Among the patients, 70 were successfully implanted with the stents. Unilateral metal stents were implan-ted in 62 patients, bilateral metal stents in three patients, and metal + plastic stents in five patients. The effective rate of jaundice release was 87% (61/70), the median duration of patency of the stent was 190 days, and the median survival time was 246 hours. Seven patients had complications of cholangitis, three had pancreatitis and two had bleeding. Conclusions The advantages of endoscopic metal stent implantation include minimal trauma and good efficacy in alleviating jaundice. It is the option of choice for the treatment of malignant biliary obstruction in patients with inoperable hilar cholangiocarcinoma.

OBJECTIVETo prepare gastric floating sustained-release formulation of Tripterygium wilfordii by using multiparticulate time-controlled release technology.

METHODThe intra-gastric floating blank-pellets were made by extrusion-spheronization method with 10% MCC as diluent and 90% cetylalcohol as floating assistant. The drug-loaded pellets were prepared in a fluid-bed coater with 1% HPMC, 0.5% SDS and extraction of T. wilfordii as coating solution. The gastric floating time-controlled release pellets were prepared with 3% L-HPC, 1% HPMC and 1% SDS as the inner swelling layer and ethylcellulose aqueous dispersion as the outer controlled layer. Finally, gastric floating sustained-release capsules of T. wilfordii were developed by encapsulating the five kinds of coated pellets whose coating load were 0%, 8%, 12%, 15% and 22% at equivalent ratio in hard gelatin capsules.

RESULTAfter formulation and coating load of swelling layer was fixed, the coated pellets would release active compositions in the different time expectably through regulating coating level of controlled layer. Several kinds of coated pellets whose controlled layer had different coating load were mixed and encapsulated into gastric floating sustained-release capsules of T. wilfordii. The capsules could float immediately in the dissolution medium and the floating rate of pellets was more than 80% in 8 h. The various kinds of coated pellets could release active compositions in accordance with time and show a characteristic of sustained-releasing as a whole.

CONCLUSIONThe gastric floating sustained-release capsules of T. wilfordii prepared by using multiparticulate time-controlled release technology have effective floating behavior and sustained release characteristics.

Capsules ; chemistry ; Chemistry, Pharmaceutical ; Delayed-Action Preparations ; chemistry ; Drug Delivery Systems ; methods ; Plant Extracts ; chemistry ; Tripterygium ; chemistry