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 safety and feasibility of robotic-assisted laparoscopic colectomy for colonic cancer.

METHODSThe clinical outcomes of 13 patients with colon cancer undergoing robotic-assisted laparoscopic colectomy from May 2010 to November 2010 were retrospectively evaluated.

RESULTSAll the operations were performed successfully, including 5 right colectomies, 3 left colectomies, and 5 sigmoidectomies. The operative time was (171.5±31.8) minutes. The estimated blood loss was (54.6±21.8) ml. Time to the return of bowel function was (60.9±15.8) hours and postoperative hospital stay was (6.4±3.6) days. There was one patient developed fat liquefaction at the incision. No bleeding, anastomotic fistula, anastomotic stenosis, or other complications were found.

CONCLUSIONRobotic-assisted laparoscopic colectomy is safe and feasible for colon cancer resection.

Adult ; Aged ; Colonic Neoplasms ; surgery ; Digestive System Surgical Procedures ; methods ; Female ; Humans ; Laparoscopy ; Male ; Middle Aged ; Retrospective Studies ; Robotics ; Treatment Outcome

OBJECTIVETo compare the prognosis between staged surgery and one-stage surgery in active complex Crohn disease(CD).

METHODSClinical data of 33 patients with active complex CD from February 2006 to September 2010 were analyzed retrospectively.

INCLUSION CRITERIAPatients who were diagnosed with CD by pathology or endoscopy with CD activity index(CDAI)>220 and long history of preoperative steroid use(over 6 months), or complicated with severe preoperative malnutrition. The indications for surgery included enterocutaneous or entero enteric fistula, with/without intra-abdominal abscess, intestinal obstruction, and acute intestinal perforation intra-abdominal sepsis. The surgical procedures, including staged surgery and one-stage definite surgery were chosen by experienced surgeons. All the patients quit smoking and received immunosuppressant therapy (TwHF or azathioprine) together with enteral nutrition supplement for preventing postoperative recurrence. All the patients were followed up after the surgery with regards to CDAI, serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR). Postoperative complications, clinical and endoscopic recurrence were recorded.

RESULTSOf the 33 patients, 14 underwent one-stage definite surgery and 19 received staged surgery. Postoperative complication rates in the two groups were 71% and 26% respectively(P=0.015). The early clinical recurrence rates within postoperative 3 months were 36% and 0(P=0.008). In regard to cumulative probability of post-operative clinical and endoscopic recurrence, staged surgery group was superior to one stage definite surgery group(P=0.000 and 0.006).

CONCLUSIONStaged surgery may significantly increase the success rate of operation, reduce postoperative complications and postoperative early relapse, and decrease postoperative recurrence.

Adolescent ; Adult ; Aged ; Crohn Disease ; surgery ; Digestive System Surgical Procedures ; methods ; Female ; Follow-Up Studies ; Humans ; Logistic Models ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the efficacy of enteral nutrition(EN) therapy for active Crohn disease(CD) complicated with incomplete intestinal obstruction.

METHODSClinical data of 37 patients with active CD complicated with incomplete intestinal obstruction treated with EN(n=37) between January 2003 and September 2009 were retrospectively analyzed. CD activity index (CDAI) was between 150 and 450. The patients received total enteral nutrition (TEN) 125 kJ/kg by nasogastric tube or percutaneous endoscopic gastrostomy/jejunostomy(PEG/J) tube. Clinical response was defined as a decrease in CDAI≥70 from baseline since EN therapy, and clinical remission was defined as CDAI<150. Nutritional status, disease activity index, and side effects were recorded at the 0, 4th, and 12th week after EN therapy.

RESULTSStricture or stenosis location included ileum in 8 (21.6%) patients, ileocolon in 19(51.4%), colon in 4(10.8%), jejunoileum in 5(13.5%), and duodenum in 1(2.7%). At 4 weeks after EN, CDAI significantly decreased(112.0±39.6 vs.174.6±34.7,P<0.05). The ratio of clinical response was 43.2%(16/37) and clinical remission was 72.9%(27/37). At 12 weeks, CDAI was 70.2±32.9, lower than that at week 4(P<0.05). The ratio of clinical response was 70.2%(26/37) and clinical remission was 78.4%(29/37). Other disease activity indexes such as C-reactive protein, erythrocyte sedimentation rate, and nutritional status such as BMI, serum albumin, prealbumin, transferrin and hemoglobin showed similar trend. During therapy, 7 cases had progressive intestinal obstruction resulting in bowel resection, 11 cases had diarrhea and/or abdominal distention due to inadequate infusion of home EN whose symptoms were improved after correction by the doctor.

CONCLUSIONSEN therapy can induce clinical response and remission in CD complicated with incomplete intestinal obstruction, relieve obstruction, alleviate the inflammatory response which plays positive role in the treatment of CD.

Adult ; Aged ; Crohn Disease ; complications ; therapy ; Enteral Nutrition ; Female ; Humans ; Intestinal Obstruction ; complications ; therapy ; Male ; Matched-Pair Analysis ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult