Objective To evaluate the safety and efficacy of laparoscopy-assisted total gastrectomy (LATG) for gastric cancer by systematic review and meta-analysis.Methods The literature database before February,2012 was extensively searched to retrieve the comparative studies of LATG and open total gastrectomy(OTG) with a relevance of study goal.The inclusion and exclusion criteria were formulated.Aftera quality evaluation,the data was extracted.The Cochrane collaboration RevMan 5.1 version software was used for meta-analysis.Results There are ten studies meeting the inclusion criteria for meta-analysis.The total sample size of these studies was 942 cases.Compared to OTG,LATG experienced longer operation time [weighted mean difference(WMD) =41.12 min,95％ confidence interval(CI):20.62-61.63,P ＜0.01)],less blood loss(WMD =-198.36 ml,95％ CI:-300.94--95.78,P ＜ 0.01),earlier time to flatus(WMD =-0.80 days,95％ CI:-1.17--0.42,P＜0.01),shorter hospital stay(WMD =-4.02days,95％ CI:-6.03--2.01,P ＜ 0.01) and decrease in overall complications [relative risk (RR) =0.55,95％ CI:0.40-0.76,P ＜ 0.01)].The number of dissected lymph nodes,proximal or distal resection margin and mortality were similar between the two groups.Conclusions Laparoscopy-assisted total gastrectomy is a safe and feasible procedure with less blood loss,less overall complications and quick recovery.

BACKGROUNDThe heavy incidence and mortality of hemorrhagic fever with renal syndrome, as well as no specific drugs in curing the disease, clearly indicate the need for development of the more effective hantavirus vaccine. Refining the DNA vaccination strategy to elicit more clinically efficacious immune responses is now under intensive investigation. In the present study, we examined the effects of using an interleukin-12 expression plasmid as a genetic adjuvant to enhance the immune responses induced by a DNA vaccine based on the S gene encoding nucleocapsid protein against hantavirus.

METHODSBALB/c mice were immunized three times by intramuscular inoculations of DNA vaccine encoding of hantanvirus nucleocapsid protein alone or in combination with a plasmid expressing murine interleukin-12 (pcIL-12). Booster immunizations were employed 2 times at 2-week interval. To evaluate the humoral and cellular immune responses, antigen-specific lymphocyte proliferation and antibody production were assayed by MTT method and ELISA respectively. The level of interleukin-4 and interferon-gamma in the splenic lymphocytic cultured supernatant were detected with ELISA kit at day 5, 10, 17, 35 and 42 after primary immunization.

RESULTSAntigen-specific IgG antibodies was increased markedly at day 17 in the experiment groups and reached a plateau after day 35. As pcIL-12 co-injected, a significant inhibition of antigen-specific IgG levels was displayed over the period and the antibody mean titre was decreased to only about 1:50 at day 42 after primary immunization, significantly lower than the group immunized with pcDNA3.1 + S alone, in which the mean titre was about 1:70. Interferon-gamma was increased remarkably by the co-injection of pcIL-12 compared with the injection of pcDNA3.1 + S alone. However, the production of interleukin-4 was inhibited by pcIL-12 co-injection. Furthermore, pcIL-12 co-injection efficiently enhanced antigen-specific lymphocyte proliferation.

CONCLUSIONHumoral and cytokine responses elicited by pcDNA3.1 + S inoculation can be modulated by co-inoculation with pcIL-12 and efficiently induced Th1-dominant immune responses.

Animals ; Cytokines ; biosynthesis ; Genetic Therapy ; Hantavirus ; immunology ; Immunoglobulin G ; blood ; Immunophenotyping ; Interleukin-12 ; genetics ; Lymphocyte Activation ; Male ; Mice ; Mice, Inbred BALB C ; Nucleocapsid ; genetics ; immunology ; Vaccines, DNA ; immunology ; Viral Vaccines ; immunology

Objective To observe the effect of Kidney-nourishing, Blood-activating, Phlegm-resolving and Resuscitation-inducing Decoction(KBPRD)on the expression of N-methyl-D-aspartate(NMDA)receptor subtype 1,2A,2B(NR1,NR2A,NR2B)in the cochlear spiral ganglion neurons(SGN)of tinnitus rats and to explore its mechanism, thus to provide experimental evidence for the treatment of tinnitus with KBPRD. Methods Sixty rats were randomly divided into normal group,model group,western medicine group,and low-,middle-,and high-dose Chinese medicine groups, 10 rats in each group. Rats were given intraperitoneal injection of sodium salicylate combined with water deprivation to induce tinnitus model. After successful establishment of the model, the rats in low-,middle-,and high-dose Chinese medicine groups were given gastric administration of KBPRD in the dosage of 5.5, 11, 22 g·kg-1·d-1 respectively, the rats in western medicine group were given gastric administration of 5 mg·kg-1·d-1 of carbamazepine,and rats in the model group and normal group were given gastric administration of 2 mL of normal saline,once every day,treatment time covering 8 weeks. The expression levels of NR1,NR2A,and NR2B in the cochlear SGN was detected by immunoblotting and real-time quantitative reverse transcription-polymerase chain reaction(qRT-PCR)after 8 weeks of treatment. Results Compared with the normal group,the expression levels of NR1, NR2A and NR2B in the model group were increased, the difference being significant (P < 0.05). Compared with the model group,the expression of NR1,NR2A and NR2B in low-,middle-,and high-dose Chinese medicine groups were significantly decreased(P<0.05).Conclusion KBPRD is effective on relieving tinnitus of rats, and its mechanism is correlated with lowering the increased expression of NR1,NR2A and NR2B in SGN of tinnitus rats.

Objective:To evaluate the diagnostic value of fractional exhaled nitric oxide (FeNO) in allergic asthma.Methods:A total of 147 cases of asthma patients who were newly diagnosed or non-standardly treated in the Respiratory Department of Zhongshan Hospital Affiliated to Fudan University from August 2015 to September 2016 were enrolled.The patients were divided into allergic asthma group (n =107) and non-allergic asthma group (n =40).Before standardized treatment,FeNO,lung function,and serum total IgE tests were performed.The receiver operating characteristic curve (ROC) was made to evaluate the diagnostic value of FeNO in allergic asthma.Results:The values of FeNO and total serum IgE were significantly higher in allergic asthma group than those in non-allergic asthma group (P＜0.05),but there was no statistical difference between these two groups in FEV1 ％ pred,FEV1/FVC,or FVC％ pred.In allergic asthma group,the FeNO level was positively correlated with serum total IgE (r=0.298,P＜0.001),but had no correlation with FEV1 ％pred,FEV1/FVC,or FVC％pred.There was no correlation between FeNO and serum total IgE,FEV1 ％,FEV1/FVC,or FVC％ in non-allergic asthma group.In allergic asthma group,there was no statistical difference in FeNO levels between positive and negative patients in the bronchial dilation test.The cut-off value of FeNO to differentiate allergic asthma was 40.05 ppb (1 ppb =1 μL/m3) according to the ROC curve (AUC 0.971,sensitivity 96.3％,specificity 85.0％).Conclusions:FeNO is significantly increased in newly diagnosed or non-standard treatment of allergic asthma and has positive correlation with serum total IgE.When the FeNO value is above 40.05 ppb,the diagnosis of allergic asthma is highly likely.

OBJECTIVETo investigate the feasibility, safety and oncological effect of totally laparoscopic total gastrectomy (TLTG).

METHODSThe clinical data of TLTG cases and open total gastrectomy (OTG) patients between November 2007 and October 2011 were analyzed. Also compared the feasibility, safety and short-term outcomes of TLTG with OTG.

RESULTSNinty cases were analyzed. There were 18 cases in the TLTG group and 72 cases in the OTG group. Operation time was significantly longer in the TLTG group ((310 ± 86) minutes) than in the OTG group ((256 ± 57) min, t = 4.963, P = 0.002), However, the blood loss were significantly lower in the TLTG group ((136 ± 84) ml vs. (359 ± 141) ml, t = -11.734, P = 0.000). The post operative morbidity was similar between the TLTG and OTG group. First flatus time (t = -7.020), first diet time (t = -6.166 and -5.698), and post operative hospital stay (t = -4.610) were significantly shorter in the TLTG group than in the OTG group (P < 0.05).

CONCLUSIONSLTG is a safe and feasible procedure with quick post-operation recovery. The laparoscopic side-to-side esophagojejunal anastomosis is a safe and feasible method of alimentary reconstruction after laparoscopic total gastrectomy.

Adult ; Aged ; Female ; Gastrectomy ; methods ; Humans ; Laparoscopy ; Laparotomy ; Length of Stay ; Lymph Node Excision ; Male ; Middle Aged ; Stomach Neoplasms ; surgery ; Treatment Outcome

OBJECTIVETo investigate the distribution patterns and proliferative activity of lymphatic vessels in colorectal carcinomas (CRC) and their relationship with tumor metastasis and disease prognosis.

METHODSThe microlymphatic density (MLD) and microvascular density in tumoral and non-tumoral areas of 96 cases of CRC were evaluated by immunohistochemistry, using monoclonal antibodies for podoplanin and CD34 respectively. The Ki-67 expression of the lymphatic and blood vessels was detected by double-labeling immunohistochemistry. The relationship between MLD and clinicopathologic features and prognosis was analyzed.

RESULTSThe lymph vessels at central and superficia1 portions of CRC often had a reticular architecture with numerous tiny and ill-defined lumina, while those at the tumor borders had large and open lumina. The MLD at tumor borders (51.2 +/- 25.5) was significantly higher than that in normal colorectal mucosa (29.4 +/- 9.0) and other portions of CRC (P < 0.01). The Ki-67 labeling index of the lymphatic lining cells at tumor borders (0.23 +/- 0.17) was significantly higher than that in other portions of CRC (P < 0.05). The MLD significantly correlated with lymphatic involvement by tumor cells, regional lymph node metastasis and distant metastasis (P < 0.01). The 5-year survival rate was also significantly lower in patients with high MLD (P < 0.05).

CONCLUSIONSNeolymphatic vessels are commonly seen in CRC, especially at tumor borders. High MLD at tumor borders is associated with metastasis. The detection of MLD at tumor borders may thus be useful in predicting lymph node metastasis and prognosis in patients with CPC.

Adenocarcinoma ; immunology ; pathology ; physiopathology ; Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms ; immunology ; pathology ; physiopathology ; Endothelium, Vascular ; immunology ; Female ; Follow-Up Studies ; Humans ; Ki-67 Antigen ; metabolism ; Lymphangiogenesis ; Lymphatic Metastasis ; Lymphatic Vessels ; pathology ; Male ; Middle Aged ; Prognosis ; Survival Rate

Objective To study the efficacy and safety of different dual antiplatelet therapy(DAPT)in patients with acute myocardial infarction(AMI)undergoing percutaneous coronary intervention(PCI)treatment.Methods AMI patients receiving PCI treatment were randomly divided into treatment group and control group.The treatment group was given clopidogrel(50 mg,bid)combined with ticagrelor(90 mg,bid)after PCI,while the control group was given aspirin(100 mg,qd)combined with clopidogrel(75 mg,qd)after PCI.The treatment course for both groups was 6 months.Platelet activation and endothelial function-related indicators were compared between the two groups,and major adverse cardiovascular events(MACE)and adverse drug reactions were followed up during the treatment period.Results During the trial,5 cases dropped out,and finally,98 cases and 97 cases were included in the treatment group and control group,respectively.After treatment,the incidence of stent restenosis in the treatment group and control group were 2.04％(2 cases/98 cases)and 9.27％(9 cases/97 cases),respectively;the incidence of MACE were 4.08％(4 cases/98 cases)and 13.40％(13 cases/97 cases),respectively,with significant differences between the two groups(P＜0.05).After treatment,the inhibition of platelet aggregation(IPA)in the treatment group and control group were(54.97±6.43)％and(52.38±6.12)％,respectively;the serum nitric oxide(NO)levels were(64.29±8.12)and(59.61±8.45)μmol·L-1,respectively;the prostacyclin(PGI2)levels were(42.15±3.94)and(38.46±3.71)ng·L-1,respectively;the maximum platelet aggregation rate(MPAR)were(31.65±3.86)％and(32.97±4.25)％,respectively;the platelet count(PC)were(169.84±36.71)× 109·L-1 and(172.63±38.94)× 109·L-1,respectively;the positive rates of P-selectin(CD62P)were(24.58±5.34)％and(27.13±5.82)％;the positive rates of platelet activated complex-1(PAC-1)were(7.63±2.15)％and(8.45±2.69)％;serum endothelin-1(ET-1)levels were(61.03±5.97)and(65.39±7.14)ng·L-1,which were significantly reduced compared with those before treatment(all P＜0.05).The adverse drug reactions in treatment group were mainly headache,dyspnea and bleeding events,and the adverse drug reactions in control group were mainly dyspnea and bleeding events.The total incidence rates of adverse drug reactions in treatment group and control group were 11.22％(11 cases/98 cases)and 9.28％(9 cases/97 cases),respectively(P＞0.05).Conclusion Cilostazol combined with ticagrelor in patients with AMI after PCI is beneficial to inhibiting the platelet aggregation and activation,relieving the vascular endothelial function injury and reducing the risk of in-stent restenosis and MACE,and it has obvious advantages over aspirin combined with clopidogrel.

OBJECTIVE: To explore the rule of point selection in treatment of cerebral palsy with acupuncture in preschool children. METHODS: Based on the electronic medical records of Xi'an Encephalopathy Hospital of TCM, through structuring medical record text, acupuncture prescriptions were extracted. Using the data mining tools of the ancient and modern medical record cloud platform V2.2.3 and the clinical effective prescription and molecular mechanism analysis system of traditional Chinese medicine V2.0, the cluster analysis and complex network analysis were conducted on acupuncture prescriptions. RESULTS: Of 1584 acupuncture prescriptions for cerebral palsy in children, there were 84 acupoints and stimulating areas of scalp acupuncture, of which, foot-motor-sensory area, balance area and Sanyinjiao (SP 6) were the top 3 acupoints with the highest use rate. With cluster analysis, 5 groups of common supplementary acupoints and stimulating areas were found, named, Weizhong (BL 40) and Waiguan (TE 5), Shousanli (LI 10), Xingjian (LR 2), Xuanzhong (GB 39) and Chengfu (BL 36), foot-motor-sensory area, balance area and Sanyinjiao (SP 6), Xuehai (SP 10) and Fenglong (ST 40), Pishu (BL 20), motor area and Yanglingquan (GB 34). With complex network analysis on core prescriptions, 13 core acupoints and stimulating areas of scalp acupuncture were obtained, including 3 core main points, i.e. Sanyinjiao (SP 6), balance area and foot-motor-sensory area and 10 sub-core points, i.e. Taichong (LR 3), motor area, Xuehai (SP 10), Ganshu (BL 18), Pishu (BL 20), Yanglingquan (GB 34), Sishencong (EX-HN 1), Baihui (GV 20), Fengchi (GB 20) and Shenshu (BL 23). CONCLUSION In treatment of acupuncture for cerebral palsy in preschool children, the core prescriptions reveal the simultaneous treatment of exterior and interior, the mutual regulation of
Acupuncture Points ; Acupuncture Therapy ; Cerebral Palsy/therapy* ; Child, Preschool ; Data Mining ; Electronic Health Records ; Humans

OBJECTIVETo explore the biological function of BMAL1 in human acute myeloid leukemia by means of the HL-60 cell line in whica circadian gene BMAL1 was konocked-out by the CRISPR/Cas9 technology.

METHODSTwo sgRNAs for BMAL1 were designed and the PX459 knockout vectors containing the sgRNA were constructed. The activity of 2 sgRNAs was detected by T7 endonuclease I. the BMAL1 knocked out HL-60 cells were prepared by transient transfection of the target vectors into the cells. Western blot was used to detect the expression of BMAL1 protein. The apoptosis of the targeted cells was detected by flow cytometry. The proliferation status of the cells was assessed by the CCK-8 assay.

RESULTSThe PX459-sgRNA vectors were successfully constructed and screened to assure the activity of the targeting vector. It was found that the expression of BMAL1 protein was not detected in BMAL1-knocked out HL- 60 cells. Further, it was shown that BMAL1 knockdout could promote the apoptosis of HL-60 cells and inhibit the cell proliferation ability.

CONCLUSIONBMAL1 knocked out HL-60 cells have bean successfully established using the CRISPR/Cas9 gene editing technique, and BMAL1 knockout can promote the HL-60 cell apoptosis and inhibit its proliferation.These result reveal the biological role of the BMAL1 circadian gene in acute myeloid leukemia.

Apoptosis ; Cell Proliferation ; HL-60 Cells ; Humans ; Leukemia, Myeloid, Acute ; Transfection

Aim To study the therapeutic effect of Balanophora polysaccharide(BPS)on gastric ulcer(GU)induced by acetic acid in rats and to investigateits mechanisms. Methods Sixty male SD rats were randomly divided into sham-operated group, GU model group, omeprazole positive group(3.6 mg·kg-1), and low, medium and high dose of BPS treatment groups(100, 200 and 400 mg·kg-1). The GU model group was prepared by acetic acid cautery method, and the morphology and pathological changes of ulcers were observed by visual observation combined with HE staining, and the ulcer area and inhibition rate were measured and calculated; superoxide dismutase(SOD)activity, malondialdehyde(MDA)content and glutathione peroxidase(GSH-PX)activity were measured by enzymatic assay; tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)content were detected by ELISA. The expression levels of epidermal growth factor(EGF)and epidermal growth factor receptor(EGFR)were measured by immunohistochemistry staining and Western blot. Results Compared with the sham-operated group, obvious ulcer damage was seen in the model group. Compared with the model group, the BPS-treated group showed a significant reduction in ulcer area, an increase in SOD and GSH-PX activity and EGF and EGFR expression levels, and a significant decrease in MDA, TNF-α and IL-6 content. Conclusions BPS has a therapeutic effect on GU in rats, and its mechanism may be related to the inhibition of oxidative stress, suppression of inflammatory stimuli and promotion of regenerative repair of gastric mucosa.