Objective To evaluate the effects of propofol on TREM-1 expression in THP-1 cells stimulated by lipo-polysaccharide (LPS). Methods Cells were divided into 7 groups: (1) control group; (2) LPS group that was exposed to LPS in final concentration of 100μg/L;(3) Progroup that was incubated with 100μmol/L propofol;(4-7) groups combined 100μg/L LPS with propofol at different dose of 12.5μmol/L (P1 group), 25μmol/L (P2 group), 50μmol/L (P3 group), 100μmol/L (P4 group) respectively. After 16 hours of incubation, the TNF-α concentration in supernatants were measured by ELISA. TREM-1 expression were examined by FACS and TREM-1 mRNA were detected using qRT-PCR. Results TREM-1 on THP-1 increased significantly in group P3 and group P4 compared with LPS group (P<0.05). The concentra-tions of TNF-αin P3 and P4 (P<0.05) decreased substantially in supernatant compared with LPS group. TREM-1 mRNA transcription level in group LPS rise considerably (P < 0.05) compared to that in control group, and it dropped greatly in group P4 (P <0.05) compared with that in group LPS. Conclusion Propofol could enhance TREM-1 expression on sur-face of THP-1 stimulated by LPS. Propofol reduces TNF-αlevel in culture supernatant. And propofol may restrain TREM-1 mRNA expression.

A method for determinations of germanium in garlic was developed by means of acid digestion and extraction under reflux. It obriated not only the volatile loss of Ge but also the loss of volatile Allicin in the Allium sativum, with usual distillation methods. At the same time the sensitivity was remarkably increased under coprecipitation with ferric hydroxide and extraction operation. A good linear relation was obtained in the range of 0-2.0?g Ge. The average recovery of Ge is 90.9%, coefficient of variation is 4.0%, and detection limit in the Allium sativum is 0.14?g. The method is suitable for determination of Ge in other biological samples as well.

Objective To investigate the risk factors for postoperative cognitive dysfunction (POCD) and nursing intervention in patients undergoing laparoscopic radical hysterectomy. Methods One hundred patients undergoing laparoscopic radical hysterectomy were included, surgical history, general anesthetics way, education, family factors(alone), body mass index, age, duration of anesthesia, dose of sufentanyl, hematocrit, the time for regaining orientation, dysphoria, postoperative pain degree were recorded. The occurrence of POCD was observed at 7 days (early period) and 3 months (later period) after surgery. Logistic regression analysis was used to examine the risk factors for POCD at early period and later period. Results The incidence of POCD at early period was 29.0%(29/100). Logistic regression analysis of surgical history, general anesthetics way, body mass index, age, hematocrit, the time for regaining orientation, postoperative pain degree in patients, general anesthetics way (OR=2.821, 95%CI 1.099-7.240) and postoperative pain degree(OR=2.292, 95%CI 1.129-4.654) were the significant risk factors for POCD at early period. The incidence of POCD at later period was 7.0%(7/100). Logistic regression analysis of education and family factors(alone) in patients, family factors(alone) was the significant risk factor for POCD at later period (OR=5.517, 95%CI 1.010-30.126). Conclusions General anesthetics way and postoperative pain degree are the significant predictors for POCD in patients undergoing laparoscopic radical hysterectomy during hospitalization, and family factors(alone) is the risk factor for POCD at 3 months after surgery, and active nursing intervention could reduce the occurrence of POCD.

Objective To investigate the influence of two general anesthestic modes on postoperative cognitive dysfunction (POCD) in the patients undergoing laparoscopic radical hysterectomy .Methods One hundred ASA Ⅰ‐Ⅱ patients undergoing lapa‐roscopic radical hysterectomy were randomly allocated to the propofol group (group P) and sevoflurane group (group S) ,50 cases in each group .The anaesthesia time ,total dose of sufentanil ,total dose of vecuronium ,recovery time ,recovery time for regaining ori‐entation and complications during anesthetic recovery period were recorded .The cognitive function was assessed by the mini‐mental state examination (MMSE) on preoperative 1 d (T0 ) ,postoperative 1 d (T1 ) ,postoperative 3 d ,(T2 ) ,postoperative 7 d (T3 ) ,post‐operative 1 month (T4 )、postoperative 3 months (T5 ) and the POCD occurrence situation was evaluated by adopting the Z scoring . Results The total dose of sufentanil and vecuronium in the group S was lower than that in the group P (P<0 .05) ,the recovery time and time for regaining orientation in the group S was longer than that in the group P (P<0 .05);the incidence rates of shive‐ring ,dysphoria and upper respiratory tract obstruction in the group S were higher than those in the group P (P<0 .05) .There were no statistically significant difference in the MMSE scores between the two groups (F=0 .14 ,P=0 .709);the MMSE scores in each group had statistical differences among different time points (F=74 .46 ,P<0 .01) .The interaction effect existed between the gen‐eral anesthetic mode and time with MMSE score (F=7 .99 ,P<0 .01);the MMSE scores at T1 ,T2 in the group S were lower than those in the group P (P<0 .05) .The incidence rate of POCD at T1 ,T2 、T3 ,T4 in the group S was higher than that in the group P (P<0 .05) .Conclusion The incidence rate of POCD in the patients undergoing laparoscopic radical hysterectomy by adopting sevoflurane inhalation general anaesthesia is higher than that by adopting propofol anesthesia ,but which has no difference after postoperative 3 months .

Aim To explore the effects of niacin on LDL-C uptake and metabolism in HepG2 cells,and to clarify the functions of niacin in lipid-lowering and slo-wing the atherosclerosis process,thus to provide a sci-entific basis for niacin as a lipid-lowering drug in clini-cal development.Methods Oil red O staining was used to observe HepG2 cells after lipid uptake.Enzy-matic method was used to determine the content of in-tracellular free cholesterol (FC)and total cholesterol (TC).The LDLR levels on the surface of cell mem-brane were detected by immunofluorescence flow cy-tometer.The mRNA and protein expressions of LDLR, SREBP2 and PCSK9 were analyzed by qPCR and Western blot.Results The results of oil red O staining showed that the rate of oil red O-positive cells and the number of red lipid droplets were significantly in-creased in niacin group than control group.Niacin sig-nificantly increased the levels of TC and FC in HepG2 cells(P <0.05 ).What’s more,niacin significantly upregulated the expression of LDLR and significantly downregulated the protein expression of PCSK9,while it had no effect on the expression of SREBP2.Conclu-sion Niacin accelerates LDL-C uptake probably via downregulating the expression of PCSK9 and reducing the degradation of LDLR protein in HepG2 cells.

OBJECTIVETo investigate the clinical factors related with liver metastasis from colorectal cancer.

METHODS1 312 colorectal cancer patients treated from 1988 to 1997 were collected to set up the database. Binary and multinomial logistic regression (SPSS 10.0 for windows) and then correlation analysis were used to evaluate the factors concerned.

RESULTSSex, disease course, gross tumor type, differentiation degree, pathological grade, infiltration depth and lymph node metastasis were related with liver metastasis by single factor analysis. Only sex, infiltration depth and lymph node metastasis were related with liver metastasis by multiple factor analysis. More male than female were observed in patients with liver metastasis from colorectal cancer (1.9:1, P = 0.006). Liver metastasis in colorectal cancer was positively related to the infiltration depth into the intestine wall (r = 0.926, P = 0.024). However, the correlation between the distance of lymph node metastasis and liver metastasis in colorectal cancer had no statistical significance (r = 0.748, P = 0.252).

CONCLUSIONSex, depth of infiltration and lymph node metastasis are the main clinical factors related with liver metastasis from colorectal cancer. Male colorectal cancer patients are apt to develop liver metastasis. The deeper the tumor infiltrates, the more the liver metastasis. Age, blood type, symptoms, course, complications, tumor size and site are not related with liver metastasis in colorectal carcinoma.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms ; pathology ; Female ; Humans ; Liver Neoplasms ; secondary ; Logistic Models ; Lymphatic Metastasis ; Male ; Middle Aged

Objective:To study the risk factors of axillary lymph node metastasis by analyzing the acoustic image characteristics of the automated breast volume scanner (ABVS) of breast cancer masses.Methods:The imaging features of ABVS of 212 patients with breast cancer, unilaterally and singly, confirmed by pathological examination admitted in Hangzhou First People’s Hospital from Jan. 2016 to Dec. 2018 were retrospectively analyzed. There were 83 cases with axillary lymph node metastasis (metastatic group) and 129 cases without (non-metastatic group) . The correlation of clinical and the imaging features of ABVS with axillary lymph node metastasis was analyzed using univariate analysis and multivariate logistic regression. ROC curve was used to analyze the cut-off value of the maximum diameter of the mass in predicting the breast cancer axillary lymph node metastasis. The sensitivity, specificity, positive predictive value, and negative predictive value of each risk factor were analyzed for predicting breast cancer axillary lymph node metastasis.Results:The retraction phenomenon and micro-calcification of breast cancer in the metastatic group (60.2%, 65.1%) were higher than those in the non-metastatic group (43.4%,37.2%) ( P=0.017 vs P<0.001) . The maximum diameter of the breast cancer in the metastatic group was bigger than in the non-metastatic group ( Z=2.18, P=0.029) . Multivariate logistic regression analysis showed that the micro-calcification of breast cancer ( OR=2.522, P=0.003) was an independent predictor of lymph node metastasis in breast cancer. The area under the curves and the cut-off value of the maximum diameter of the mass in predicting the breast cancer axillary lymph node metastasis were 0.589 and 2.85 cm. The sensitivity was 34.9%, the specificity was 82.9%, the positive predictive value was 56.9%, and the negative predictive value was 66.5%. The sensitivities of micro-calcification and retraction phenomenon to predict the occurrence of axillary lymph node metastasis in breast cancer patients were 65.1% and 60.2%, specificities were 62.8% and 56.6%, positive predictive values were 52.9% and 47.2%, and negative predictive values were 73.6% and 68.9%. Conclusion:The study suggests that the maximum diameter, micro-calcification, and retraction phenomenon of masses are associated with the occurrence of the axillary lymph node metastasis in breast cancer.

OBJECTIVETo explore the clinicopathological characteristics, efficacy, and prognostic factors for patients with rectal gastrointestinal stromal tumor(GIST).

METHODSClinicopathological and follow-up data of 61 patients with rectal GIST in our department from January 1990 to October 2012 were analyzed retrospectively and pathology specimens were reviewed. Kaplan-Meier method was used to calculate the survival. Univariate analysis and multivariate analysis were performed to investigate the influencing factors of prognosis with Log-rank test and Cox regression model.

RESULTSThere were 42 male and 19 female patients with a median age of 59 years old. Eighteen cases(29.5%) were confirmed preoperatively as GIST by biopsy and 46 cases were diagnosed as GIST by first pathological examination. Fifteen cases(24.6%) were revised as GIST after re-examination of specimes among whom 14 cases had been diagnosed as leiomyoma or sarcoma, and 1 as neurolemmoma. Tumor location was above peritoneal reflection in 12 cases(19.7%) and below peritoneal reflection in 49(80.3%). Fifty-two patients underwent surgery, including 21 extended resections(lymph nodes clearance and combined organs resection simultaneously) and 31 local resections(tumor rejection or partial resection of rectal wall). Eleven patients received preoperative imatinib(400 mg/d). Forty-one cases received imatinib therapy after operation or biopsy diagnosis, including 25 cases who received palliative treatment for postoperative recurrence. Median follow-up time was 55(6 to 391) months and follow-up longer than 2 years was carried out in 46 patients. Overall survival rates of 1-, 2-, 3- , 5-year were 98%, 95.6%, 86.0% and 73.7% respectively. There were no significant differences between local resection group(96.4%, 92%, 83.3% and 77.3%) and extended resection group (100%, 94.7%, 89.50% and 82.6%)(χ(2)=0.004, P=0.947). Univariate analysis showed that survival was only associated with recurrence and metastasis (χ(2)=4.292, P=0.038). Multivariate Cox analysis showed postoperative survival was not associated with any factors(all P>0.05). The 3-year survival rate of patients with postoperative recurrence or metastasis receiving imatinib therapy was better as compared to those who did not received imatinib(82.7% vs. 71.4%).

CONCLUSIONSRectal GIST are more common in the lower rectum. Surgery is the main treatment for rectal GIST. Local complete resection is the mainstay treatment. Extensive resection and lymph node clearance may not improve survival. Imatinib can improve the prognosis of patients with recurrence or metastasis.

Benzamides ; Female ; Gastrointestinal Stromal Tumors ; therapy ; Humans ; Imatinib Mesylate ; Male ; Neoplasm Recurrence, Local ; Piperazines ; Prognosis ; Pyrimidines ; Rectal Neoplasms ; pathology ; therapy ; Retrospective Studies ; Survival Rate

OBJECTIVETo explore clinicopathologic characteristics, surgical features and prognostic factors in patients with primary gastrointestinal lymphoma(PGIL) in order to provide evidence for optimizing surgical treatment.

METHODSClinicopathological data of 57 PGIL patients undergoing abdominal surgery in Sun Yat-sen University Cancer Center between October 1990 and January 2015 were retrospectively collected. The survival rates were compared among patients with different clinicopathologic characteristics by Kaplan-Meier method, while Cox regression model was employed to analyze the prognostic factors.

RESULTSAmong 57 patients, 43 were male and 14 were female, with a median age of 48 (range 16 to 80) years. Seventeen (29.8%) cases were classified as Musshoff I( stage, 19 (33.3%) cases as II( stage, 9 (15.8%) cases as III( stage, and 12(21.1%) cases as IIII( stage. Forty-four (77.2%) cases underwent selective operation, 13(22.8%) cases underwent emergent operation due to acute abdomen. Thirty-two(56.1%) cases had radical resection, 18 (31.6%) cases had partial resection and the rest 7(12.3%) cases failed to perform resection. Four (7.0%) cases received simple surgical operation, and 53 (93.0%) cases received comprehensive treatment, including 5(8.8%) cases with preoperative chemotherapy and surgery, 40 (70.2%) cases with surgery and postoperative chemotherapy, and 8 (14.0%) cases with surgery and perioperative chemotherapy. Stage III( and IIII( accounted for 76.9%(10/13) in patients undergoing emergent operation and accounted for 25.0%(11/44) in patients undergoing selective operation, whose difference was statistically significant (χ=9.503, P=0.002). Univariate prognostic analysis showed that T lymphocyte source pathological cell phenotype (P=0.000), clinical Musshoff stage III( and IIII((P=0.001), emergent operation (P=0.000) and incomplete tumor resection(P=0.007) had worse 5-year overall survival. Multivariate Cox regression analysis indicated that tumor pathological cell phenotype (HR=13.75, 95%CI:3.546-53.308, P=0.000) and surgical timing (HR=7.497, 95%CI:1.163-48.313, P=0.034) were independent prognostic risk factors of patients with stage I( and II(.

CONCLUSIONSSurgical operation is an important part of comprehensive treatment for PGIL. T lymphocyte source and ulcerative lymphoma indicates poorer prognosis.

Objective:To compare the safety and efficacy of the " step-up approach" versus the " step-jump approach" in treatment of infected pancreatic necrosis (IPN).Method:The clinical data of IPN patients who underwent step-up strategy or step-jump strategy treatment at the Department of Pancreatic and Biliary Surgery of the First Affiliated Hospital of Harbin Medical University from December 2018 to November 2022 were analyzed retrospectively. Propensity score matching (PSM) was done based on the nearest neighbor matching method (1: 1 ratio). After matching the baseline data (the caliper value was 0.01), a total of 62 patients with IPN were included, including 41 males and 21 females, aged (41.1±13.1) years old. Patients who were treated with the step-up strategy were included in the step-up group, while patients who were treated with the step-jump strategy were included in the step-jump group. There were 31 patients in each group after PSM, and the treatment effect of the two groups were compared.Results:Of the 62 patients with IPN, 43 received surgical intervention, and 19 were managed successfully using symptomatic anti-inflammatory treatment or percutaneous catheter drainage. The total hospitalization cost of patients in the step-jump group was significantly higher than that in the step-up group [122 000 (73 000, 179 000) yuan vs. 88 000 (46 000, 144 000) yuan, P=0.034]. The overall cure rate of IPN patients in the step-jump group was 93.5%(29/31). The 2 patients who died had type Ⅲ IPN. In the IPN patients in the step-up group were all cured, and the overall cure rate was 100%(31/31), with no death. There were no statistical differences between the two groups in the rates of death, postoperative complications, residual infection, debridement ≥2 times, and positive bacterial culture in blood or drainage fluid (all P>0.05). A total of 19.4% (12/62) patients had postoperative complications, including 4 patients with abdominal bleeding, 3 patients with new organ dysfunction, 2 patients with gastrointestinal bleeding, 2 patients with gastrointestinal fistula, and 1 patient with venous thrombosis in both lower limbs. Conclusion:Both the step-up treatment strategy and the step-jump treatment strategy were safe and effective for treatment of IPN patients.