Objective To discuss how to improve the current status on clinical therapy for advanced gastric carcinoma. Methods Related literatures searched on Medline were collected and reviewed. Results The 5th edition of UICC/AJCC TNM staging system of gastric carcinoma is useful to evaluate the prognosis of patients with advanced gastric carcinoma followed by extended lymphadenectomy. There are many factors influencing their prognosis including disease stage, extent of lymphadenectomy, assistant therapy and so on. Conclusion It is significant for patients with advanced gastric carcinoma to undergo individualized extended lymphadenectomy and comprehensive therapy to improve their prognosis after radical gastrectomy

Objective:To investigate the clinical and diagnostic characteristics of audiometric findings and vestibular-evoked myogenic potentials in patients with large vestibular aqueduct syndrome (LVAS).Method:Thirty LVAS subjects(60 ears) recruited received pure tone audiometry, acoustic immittance, auditory brain stem responses (ABRs), distortion-product otoacoustic emission(DPOAE), Vestibular evoked myogenic potentials(VEMP) and caloric test, and the diagnostic significance of the results was analyzed.Result:All 30 cases(60 ears) showed progressive and fluctuating hearing loss, while 16 cases experienced dizziness when hearing fluctuated. Most of our cases showed sensorineural hearing loss, and 47 ears(94.0%) showed air-bone gap in the low frequencies, with mean gaps of (43±17)dB HL at 250 Hz, (33±18 )dB HL at 500 Hz, in which the middle ear function showed normal. The acoustically evoked short latency negative response(ASNR) with medium latency(3.06±0.52)ms was elicited from 18 ears(64.3%). The mean amplitude of vestibular evoked myogenic potentials(VEMP) of 42 ears was (147.10± 107.55)μv,and the threshold of VEMP of 19 ears was 75 dB nHL,of 7 ears was 65 dB nHL.Conclusion:Characteristics of hearing performance, such as progressive and fluctuating hearing loss, air-bone gap at the low frequencies with normal middle ears, the ASNR, and increased amplitude and decreased threshold of the VEMPs, will help clinicians make initial diagnosis of LVAS ,and provide a reference for further imaging examination.

Aim To investigate the effect of plumbagin on invasion and apoptosis of human hepatocellular car-cinoma ( HepG2 ) . Methods HepG2 cells were cul-tured in vitro with different concentrations of plumba-gin, then cell proliferation was observed by MTT as-say; cell invasion was observed by transwell invasion assay; cell apoptosis was detected by flow cytometry, and the protein expression of Bax, Bcl-2 was detected by immunocytochemistry. Results MTT results showed that plumbagin could significantly inhibit cell proliferation compared with the control group, and in a dose-dependent manner ( P <0. 05 ) . Transwell inva-sion assay showed that cell invasion was significantly decreased with increasing concentrations of plumbagin ( P < 0. 01 ) . Flow cytometry showed that apoptosis rate was significantly higher in 4 , 8 μmol · L-1 group of plumbagin compared with that of the control group ( P<0. 01 ) . Immunocytochemistry showed that, with the increasing concentration of plumbagin, Bax protein expression increased, Bcl-2 protein expression was de-creased, both in a dose-dependent manner ( P <0. 01 ) . Conclusion Plumbagin can inhibit HepG2 cell proliferation and accelerate apoptosis of HepG2 cells, but also has the ability to inhibit HepG2 cell in-vasion.
( P < 0. 01 ) . Flow cytometry showed that apoptosis rate was significantly higher in 4 , 8 μmol · L-1 group of plumbagin compared with that of the control group ( P<0. 01 ) . Immunocytochemistry showed that, with the increasing concentration of plumbagin, Bax protein expression increased, Bcl-2 protein expression was de-creased, both in a dose-dependent manner ( P <0. 01 ) . Conclusion Plumbagin can inhibit HepG2 cell proliferation and accelerate apoptosis of HepG2 cells, but also has the ability to inhibit HepG2 cell in-vasion.

Objective To explore the auditory neuropathy(AN) characteristics in a child with cochlear nerve deficiency.Methods Audiological test,HRCT image and HRMRI from this child were analyzed.Results ABR responses were absent from the both ears while normal DPOAE in the right ear was noted with abnormal DPOAE at some frequencies in the left.The neural responses from the right cochlea were absent but weak responses were noted in the left by means of the oblique sagittal MRI on the internal auditory canal.Conclusion The child with cochlear nerve deficiency can present with electrophysiological evidence of AN.The cochlear nerve deficiency was considered about the main site of lesion and one of the etiology of AN.The inclined sagittal MRI scanning plays a very important role in assessing cochlear nerve deficiency.

OBJECTIVE: To investigate the audiological characteristics in unilateral auditory neuropathy (UAN). METHOD: By the retrospective studies, 11 patients which were diagnosed as UAN and bilateral auditory neuropathy (AN) group and control group were measured. RESULT: By the statistical studies of patients from otology clinic data from January 2001 to September 2006,11 patients (11 ear, 5 left ear and 6 right ear, 3.2%) in 340 AN patients diagnosed as UAN were summarized. Four patient were male and 7 were female in 11 patients (1: 1.75). The average age of 11 patients was 20 years old and the average period of diseases was 3.1 years. All patients complained of unilateral gradual hearing loss, and 6 patients in all UAN patients can't discriminate speech correctly. Four patients complained of tinnitus and none of UAN patients complained of dizziness. The pure tone audiograms of 5 patients in all UAN patients (45.4%) were descending curve and those of 4 patients (36.4%) were ascending curve. Eleven patients mostly showed severity degree or midrange degree (6 ear, 54.5%) sensorineural hearing loss. The average pure tone threshold of UAN was obviously higher than the AN group and the speech hearing of UAN is obviously worse, and ABR of all patients was absent, while uninjured side of UAN was normal. Bilateral ears of UAN patients were evoked distortion products otoacoustic emissions. The amplitude of DP-gram and SNR in UAN group was lower obviously (P < 0.05) than the normal control group at all frequencies (0.5-8.0 kHz) and was lower significantly (P < 0.01) at flat and high-frequency, but was lower obviously (P < 0.01) than the AN group at low-frequency. The contralateral suppression effect of DPOAE amplitude in 4 UAN patients of normal ears was suppressed, and that in injured ears was reduced or disappeared, even 0.5 kHz increased DPOAE amplitude. ENG and VEMP were observed in 5 UAN patients, and 1 patients shows semicircular canal failure and 1 patients shows paralysis unilateral. The VEMP of them showed no response in 1 (2 ear) of 5 and showed response in 4 of 5, but the amplitudes of VEMP were lower in 2 UAN patients. CONCLUSION The UAN patients mostly showed ascending curve and ponderosity degree sensorineural hearing loss. The diagnosis of UAN is different from other common sensorineural deafness. The detection of DPOAE and ABR has great significance in diagnosing the UAN.
Adolescent ; Adult ; Audiometry, Pure-Tone ; Auditory Threshold ; Case-Control Studies ; Child ; Child, Preschool ; Evoked Potentials, Auditory, Brain Stem ; Female ; Hearing Loss, Central ; diagnosis ; physiopathology ; Hearing Loss, Unilateral ; diagnosis ; physiopathology ; Humans ; Male ; Retrospective Studies ; Young Adult

Objective To investigate the expression changes of aspartic proteinase (cathepsin D) and cysteine proteinase (cathepsin K) in photoaged fibroblasts. Methods The senescence of human fibroblasts was induced via culture in the presence of 8-methoxypsralen (MOP) of 50 mg/L in darkness for 24 hours followed by irradiation with UVA of 80 kJ/m~2. Then, aged fibroblasts were confirmed by senescence-associated β-galactosidase (SA-β-gal) staining. Real-time RT-PCR and Western blot were carried out to detect the mRNA and protein expressions of cathepsin D and cathepsin K in photoaged and normal control fibroblasts, respectively. Results Western blot showed a significant difference between photoaged and control fibroblasts in the grey scale of cathepsin D and cathepsin K (3.25 ± 0.33 vs 14.18 ± 2.25, f = 30.61, P < 0.01; 2.39 ± 0.66 vs 29.38 ± 4.62, t = 12.63, P< 0.01). The △Ct values for cathepsin D and cathepsin K mRNA were 2.79 ± 0.17 and -0.92 ± 0.06, respectively, in photoaged fibroblasts, significantly lower than those in the control fibroblasts (4.54 ± 0.34, 2.57 ± 0.13, t = 20.78, 28.50, respectively, both P < 0.01). According to the value of 2~(-△△Ct), the expression of cathepsin D and cathepsin K mRNA decreased 0.24 ± 0.021 and 0.09 ± 0.005 folds, respectively, in photoaged fibroblasts compared with the control fibroblasts. Conclusion The expression of cathepsin D and cathepsin K is decreased in photoaged fibroblasts.

Aim To identify differentially expressed microRNAs (miRNAs) in rat myocardial infarcted tissues and predict their interaction with IncRNAs and target genes, as well as to explore potential pathophysiology mechanisms in myocardial infarction. Methods A rat model of myocardial infarction was established by ligating the left anterior descending coronary artery. Trizolwas used to extract total RNA from infarcted myocardial area for microarray detection. Bioinformatics methods were used to predict interaction IncRNAs, target genes, and functional enrichment of miRNAs thatwere significantly differently expressed. The possible IncRNA-miRNA-mRNA regulatory networks were identified finally. Results The elevation of ST segment of ECG showed that the rat model of myocardial infarction was successfully prepared. Microarray results showed that there were 19 significantly differently expressed miRNAs. Eight of these miRNAs (miR-21, miR-132, miR-222, miR-223-3p, miR-146a/b, miR-181b, miR-449a-5p, miR-122) were proven to be myocardial infarction treatment candidates. Whether seven miR-NAs (miR-365-5p, miR490-5p, miR-6333, miR-30cl-3p, miR-3591, miR-3596c, miR-877) were related to myocardial infarction called for further confirmation. There might be several new IncRNA-miRNA-mRNA mechanisms in the development of myocardial infarction. ENSRNOT00000076620-miR-146b-5p-STAT3/Rnf7/Qrsll may be involved in the process of cardiomyocyte apoptosis and mitochondrial damage during myocardial infarction. ENSRNOT00000071991-miR-122-Deptor might inhibit the autophagy of cardiomyocytes and exacerbate myocardial infarction. Conclusions The ternary relationship of IncRNA-miRNA-mRNA obtained in this study may provide possible research directions and a certain theoretical basis for further exploration of the molecular level pathological mechanism of myocardial infarction, and new therapeutic targets for myocardial infarction as well.

OBJECTIVETo investigate the efficacy and safety of fast-track surgery(FTS) in patients with colorectal cancer.

METHODSOne hundred and sixteen patients with colorectal cancer underwent colorectal operation between June 2006 and May 2008. FTS procedures were used in these patients during the study period. Data were retrospectively analyzed pertaining to post-operative hospital stay and operative complications.

RESULTSThe median postoperative hospital stay was (5.6+/-5.4)(range 1-54) d. Fourteen patients(12.1%) had postoperative complications, in which the rate of anastomotic leakage and wound infection was 1.7% and 2.6% respectively. 30-day readmission rate was 1.7%, and the 30-day mortality was 0.9%.

CONCLUSIONFast-track surgery is feasible in an unselected patient population undergoing elective colorectal cancer resection without compromising surgical outcomes.

Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms ; rehabilitation ; surgery ; Digestive System Surgical Procedures ; Female ; Humans ; Male ; Middle Aged ; Postoperative Care ; methods ; Retrospective Studies

To compare the performance of ArcCheck and film verification for volumetric intensity modulated arc therapy (VMAT) in the treatment of nasopharyngeal carcinoma, and to study the feasibility of ArcCheck in VMAT dosimetric verification. Five patients of nasopharyngeal carcinoma treated with VMAT were enrolled in this study. Dose verification was carried out by ArcCheck and film respectively. The result showed that there were no significant differences between ArcCheck and film verification. ArcCheck software can obtain three dimensional dose distribution directly with simple operation. It is convenient for ArcCheck to be used for VMAT dosimetric verification.
Carcinoma ; Humans ; Nasopharyngeal Neoplasms ; radiotherapy ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; methods ; Software

OBJECTIVESTo evaluate the safety and define the contraindication of regional citrate anticoagulation treatment on various critically ill patients being treated by continuous blood purification, who also had bleeding tendencies.

METHODSForty critically ill patients being treated by continuous blood purification (CBP) were involved in this study. Due to their bleeding tendencies, regional citrate anticoagulation treatment was given to all of them. Those with hepatic function impairment (n = 10) were classified as Group A, those with hypoxemia were classified as Group B (n = 10), and the others as Group C (n = 20). Blood samples were collected before treatment, and at 4, 12, 24, 36, and 48 hour intervals during CBP. These samples then were used arterial blood gas analysis, whole blood activated clotting time (WBACT) pre- and post-filter, and serum ionized calcium examination.

RESULTSWBACT pre-filter showed little fluctuant through the 48 hr period of CBP, and WBACT post-filter showed obvious prolongation than that of the pre-filter (P < 0.05) at all time points. Metabolic acidosis was found in Group A patients before CBP, and improved during CBP. Normal acid-base conditions of patients were disturbed and deteriorated in Group B during CBP, but not in Group C. Serum ionized calcium was maintained at a normal range during CBP in Group A and C patients, but declined significantly in Group B patients (vs. pre-treatment, P < 0.05).

CONCLUSIONSRegional citrate anticoagulation can be safely used in conjunction with CBP treatment for patients with hepatic function impairment, but may induce acidosis and a decline in serum ionized calcium when used with hypoxemic patients.

Adult ; Aged ; Anticoagulants ; administration & dosage ; Calcium ; blood ; Citric Acid ; administration & dosage ; adverse effects ; Critical Illness ; Female ; Hemofiltration ; Humans ; Male ; Middle Aged