BACKGROUND:Autologous stem celltransplantation to the heart is a research direction of heart failure treatment, but there are relatively few of studies about autologous bone marrow mesenchymal stem celltransplantation targeting the cardiac conduction system. OBJECTIVE:To evaluate the potential of rabbit bone marrow mesenchymal stem cells for treatment of heart block. METHODS:Rabbit bone marrow mesenchymal stem cells were induced by 5-azacytidine to differentiate into cardiomyocyte-like cells. After thoracotomy, the left atrium-left ventricular anterior wal was sutured in 14 New Zealand white rabbits (8 in the experimental group and 6 in the control group). One month after the surgery, in the experimental group, autologous bone marrow mesenchymal stem cells induced by 5-azacytidine for 4 weeks were labeled with 4',6-diamidino-2-phenylindole and then injected into the suture area when opening the thoracic again. In the control group, cells cultured in medium were used. One month after celltransplantation, the third thoracotomy was done to insert electrodes into the left atrium and left ventricular anterior wal , for cardiac electrophysiological detection. Whether atrioventricular pathway formed in the suture area was observed. RESULTS AND CONCLUSION:After cells were transplanted into the sutured area, two rabbits in the experimental group were discovered to form the atrioventricular pathway in the sutured area through cardiac electrophysiological examination. After transplantation, transplanted cells were visible on the heart frozen sections under fluorescence microscope in the left ventricle and sutured area, but there was no cellin the control group. In the experimental group, bone marrow mesenchymal stem cells expressed Cx43 and formed gap junction intercellular communication with cardiomyocytes, which was presented as formation of the atrioventricular pathway on cardiac electrophysiology examination. These findings indicate that bone marrow mesenchymal stem cells can be used to treat cardiac conduction system block diseases.

Objective To explore the reversing mechanism of multidrug resistance of ciclosporin(CsA) on K562/A02 cell line,attenuating DNA damage repair through H2AX suppression.Methods K563 and K562/A02 respectively co-cultured with adriamycin(ADM) of different concentrations and CsA.MTT assay was employed to determine the inhibitory concentration of 50 percent(IC50),the resistance times and the reversal times.The K562/A02 cells treated with CsA,and reverse transcriptase(RT)-PCR technique was used to examine the mdr1 and H2AX mRNA level.Flow cytometry was used to measure P-glycoprotein(P-gp) and H2AX expression.Neutral comet assay was used to detect the level of DNA double strands break(DSBs) of the K562/A02 treated with ?H2AX antibody.Results 2?10-3g/L CsA could increase the sensitivity of K562/A02 to ADM,and the reversal times was 5.28.Mdr1 mRNA level and H2AX mRNA level were decreased when treated with CsA(P

Objective To survey the distribution of TCM constitution of Guangxi adults.Methods Identification questionnaire of constitution in TCM was performed to identify the TCM constitution types of 3000 adults who were taken medical examination in the first affiliation hospital to GuangXi TCM university Health Administration Center or of permanent residence in Nanning,Wuming,Qinzhou,Hezhou.Results 612 cases (20.4％) had constitution of phlegm-dampness in 504 cases (16.8％) had constitution of phlegm-dampness,431 cases (14.3％) had constitution of yang asthenia,422 cases (14.1％) had constitution of qi asthenia,353 cases (11.8％) had constitution of damp-heat,348 cases (11.6％) had constitution of yin asthenia,159 cases (5.3％) had constitution of qi stagnation,100 cases (3.3％) had constitution of blood stasis,and 71 cases (2.4％) had allergic constitution.Conclusion There were 9 kinds constitutions in the adults of GuangXi province.The constitution of yin-yang harmony was the most among all.Most male had phlegm-dampness or damp-heat constitution.Most female had yang asthenia,qi asthenia,qi stagnation or yin asthenia constitution.

Objective To study the influences of fenofibrate on oxidative stress and endoplasmic reticulum stress in livers of hyperlipidemic rats. Methods Male SD rats were fed with high-fat diet for 12 weeks to induce a model of hyperlipidemia, then divided into control group, high-fat diet group with another four-week high-fat diet and fenofibrate group, in which rats were treated with fenofibrate [100 mg / (kg·d)] for 4 weeks. Then improvement of insulin resistance was detected in rats with GTT and ITT experiment. The serum levels of glucose (GLU), fasting insulin (FINS),triglyceride (TG) and total cholesterol (TC) were detected. The pathological changes of livers were detected with Oil Red O staining. The oxidative stress indices such as T-SOD, Mn-SOD, GSH and T-AOC were detected with liver homogenate. The expression of GRP78 was detected with real-time quantification RT-PCR and Western blot analysis respectively. Results Compared with rats with high-fat-diet, rats after fenofibrate treatment showed obviously improved insulin resistance, lower serum level of TG, TC and FINS (P < 0.05), decreased number and size of lipid droplets in liver tissue sections. T-SOD level in liver homogenate was significantly increased (P < 0.05), while GSH and T-AOC levels increased but had no obvious differences when compared with control group (P > 0.05). The expression of GRP78 at mRNA and protein levels were increased significantly after fenofibrate treatment (P < 0.05). Conclusions Fenofibrate has significant effects on improving insulin resistance and lipid regulation, which might be related to decreased oxidative stress and subsequent endoplasmic reticulum stress.

Objective Intrahepatic biliary papillomatosis(IBP)is a rare disease that is characterized by multiple numerous papillary adenomas in the intrahepatic biliary duct(IBD).The clinical features and outcome,however,are not well known.The clinicopathologic features,treatments and follow-up results were retrospectively analyzed in order to improve the efficiency of diagnosis and treatment for the disease.Methods Between August 2006 and October 2008,9 patients were diagnosed with IBP by histological findings at a tertiary referral center,Ningbo Medical Center(University of Ningbo,College of Medicine,Ningbo,China).The authors retrospectively reviewed the medical records to obtain clinical,radiological and pathologic data.The therapeutic results and follow-up data were also reviewed.Results The ratio of male to female was 2:7 and the middle age was 59 years.Repeated episodes of fever and right upper quadrant abdominal pain with or without jaundice were the common clinical manifestations.There were intrahepatic choledocholithiasis and/or history of previous biliary operation in 8 cases.The level of CA19-9 and CEA were almost normal.Imaging workup demonstrated cyst-like dilatation of intrahepatic biliary tree with or without liver atrophy,which were more obvious in the mucin-hypersecreting IBP.All of the 9 cases underwent curative resection with an adequate resection margin.Macroscopic findings demonstrated that the tumors of 9 cases were all located in the left lobe with mucin-hypersecreting type in 7 cases.The diameter of numerous papillary granular was usually less than 10 mm(from 2 to 5 mm.frequently)and friable,that filled the dilated IHD dispersive.Fine fibrovascular cores lined by dysplastic epithelial cells were frequently found under microscope.Few foci of stromalinvasion were noticed in the two cases with malignant transformation.All of the 9 cases survived and there was no recurrence.Conclusion IBP occurs more often in middle and old women who have history of biliary disease. Repeated episodes of cholangitis are the common clinical manifestations. Extra- and intrahepatic biliary tract dilatation is the common imaging finding.MRCP/ERCP is more valuable than others in diagnosis. Clinical and histological finding shows that IBP is a premalignant disease with high malignant potential. Curative resection should be done as earlyas possible for the long-term survival rate. The use of cholangioscopy in operation and rapid biopsy of resection margin will benefit the curative resection.

Objective To assess the sleep quality of postoperative patients with breast cancer,and find out influencing factors.Methods The measurement was to adopt Athens Insomnia Scale,Hamilton Depression Scale and Big Five Personality Scale to do questionnaire for 60 breast cancer postoperative patients and 60 healthy subjects.Results 88.34％ patients had sleep difficulty after operation.The score of sleep quality of patients (12.60 ± 4.65) were higher than that in control group (3.70 ± 3.77,P ＜ 0.05).Similarly,according to the stepwise multiple regressions,the score of sleep quality of patients were positively associated with anxiety,adaptability of personality and negatively associated with openness of personality.Conclusion Sleep problems of breast cancer postoperative patients are quite severe.The influencing factors of sleep quality of patients are anxiety,openness and adaptability of personality.

Objective To investigate the influence of preoperative diabetes mellitus (DM) on postoperative morbidity of pancreatoduodenectomy for pancreatic ductal adenocarcinoma.Methods The clinical data of 302 pancreatic ductal adenocarcinoma patients who underwent pancreatoduodenectomy from January 1,2005 to August 31,2012 were retrospectively analyzed.Results 113 patients (37.4％)had preoperative DM among the total 302 patients.The percentage of the major complication including pancreatic fistulas,delayed gastric emptying,infections,acute kidney injury and mortality accounted for 19.9％,12.9％,25.9％,36.0％,3.2％ and 3.5％ respectively.In the DM group,firm pancreatic texture was more common than that in non-DM group (x2 =15.175,P ＜ 0.01).While pancreatic fistula in the DM group developed less frequently(x2 =7.811,P =0.005) than that in non-DM group.Delayed gastric emptying,infections,acute kidney injury,hemorrhage,pulmonary,cardiovascular and neurologic complications,as well as length of stay in hospital and mortality were in similar frequency in the two groups (P ＞ 0.05).Binary Logistic regression analysis showed DM(OR =0.358,P =0.035) and firm pancreatic texture(OR =0.395,P =0.032) were protective factors against pancreatic fistula while preoperative jaundice(OR =3.819,P =0.010) and intraoperative blood transfusion (OR =1.268,P =0.001) were predisposing factors for pancreatic fistula.Conclusions With good control of perioperative glucose level,DM does not increase operation risk in pancreatoduodenectomy for pancreatic ductal adenocarcinoma.

Objective To investigate the potential role and changes of CD14, TNF-ct and IL-10 in liver in Vibrio vulnificus septic rats, and detect the intervention effects of eefoperazone sodium combined with levofloxacin. Methods To make Vibrio vulnificus sepsis model (VV group) and drug intervention model (AA group) in rats, the expression of CD14, TNF-α, IL-10 in liver were detected by RT-PCR. Results Compared with normal control (NC) group,CD14 mRNA and TNF-α mRNA expression increased markedly at 2, 6, 9, 12, 16 h in VV group (P<0.05), IL-10 mRNA raised greatly at 9, 12, 16 in VV group (P<0.05). CD14 mRNA expression was also rised in AA group at 9 h(P<0.05). TNF-α mRNA at 9, 12 h and IL-10 mRNA at 9, 12, 16 h in the AA group increased (P<0.05). Compared with VV groups, CD14 mRNA expression diminished greatly at 9, 12, 16 h in AA group (P <0.05), TNF-α mRNA and IL-10 mRNA diminished in the AA group at 16 h(P<0.05). Conclusion The treatment with cefoperazone sodium and levofloxacin may reduce expression of CD14, TNF-α and IL-10 in liver of rats with VV sepsis, it may inhibit the level of pro-inflammatory/anti-inflammatory cytokines, thereby regulating the balance of the inflammatory response in VV sepsis.

Objective:To evaluate the clinical efficacy of transanal total mesorectal excision (taTME) on transanal endoscopic microsurgery (TEM) platform in the treatment of middle and low rectal cancer.Methods:The retrospective and descriptive study was conducted. The clinico-pathological data of 28 patients with middle and low rectal cancer who underwent taTME on TEM platform in the Peking Union Medical College Hospital of Chinese Academy of Medical Science from October 2014 to October 2017 were collected. There were 21 males and 7 females, aged 59 years (51 years, 68 years). Observation indicators: (1) surgical and postoperative situations; (2) follow-up. Follow-up was conducted using outpatient examination or telephone interview to detect post-operative defecation function and survival of patients up to October 2020. Patients underwent physical examination, examination of tumor markers including carcinoembryonic antigen and CA19-9, colonoscopy, rectal magnetic resonance imaging, thoracoabdominal and pelvic enhanced computed tomography (CT) and (or) PET-CT examination during the follow-up. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was analyzed using the independent sample t test. Measurement data with skewed distribution were represented as M( P25,P75) or M (range), and comparison between groups was analyzed using the non parameter Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Results:(1) Surgical and postoperative situations: 28 patients underwent successful surgery, without intra-operative conversion to laparotomy. Of 28 patients, 24 cases underwent colorectal anastomosis and 4 cases underwent colon-anal anastomosis. Twenty-six cases underwent primary protective enterostomy and 2 cases didn't undergo primary protective enterostomy. The operation time of 28 patients was (182±37)minutes and the volume of intraoperative blood loss was 40mL(30 mL, 55 mL). One patient with intraoperative presacral hemorrhage received compression hemostasis. Eleven patients had postoperative complications, including 4 cases with anastomotic leakage, 2 cases with alteration of intestinal flora, 2 cases with paralytic ileus, 2 cases with urinary retention, 2 cases with urinary infection, 1 case with prolapse necrosis of small intestinal stoma, 1 case with anal hemorrhage, 1 case with rectovaginal fistula, 1 case with pelvic infection; some patients had multiple complications. Three patients had non-planned reoperation. One case without primary protective enterostomy had anastomotic leakage at postoperative 3 days, and was improved after emergency transversostomy. One case had prolapse necrosis of small intestinal stoma at postoperative 3 days and was improved after emergency enterostomy and reconstruction. One case with anal hemorrhage was stopped hemorrhage under anoscopy. Patients with other complications were cured after conservative treatments. The duration of postoperative hospital stay of 28 patients was 8 days(7 days, 9 days). Results of pathological examination in 28 patients showed 16 cases of moderately differentiated adenocarcinoma, 3 cases of moderately to highly differentiated adenocarcinoma, 5 cases of highly differentiated adenocarcinoma, 1 case of mucinous adenocarcinoma, 3 cases of pathological complete response. TNM staging of 28 patients showed 3 cases in stage T0N0, 4 cases in stage T1N0, 6 cases in stage T2N0, 4 cases in stage T2N1, 7 cases in stage T3N0, 3 cases in stage T3N1, 1 case in stage T4N1. The distance from tumor to distal margin was (2.2±1.7)cm. The surgical specimens of 28 patients showed negative for proximal, distal and circumferential margins. The number of lymph node dissection was 15±7. The complete rate of total mesorectal excision was 100%(28/28). Eleven of 28 patients underwent neoadjuvant therapy and 17 patients didn't receive neoadjuvant therapy. The tumor diameter, distance from tumor to anal margin, operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 2 cm(1 cm, 4 cm), 5 cm(4 cm, 6 cm), (187±25)minutes, 45 mL(38 mL, 53 mL), 8 days(7 days, 12 days) for patients with neoadjuvant therapy, respectively, versus 3 cm(2 cm, 4 cm), 5 cm(4 cm, 6 cm), (177±35)minutes, 40 mL(30 mL, 60 mL), 8 days(7 days, 8 days) for patients without neoadjuvant therapy, showing no significant difference between the two groups ( Z=-1.127, -0.293, t=0.590, Z=-0.790, -0.876, P>0.05). (2) Follow-up: 23 of 28 patients were followed up for (44±14)months. Of the 23 patients,11 cases were classified as grade A of Williams score for defecation function at postoperative 6 months, 8 cases were classified as grade B and 4 cases were classified as grade C. Eighteen of 23 patients with follow-up had disease-free survival, 1 of whom didn't undergo stoma closure due to anastomotic stenosis at postoperative 6 months. Three patients had distant metastasis, including 1 case with parastomal implantation metastasis, 1 case with sacral metastasis, 1 case with pulmonary metastasis. Two patients died, 1 case of whom died of urinary obstruction and 1 case with mucinous adenocarcinoma died at postoperative 24 months. Conclusion:TaTME based on TEM platform is feasible for middle and low rectal cancer, which has the advantages of preserving anus and negative circumferential margin.

Objective To investigate the role and mechanism of TMPRSS4 in radiation induced metastasis of hepatocellular carcinoma (HCC).Methods Metastatic model of human HCC was established by orthotopic implantation of histologically intact human HCC tissue into the liver of nude mice.Mice bearing xenografts in liver were killed after radiation and the residual tumors were resected and reimplanted into the liver of normal nude mice.At the end of sixth week,the mice were killed and the histopathological features,tumor volume,intrahepatic and lung metastasis were evaluated.Expression of epithelial-mesenchymal transition (EMT) related genes including N-cadherin,Vimentin,SIP1 and TMPRSS4 were measured by Western blotting and RT-PCR.Results The tumor volume and frequency of lung metastasis of control group was 2.25±0.52 cm3 and 66.7％,respectively.Compared to control group,tumor diameter (1.61±0.51 cm3,P＜0.05) and lung metastasis (12.5％,P＜0.05) were significantly inhibited 2 days after radiation.Whereas,30 days after radiation,tumor growth recovered (2.60±0.61 cm3,P＞0.05) and lung metastasis was enhanced (100％,P＜0.05).There were no intrahepatic metastasis in the control group and in the group of reimplantation of HCC 2 days after radiation,while the tumors from those 30 days after radiation showed enhanced intrahepatic metastasis (18 ± 8.05,P＜ 0.01 ),with overexpression of SIP1,N-cadherin,Vimentin and TMPRSS4,and reduced expression of E-cadherin.Conclusion The metastasis potential of residual HCC after radiation was first inhibited and then promoted.Overexpression of TMPRSS4 plays a critical role in radiation induced long-term metastasis of HCC by facilitating EMT.