Objective To investigate the number, distribution and metastatic rule of lymph nodes in the mesorectum of rectal cancer specimen after processing the recta] cancer specimen with modified fat clearance technique. Methods Sixty patients with mid-low rectal cancer who had been admitted to Peking University School of Ontology from 2003 to 2008 were assigned to test group. All the 60 patients who denied neo-adjuvant therapy were treated with total mesorectal excision, and the rectums resected were processed with the modified fat clearance technique. Rectums from another 50 patients with mid-low rectal cancer in control group were fixed in formalin solution for 24 hours. The mesorectum was divided into anterior, posterior, left and right quadrants, and each quadrant was further divided into upper, middle and lower parts. The numbers of lymph nodes harvested and metastatic rate of lymph nodes between the 2 groups were analyzed by t test and chi-square test. Results (1) The numbers of lymph nodes harvested in the test and control groups were 1436 and 525, with statistical difference between the 2 groups (t =- 12. 153, P <0.05). The number of small lymph nodes(diameter≤5 mm) harvested in test group was 985. (2) The numbers of lymph nodes harvested in the anterior, posterior and bilateral mesorectum were 125,696 and 615, respectively. The numbers of lymph nodes harvested in the upper, middle and lower part of the mesorectum were 395,534 and 507, respectively. The metastatic rate of lymph nodes in the upper part of the mesorectum was 18.5% (37/200), which was significantly lower than in the middle [43.5% (87/200)] and lower [38.0% (76/200)] part of the mesoreetum (X2= 9. 414, 6.406, P < 0.05). Two hundred metastatic lymph nodes in 33 patients were harvested, 48.0% (96/200) of which with a diameter of ≤ 5 mm. Twenty percent patients had their TNM stage changed after the retrieval of metastatic small lymph nodes. Conclusions Modified fat clearance technique significandy improves the retrieval of lymph nodes, and more small lymph nodes retrieved can increase the accuracy of staging. Rectal cancer cells have strong tendency to disseminate to the distal mesorectum. Adequate excision of the distal mesorectum is key in controlling the local recurrence.

Objective To explore the changes in plasma nitric oxide (NO) and nitric oxide synthase (NOS) activity in children with orthostatic hypertension(OHT) and the relationship with blood pressure changes.Methods The OHT group included 51 children who were diagnosed OHT in in-patient and out-patient departments of Peking University First Hospital from Jun.2012 to Jun.2013.Their age range was (12 ± 2) years.At the same time,control group consisted of 28 normal children who received physical examination with their age range of(12 ± 1) years.The diagnosis of OHT was based on the clinical manifestation and head-up tests.Plasma NO was determined by using a nitrate reductase method and plasma NOS activity by a chemical colorimetric method.Results 1.There were no significant differences between OHT group and control group in age,sex ratio,height,weight and body mass index (all P ＞0.05).2.In OHT children,the upright systolic blood pressure was higher than that of the supine [(114 ± 10) mmHg vs (104 ± 9) mmHg,t =-12.853,P ＜ 0.001],and the upright diastolic blood pressure was higher than that of the supine[(73 ±7) mmHg vs(59 ± 8) mmHg,t =-21.859,P ＜0.001].3.Plasma NO level and NOS activity,however,were significantly lower in OHT group than those in the control group [NO:(28.947 ± 6.031) μmol/L vs (35.216 ±6.662) μmol/L,t =4.257,P ＜ 0.001 ; NOS activity:(14.753 ± 3.060) U/mL vs (17.560 ± 4.253) U/mL,t =3.026,P =0.006].4.There was significantly negative correlation between plasma NO and the upright systolic blood pressure(r =-0.276,P ＜ 0.05) and the systolic blood pressure change (r =-0.280,P ＜ 0.05).Conclusions Plasma NO level and NOS activity were significantly lower in OHT children than those in control group.The abnormal vascular endothelial function may play an important role in OHT in children.

Objective To study the effect of urodynamic factors on the urinary retention of the patients with cervical cancer received radical hysterectomy. Methods Seventy-two patients with cervical cancer Ininternational Federation of Gynecology and Obstetrics (FIGO) stage Ⅰ bl to Ⅱ a hospitalized in Fujian Provincial Maternity and Child Health Hospital between June 2006 and August 2009, who were not found any abnormal representation of urodynamics before the operation, were divided into the group with urinary retention and the group without urinary retention based on whether urinary retention after the operation. All patients were detected by urodynamic examination following radical hysterectomy. Data obtained from urodynamic examination were analysed by logistic regression to evaluate the influence of urodynamic factors on the urinary retention postoperation. Results Twenty-one patients out of all were found with urinary retention after the operation , the incidence rate of urinary retention was 29%. The first sensation after operation in both groups were increased significantly than those before operation[ ( 171 ±61 )ml vs.(126 ±28)ml, (134±39)ml vs. (119 ± 17)ml,all P＜0.05], while the maximum volume[ (337 ±66) and (300 ±66)ml, respectively], the compliance[ (31 ±25) and (29 ± 18) ml/cm H2O (1 cm H2O =0. 098 kPa), respectively], the maximum flow rate[ (10 ±4) and (12 ±5) ml/s, respectively] and the pressure at the maximum flow rate [ (27 ±9) and (32 ±8) cm H2O, respectively] were decreased obviously after radical hysterectomy in both the group with urinary retention and the group without urinary retention ( all P ＜0.05), compared with the corresponding value before the operation. The urodynamic changes in urinary retention group was much more severe than those in group without urinary retention ( P ＜ 0. 05 ). The single factor analysis results showed that bladder destusor dysfunction ( OR = 8. 20, 95% CI: 2.62 - 25. 66, P ＜0. 01 ) and lack of sensation ( OR = 6. 90, 95% CI: 1.95 - 24. 43, P ＜ 0. 01 ) were relevant to the urinary retention post-operation. While there were not relationship was found between low compliance bladder( OR =1.99, 95% CI:0. 70 - 5.63, P = 0. 195 ), detrusor overactivity ( OR = 2. 51, 95% CI: 0. 73 - 8.67, P =0. 144), bladder outlet obstruction ( OR = 3.77, 95% CI: 0. 76 - 18. 57, P = 0. 104 ) or dyssynergia of urethral external sphincter( OR =2. 67, 95% CI:0. 49- 14. 45, P =0. 255 ) and urinary retention following the operation. There were an antagonistic effects ( OR = 7.60, 95% CI: 1.43 - 40. 39, P = 0. 017 ) of detrusor overactivity and bladder destrusor dysfunction on urinary retention. The multiple factors analysis results revealed that bladder destusor dysfunction( OR = 7.01, P ＜ 0. 01 ) and lack of sensation( OR = 5.45, P =0. 018)were the independent risk factors influening on the urinary retention post-operation. Conclusions There are obvious urodynamic change in cervical cancer patients following radical hysterectomy. Bladder destrusor dysfunction and lack of sensation are the independent urodynamic risk factors influencing on urinary retention following radical hysterectomy, while detrusor over activity may be a protective effect on bladder destrusor dysfunction post-operation in some degree. Urodynamic test is important for analysis and treatment of urinary retention following radical hysterectomy.

Objective To measure the longitudinal elastic modulus in patients with acute ischemic stroke by shear wave elasotography(SWE),and to study its feasibility and related factors.Methods There were 1 79 cases with acute ischemic stroke (AIS)including 103 cases with large artery atherosclerosis and 76 cases with lacunar infarction classified according to the TOAST classification.There were 168 age and sex-matched cases as control group.Pulse wave velocity (PWV ) of bilateral carotid was measured by radiofrequency ultrasound.The 20 areas of superficial walls of bilateral carotid artery were analyzed by SWE,and the average values of longitudinal average elastic modulus (MEmean ),the maximum elastic modulus (MEmax )and minimum elastic modulus (MEmin )were calculated.The independent factors of MEmean were analyzed using multiple linear regression analysis.Results ①Compared with control group, PWV in patients with AIS was increased (P <0.05).②The MEmax and MEmean of carotid artery in patients with AIS were more than those in the control group (P <0.05).③Age,systolic blood pressure,PWV and low-density lipoprotein cholesterol(LDL-C)were positively related to MEmean (r =0.221 ,0.1 74,0.776 and 0.1 73,respectively,P <0.05 ),and were independent factors for MEmean .Conclusions SWE can evaluated the arterial stiffness using longitudinal elastic modulus of carotid.Age,systolic blood pressure,PWV and LDL were independent factors for longitudinal elastic modulus.

OBJECTIVE:To optimize the formulation optimization of Nicorandil sustained-release matrix tablet,and evaluate its drug release properties in vitro. METHODS:Based on single factor test,powder direct compression method was used,using nicorandil cumulative release rate (Q) in 1,4,8,12 h as evaluation indexes,central composite design-response surface method was adopted to optimize the amount of hydroxypropyl methylcellulose(HPMC)and ethyl cellulose(EC);Q values within 12 h in different pH (1.0,5.0,6.8,7.4) media were compared. RESULTS:The optimized formulation (every tablet) was nicorandil 10 mg,HPMC 150 mg,EC 90 mg,microcrystalline cellulose 80 mg,lactose 60 mg,magnesium stearate 2%. Q1 h,Q4 h,Q8 h and Q12 h of the obtained formulation were 23.6%,51.3%,83.7% and 96.9%,respectively;deviation from the predicted values were 2.1%,1.6%,1.0%,0.2%. Q values were similar in pH 1.0-7.4 at different time points. CONCLUSIONS:The obtained Nicor-andil sustained-release matrix tablet by optimal formulation shows sustained-release effect,and the change of pH 1.0-7.4 has no in-terference in the release characteristics of main drug.

OBJECTIVETo evaluate in vitro effect of abnormal savda munziq (ASMq) on the proliferation and apoptosis of human hypertrophic scar fibroblasts (HSFs).

METHODSHSFs were divided into six groups to receive different treatments as group A (blank control group), group B-E (ASMq in different concentration), and group F(5-Fu). Each group contains six specimens. The HSFs were cultured in vitro. After culture for 48 hours, the CCK8 test and flow cytometry methods were used to detect the proliferation, cell cycle and apoptosis.

RESULTSThe proliferation of HSFs in the B, C, D and E groups was inhibited at G2/M period, while it was inhibited at G0/S period in group F (P < 0.05). The inhibition effect of ASMq (0.1-1.0 mg/ml) on the fibroblasts enhanced in a concentration-dependent manner. Flow cytometry analysis with annexin V-FITC and PI staining confirmed the apoptotic. When HSFs were exposed to ASMq at 1.0 mg/ml (group E) for 48 h, the percentage of apoptotic cells increased to (43.7 +/- 2.58)%, which was significantly higher than that of blank control group (2.2 +/- 0.59)%. The induced apoptosis effect was also increased in a concentration-dependent manner.

CONCLUSIONASMq has a inhibitory effect on the proliferation and an enhancement effect on the apoptosis of fibroblast. ASMq could be used as an effective drug for treatment of hypertrophic scar.

Apoptosis ; Cell Cycle ; drug effects ; physiology ; Cell Division ; Cell Proliferation ; drug effects ; Cells, Cultured ; Cicatrix, Hypertrophic ; pathology ; Fibroblasts ; cytology ; drug effects ; Flow Cytometry ; Humans ; In Vitro Techniques ; Medicine, East Asian Traditional

Objective To evaluate the effect of environmental hypothermia exposure on hemodynamics and oxygen metabolism during general anesthesia in a pig model of hemorrhagic shock.Methods Twelve pathogen-free Bama miniature pigs of both sexes,weighing 20-24 kg,were divided into 2 groups (n=6 each) using a random number table:room temperature group (group RT) and environmental hypothermia group (group EH).The animals inhaled 2％ isoflurane for maintenance of anesthesia.The pigs were placed at room temperature (20-22℃) and at low temperature (-10 ℃) in group RT and group EH,respectively.Hemorrhagic shock was induced by withdrawing blood from the right femoral artery within 20 min (30 ml/kg).Before withdrawing blood (T1),immediately after the end of withdrawing blood (T2),and at 1,2,3,4 and 5 h of shock (T3-7),heart rate,mean arterial pressure,mean pulmonary artery pressure,cardiac index and systemic vascular resistance index were recorded.Blood samples were collected from the right femoral artery and internal jugular vein for blood gas analysis,and lactic acid concentrations,hemoglobin,arterial oxygen partial pressure,arterial oxygen saturation,and mixed venous oxygen saturation were recorded.Oxygen delivery index,oxygen consumption index and O2 extraction rate were calculated.Results Compared with group RT,heart rate at T3-7,cardiac index and oxygen delivery index at T5-7,oxygen consumption index at T1-7,O2 extraction rate at T2-6,and lactic acid concentrations at T5-7 were significantly decreased,and mean arterial pressure at T4,5,mean pulmonary artery pressure at T4-7,systemic vascular resistance index at T3-7,and mixed venous oxygen saturation at T2-6 were increased in group EH (P＜0.05).Conclusion Environmental hypothermia exposure inhibits cardiac compensatory responses,increases the peripheral vascular resistance,and aggravates oxygen dysmetabolism during general anesthesia in a pig model of hemorrhagic shock.

Objective To explore the characteristics of T cell immunity in peripheral blood of patients with carboxypeptidase - H antibody (CPH-Ab). Methods Forty-two latent autoimmune diabetes in adults (LADA) patients with CPH-Ab~+ alone, 20 Type 2 diabetes mellitus patients (T2DM), and 22 healthy controls were selected and their peripheral blood mononuclear cells were isolated. Human recombinant carboxypeptidase (CPH) protein was expressed and further used as a stimulant in Enzyme-linked immunospot (ELISPOT) assay to detect IFN-γ-Th1 and IL-4-Th2 cells in the 3 groups. Th1/Th2 ratios were also calculated. CPH-Ab and glutamic acid decarboxylase antibody (GAD-Ab) were determined by radioligand assay. Results Compared with healthy controls and T2DM, IFN-γ-Th1 and IL-4-Th2 numbers did not increase significantly in CPH-Ab~+ group, nor did the Th1/Th2 ratios (P ＞0. 05). We further divided the CPH-Ab~+ patients into a short duration group (n = 22) and a long duration subgroup (n = 20) according to the duration of 3 years. CPH-IL-4-T in the short duration subgroup was significantly higher than that in T2DM and healthy controls (1. 8 vs. 0.2 and 0.3, both P ＜ 0. 05) and we did not find any factor that was significantly correlated with the IL-4 spots number. There were not any significant differences in T cell responses to phaseolus vulgaris agglutinin (PHA) among all groups (P＞0.05). Conclusion CPH does not directly involve in the cellular pathological mechanism of LADA. Anti-CPH immunity may be associated with more slowly aggressive beta cell autoimmunity.

OBJECTIVETo observe the preventive effect different compatibilities of Ramulus Cinnamomi (RC) and peony in Guizhi Decoction (GD) on diabetic cardiac autonomic neuropathy (DCAN).

METHODSTotally 60 male rats were randomly divided into 5 groups, i.e., the blank control DM group, the model group, the methycobal group, the 1:1 (RC/peony) Guishao group, the 2:1 Guishao group, and the 1:2 Guishao group, 10 in each group. Rats were pretreated with corresponding drugs for 1 week, and then induced diabetes by intraperitoneal injection of STZ. Drugs were administrated by gastrogavage for 4 more weeks after STZ-injection. Enzyme-linked immunosorbent assay (ELISA) was employed to detect levels of tyrosine hydroxylase (TH), choline acetyltransferase (CHAT), nerve growth factor. (NGF), and ciliary neurotrophic factor (CNTF) in myocardial homogenates.

RESULTSAfter 4-week modeling, body weight (BW) was obviously lower, but blood glucose (BG) was higher in STZ rats than in rats of the blank control DM group. There was no statistical difference in BW or BG among the 5 groups (P >0.05). Compared with the blank control group, TH, TH/CHAT, and NGF in left ventricle and ventricular septum increased, CHAT and CNTF increased in the model group (P < 0.05, P < 0.01). Compared with the model group, TH and TH/CHAT in left ventricle decreased (P < 0.05, P < 0.01), CNTF in left ventricle increased (P < 0.05), CHAT in left ventricle and ventricular septum increased (P < 0.05, P < 0.01) in the methycobal group. TH and TH/CHAT in left ventricle and ventricular septum decreased, CNTF in left ventricle and ventricular septum increased (P < 0.05, P < 0.01), CHAT in left ventricle and ventricular septum increased (P < 0.01), NGF in ventricular septum decreased (P < 0.01) in the 1:1 Guishao group. TH/CHAT in left ventricle decreased (P < 0.01), CHAT and CNTF in left ventricle and ventricular septum increased (P < 0.05, P < 0.01) in the 1:2 Guishao group. Compared with the methycobal group, CHAT in left ventricle decreased, TH and TH/CHAT in left ventricle increased in the 2:1 Guishao group (P < 0.05, P < 0.01). TH and TH/CHAT in ventricular septum decreased (P < 0.05), CHAT and CNTF in left ventricle and ventricular septum increased (P < 0.05, P < 0.01) in the 1:1 Guishao group. Compared with the 1:2 Guishao group and the 2:1 Guishao group, CHAT in left ventricle increased, TH/CHAT in left ventricle decreased, TH and TH/CHAT in ventricular septum decreased, CHAT in ventricular septum increased, CNTF in left ventricle and ventricular septum also increased in the 1:1 Guishao group (all P < 0.01).

CONCLUSIONSSTZ model rats had autonomic neural injury, manifested as lowered vagal nerve activity and hyperactive sympathetic nerves. GD could effectively suppress hyperactive cardiac sympathetic nerves and protect the vagus. Besides, GD (1:1) showed the optimal effect in regulating the balance of cardiac autonomic nerves and could be used in early prevention of DCAN.

Animals ; Blood Glucose ; Choline O-Acetyltransferase ; Diabetic Neuropathies ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Heart ; Heart Ventricles ; Male ; Myocardium ; Nerve Growth Factor ; Paeonia ; Rats ; Tyrosine 3-Monooxygenase