ObjectiveTo investigate rational surgical approaches for Siewert type Ⅰ adenocarcinoma of the esophagogastric junction (AEG),and analyze the prognostic factors.MethodsThe clinical data of 103 patients with Siewert type Ⅰ AEG who were admitted to the Renji Hospital from January 2005 to December 2009 were retrospectively analyzed.All patients were divided into transthoracic approach group (61 patients) and thoracoabdominal approach group (42 patients).The incidences of numbers of lymph node dissected and postoperative complications of the 2 groups were compared using the chi-square test,Fisher exact probability or the t test.The survival curve was drawn by the Kaplan-Meier method and the survival was analyzed using the Log-rank test.Prognostic factors were analyzed using the one-way analysis of variance and Cox regression model.ResultsNo perioperative death was observed in the 2 groups.There were significant differences in the number of lymph node dissected and number of metastatic lymph node between the 2 groups (t =2.18,2.29,P ＜ 0.05 ).There was no significant difference in splenic injury between the 2 groups (P ＞ 0.05 ).There were no significant differences in postoperative bleeding,anastomotic fistula and stricture,esophagogastric reflux,pulmonary infection and esteomyelitis between the 2 groups (x2 =0.07,0.94,0.22,1.41,0.17,P＞0.05).Of the 103 patients,97(94.2％) were followed up.The mean postoperative survival time was 26 months.The median survival time was 26 months,and the 3-yearsurvival rate was 35.9％.The 3-year survival rates of transthoracic approach group and thoracoabdominal approach group were 32.8％ and 40.2％,with no significant difference between the 2 groups ( x2 =0.37,P ＞ 0.05).The results of univariate analysis showed that radical or palliative resection,TNM stage,lymph node metastasis stage,tumor diameter and metastasis rate,degree of radical resection were independent factors influencing the prognosis of patients with Siewert type Ⅰ AEG (x2 =21.07,26.04,22.42,6.26,32.20,20.80,P＜0.05).The results of multivariate analysis showed that degree of TNM stage,lymph node metastasis rate and radical resection were independent factors influencing the prognosis of patients ( Wald =12.01,8.75,10.03,P ＜ 0.05 ).Conclusions Thoracoabdominal approach is a reasonable selection for patients with Siewert type I AEG.Degree of TNM stage,lymph node metastasis rate and radical resection were independent risk factors influencing the prognosis of patients.

Objective To study the chemical constituents of Bombycis Feculae. Methods Chemical constituents were isolated BPLC-ELSD. The structures of the isolated compounds were determined by spectral means. Results Two compounds were isolated and identified as 1-deoxynojirimycin (1) and (2R,3R,5R)-2-(hydroxymethyl)piperidine-3,5-diol, named as 1,3-dideoxygalatonojirimycin (2). Conclusion Compound 2 is a new alkaloid. The extract of Bombycis Feculae, compound 1 and compound 2 show inhibitory activities against a-glucosidase.

In order to optimize acupuncture protocol for stephenipodia after stroke, related papers of the recent 20 years are retrieved. Interrelated factors which may influence the therapeutic effect of acupuncture are analyzed through the aspects such as acupoints, needling methods and opportunities of acupuncture. It is held that importance should be attached on relation between acupoints and anatomy during acupoint selection. Different acupuncture protocol can be adopted in different phases of stephenipodia according to its time of occurrence. And it is found that the combination of acupuncture and rehabilitation can reinforce the therapeutic effect. Relationship between effect of acupuncture and patient's condition, acupoint selection and prescription, acupuncture manipulations (including directions, angles, reinforcing and reducing, quantity of stimulus) are worth to be further studied. On the base of the above all mentioned studies, optimization can be carried out on selection of acupoints and acupuncture manipulations. And therapeutic effect can be enhanced when the optimized acupuncture protocol is combined with rehabilitation therapies.
Acupuncture Points ; Acupuncture Therapy ; Foot Diseases ; etiology ; therapy ; Humans ; Stroke ; complications

OBJECTIVESTo investigate the effects of microcystins on cell cycle and expressions of c-fos and c-jun, and explore the potential carcinogenic mechanisms of Microcystins.

METHODSMicrocystic cyanobacteria extraction (MCE) purified by Sep-Pak C(18) cartridge was added into the media and co-incubated with SHE cell for various periods. Immunohistochemistry assay was applied to detect the expressions of c-fos and c-jun at 1, 3, 6 hr time point, and cell cycle at 6, 12, 24 hr point were analyzed by flow cytometry respectively.

RESULTSSustained up-regulated expression of c-fos and c-jun were induced by MCE during the experimental period, and 5 - 6 folds increased expression were observed at 6 hour point after treatment. As much as 44.8 per cent of cells were induced to entry S-phase from resting G(0)/G(1).

CONCLUSIONUp-regulating the expression of transcript factor such as c-fos and c-jun thus to induce cell abnormal proliferation may be the potential carcinogenic mechanisms of microcystins.

Animals ; Carcinogens ; toxicity ; Cell Cycle ; drug effects ; Cell Division ; drug effects ; Cells, Cultured ; Cricetinae ; Gene Expression ; drug effects ; Microcystins ; Peptides, Cyclic ; toxicity ; Proto-Oncogene Proteins c-fos ; biosynthesis ; Proto-Oncogene Proteins c-jun ; biosynthesis

Objective To study the effects and preliminary mechanism of Stattic (Y705),an inhibitor of the signal transducer and activator of transcription-3 (STAT3),on the growth,migration,invasion and radiosensitization of hepatocellular carcinoma cell line Bel-7402.Methods Bel-7402 cells were divided to four groups:blank control group,Stattic treatment group,radiation group,and Stattic combined with radiation group.The cell growth and proliferation were detected by using CCK8 kit.The influence of Stattic on radiation sensitivity of Bel-7402 cells was determined by clone formation assay.The cell migration and invasion ability were tested by scratch migration assay and transwell assay,respectively.The protein expressions of STAT3,p-STAT3,Bax,Bcl-2,Caspase-3,Cleaved Caspase-3,MMP-2 and MMP-9 were quantified by Western blotting assay.Results Stattic significantly inhibited the growth of human hepatocellular carcinoma Bel-7402 cells with a dose-depended manner.The IC50 of Stattic after 48 h treatment was 2.5 μ mol/L.When 1.0 μmol/L Stattic was combined with 8 Gy X-rays,there was a synergistic effect in inhibition of cell proliferation with a inhibition rate of (15.00 ± 1.87) ％ (F =63.30,P ＜ 0.05).Scratch migration assay and transwell invasion assay showed that the migration and invasion abilities of the combination group were significantly reduced.In addition,compared with the radiation group,the SF2,D0and Dq values obtained from survival curve were decreased (t =4.20,6.92,9.32,P ＜0.05),the protein expressions of p-STAT3,MMP-2,MMP-9 were reduced (t =5.32,6.02,13.26,P ＜0.05),the protein expressions of Bax and Cleaved Caspase-3 were increased in the combination group(t =-7.82,-14.09,P ＜ 0.05),meanwhile the protein expressions of Bcl-2 was decreased (t =18.43,P ＜ 0.05).When the concentration of Stattic was 0.5 μmol/L,the radiation sensitization ratio at 2 Gy (SERSF2) was 1.22.Conclusions By inhibiting the activation of the p-STAT3 in Bel-7402 cells,stattic could induce cell apoptosis and increase the radiosensitivity,down regulate MMP-2 and MMP-9 and thereby reduce the invasion and migration of tumor cells.

Objective To determine the effect of deferoxamine administration on autophagy in a rat model of blast-induced brain injury.Methods Thirty-nine male SD rats were allotted to shamoperated group,injury group and deferoxamine group with 13 rats in each,according to the random number table.Feeney's method was applied to establish the model.Deferoxamine group received deferoxamine of 100 mg/kg intraperitoneally.Sham-operated and injury group were injected with saline intraperitoneally.All treatments were started two hours postinjury at 12 hour interval for up to 28 days.Hemoglobin,rectal temperature,blood glucose and mortality were detected at 1,3,7,14 and 28 days.Morris water maze was conducted.Rats were killed later for detecting the brain defect volume and level of Beclin 1 at the site of injury.Results There were no significant differences among the three groups with respect to hemoglobin,rectal temperature and blood glucose (P ＞ 0.05).Mortality in injury versus deferoxamine groups did not differ significantly (P ＞ 0.05).Volume of defected brain in deferoxamine group was (115.35 ± 13.70) mm3,smaller than (209.99 ± 16.70) mm3 in injury group (P ＜ 0.05).In Morris water maze test,the time spent in the searching the platform and latency to reach the platform were improved in deferoxamine group compared to those in injury group [(3.13 ± 0.35) vs (2.13 ± 0.64);(36.15 ± 26.63) s vs (110 ± 47.34) s respectively] (P ＜ 0.05).Both immunohistochemisty and western blot showed dramatically increased level of Beclin 1 after injury,but treatment with deferoxamine significantly reduced the Beclin 1 expression.Conclusion Level of Beclin 1 is significantly upregulated after blast-induced brain injury in rats,resulting in elevated autophagy postinjury,but the treatment with deferoxamine is neuroprotective possible by lessening autophagy damage.

Objective: Diuresis and removing urinary calculus action of Jieshitong tablet were studied. Methods: Metabolic cage method of rats was adopted to be engaged in diuresis experiment; glycol and ammonium chloride had been given orally for 30 days to form concretion model so that a removing urinary calculus trial could be done. Results: High and low doses of Jeshitong tablet both had significant diuresis effect, total urinary output in 3h of drug group increased about 50% than that of control group. Concretio formative rates of Jeshitong tablet group significantly decresed; the stronger removing urinary calculus action, the higher Jieshitong concentraction was. Conclusion: Jieshitong tablet had diuresis and removing urinary calculus action.

Objective The three-dimensional reconstructed images of maximum intensity projection (MIP) for membranous labyrinth and internal auditory meatus in Chinese adults were observed and measured in order to provide anatomic basis for otolosurgery and nerosurgery. Methods Thirty inner ears of 15 volunteers were scanned by using a circular temporal coil and three-dimension fast spin echo sequence with a 1^5T GE-signal MRI scanner. All original images were transferred to MRI workstation and all the structures of inner ear were reconstructed, rotated from various angles and measured by using maximum intensity projection. All the data were analyzed using SPSS 10.0 software. Results Anatomic structures of membranous labyrinth and internal auditory meatus were well demonstrated in three-dimensional reconstructed images of MIP in all volunteers. All three semicircular ducts, utricle, saccule, cochlear duct and internal auditory meatus produced high intensity signal. The results of measurement were statistically in significant.Conclusion Three-dimensional reconstruction of MlP might document, lively, stereoscopically and directly, the minute structures of membranous labyrinth and internal auditory meatus. We provide the basic data for the establishment of the MRI measurement criterion of inner ear.

Objective To explore the CT findings of mucoepidermoid carcinoma (MEC) of the tracheobronchial tree and improve the diagnostic accuracy. Methods The CT images, histopathological and clinical data in 24 patients with pathologically proved MEC of the tracheobroncbial tree were retrospectively analyzed. Results The clinical symptoms included cough, sputum, fever, wheezing, chest pain and hemoptysis. The patient was proved to be low-grade (n=19) and high-grade (n=5) MEC histopathologically. One lesion was located in trachea, 6 in main bronchus, 12 in lobar bronchus and 5 in segmental, subsegmental and distal bronchus. The tumor presented as no-invasive endotracheobronchial well-defined round-like nodule (n=13, locating in lobar and higher bronchus) and columnar sharp (n=3, locating in main bronchus), or intra-and-extraluminal well-defined round-like nodule or mass (n=6, locating in lobar and lower bronchus) and irregular mass with invasive pattern (n=2, high-grade type). The density of lesion was similar to the muscule and the calcification within lesion was showed in 4 patients on non-enhanced CT. The lesion had marked enhancement in 17 patients on enhanced CT. Obstructive changes were found in 20 patients. Conclusion MEC of the tracheobronchial tree is usually low-grade malignancy and locates in main and lobar bronchus with no-invasive well-defined airway mass, marked enhancement and calcification on CT.

Objective To compare the early results of total knee arthroplasty using high flexion (HF) versus standard posterior-stabilized (PS) prosthesis tibial insert. Methods From February 2005 to July 2008, 203 patients (216 knees) underwent total knee arthroplasty using Genesis Ⅱ prosthesis and were randomly distributed into group A (98 patients with 107 knees, HF insert) or group B (105 patients with 109 knees, PS insert). There were no significant differences between the two groups in the preoperative Knee Society score (KSS) knee score, KSS function score, and range of motion. They were followed-up for 1 year and compared using KSS knee score, KSS function score and range of motion. Results 91 patients (98 knees)were followed up in group A, and 94 patients (96 knees) were followed up in group B. The postoperative knee active range of motion was 121.1°±6.9° in group A, and was 118.6°±8.1° in group B. The improvement of knee active range of motion was 17.1°±13.3° in group A, and was 16.1°±18.8° in group B. The postoperative range of passive motion of group A and group B were 127.2°±7.1° and 121.0°±7.8° respectively. The postoperative KSS knee score was 86.9±7.6 in group A, and was 87.5±6.8 in group B. The postoperative KSS function score was 91.2±8.7 in group A, and was 90.1±9.3 in group B. The range of passive motion of groupA was better than that of group B (P ＜0.05). There were no significant differences between the two groups in other aspects. Complications include deep vein thrombosis (DVT), 4 patients in group A and 3 in group B,wound fat liquefaction, 3 patients in group A and 5 in group B, synarthrophysis, 2 patients in group A and 3 in group B. Conclusion This prospective randomized clinical trial demonstrates no differences between PS and HF in early clinical outcomes, except the range of passive flexion.