ObjectiveTo explore the role of HSP27 in hepatic ischemia-reperfusion (IR) injury and hepatic ischemic preconditioning (IP).MethodsMale C57BL/6 mice were randomly divided into 3 groups:control group (sham operation),IR group (only hepatic IR),rHSP27 + IR group (rHSP27 injection before IR).The extent of liver injury was evaluated among these 3 groups.Murine HSP27 was silenced by short hairpin RNA and mice were subjected to IR with or without IP after interfering succeeded.Serum ALT and AST levels,hepatic histological damages and mRNA expression levels of pro-inflammatory mediators (TNF-α,IL-1β and IL-6) were measured.Results Silencing hepatic HSP27 aggravated IR injury indicated by higher concentration of serum ALT and AST (P＜0.05),reinforced by severer histological damage and more expression of pro-inflammatory mediators (P＜0.05),while injection of rHSP27 or IP ameliorated hepatic IR injury.Western-blot showed HSP27 expression was significantly higher in IP group than sham group.Silencing HSP27 largely removed the IP-induced hepatoprotection,indicated by restoration of caspase-3 induction.ConclusionHSP27 is an essential endogenous defense of liver against IR injury.Hepatic ischemic preconditioning can improve subsequent IR injury via up-regulation of HSP27,which is related to HSP27-mediated reduction of apoptosis.

OBJECTIVE:To study the econamics effect of risperidone and quetiapine in treating of schizophrenia.METH ODS:64schizophrenia patients were randomly divided into risperidone group(34cases)and quetiapine group(30cases).The effects were evaluated based on the reduction of scores determined by brief psychiatric rating scale(BPRS);the adverse effects were evaluated by treatment emergent symptom scale(TESS).And then the cost-effectiveness analysis was carried through.RESULTS:The per capita costs for risperidone and quetiapine were3598.85yuan and3778.63yuan respectively;the re-duction of BPRS scores were(36.09?15.52)and(25.03?14.45)respectvely;the respective cost-effect ratio was99.72yuan and150.96yuan;the increment of the cost-effect ratio for the quetiapine group was-16.25compared with the risperidone group.CONCLUSION:Risperidone is more economical than quetiapine in the treatment of schizophrenia.

OBJECTIVE:To analyze the cost-effectiveness of3kinds of Chinese patent drugs in the treatment of insomnia outpatients.METHODS:78outpatients with insomnia were randomly divided into group A,group B and group C,and they were treated with shumian capsule,sweet dream capsule and compound semen ziziphi spinosae capsule,respectively,then,cost-effectiveness analysis was carried out with pharmacoeconomics.RESULTS:The per capita costs(C)for group A,B and C were288.20yuan,163.08yuan and139.22yuan respectively,the reduction in PSQI scores(E 1 )were5.15,8.88and11.84respectively,the effective rates(E 2 )were26%,46%,and64%respectively;The average cost-effect ratios C/E 1 were55.96,18.36,and11.76respectively;C/E 2 were11.08,3.55,and2.18respectively;The increment of the cost-effect ratios?C/?E 1 for group A and B were—22.27and—8.06respectively;?C/?E 2 were—3.92,—1.33respectively,as compared with group C.CONCLUSION:Compound semen ziziphi spinosae capsule is more economical in3drugs in treating insomnia outpatients.

OBJECTIVETo evaluate the feasibility of laparoscopic and endoscopic cooperative partial gastrectomy,a minimally invasive surgery, in treating gastric submucosa lesion.

METHODSWe retrospectively analyzed 63 patients [34 women and 29 men, aged (52.8±18.1) years (range:14 to 78 years)] who had undergone laparoscopic and endoscopic cooperative partial gastrectomy with preserving cardia and pylorus for gastric submucosal tumor in the past 6 years. All of the patients were followed up for 2-69 months (average 35 months). The clinicopathological data, surgical approaches, and follow-up results were analyzed.

RESULTSThe surgery was successfully performed in all these 63 patients, among whom 61 were assisted by endoscopy. The most common symptom was dyspepsia. The mean distance from the lesions locating at fundus or antrum to cardia or pylorus was(2.9±1.1)cm. The minimum distance from tumor edge to cardia was 1cm. The diseases included gastrointestinal stromal tumor (n=54), carcinoid tumors (n=3), ectopic pancreas (n=2), lipoma (n=2), and leiomyoma (n=2). The tumor size ranged from 0.8 to 8.2cm, with 44 lesions (69.8%) less than 2cm. Forty-five lesions(71.4%) were located at fundus, 12 (19.0%) at body, and 6 (9.6%) at antrum. No recurrence or death was noted during follow-up.

CONCLUSIONSLaparoscopic and endoscopic cooperative partial gastrectomy is feasible for treating gastric submucosal tumor. Endoscopy is useful for intraoperative localization and supporting, and therefore is especially helpful for preserving cardia and pylorus.

Adolescent ; Adult ; Aged ; Female ; Follow-Up Studies ; Gastrectomy ; methods ; Gastric Mucosa ; pathology ; Gastroscopy ; Humans ; Laparoscopy ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; pathology ; surgery ; Young Adult

OBJECTIVETo evaluate the prognostic effects of neoadjuvant chemotherapy (NAC) in patients with local advanced gastric cancer.

METHODSWe retrospectively analyzed prognosis in 191 patients with advanced gastric cancer, of whom 71 were treated with NAC and 120 received surgery only between February 2007 and July 2013. Postoperative complication rate was recorded. Survival by clinicopathological features, pathological T and N stages, and histopathological tumor regression was retrospectively compared between the two groups.

RESULTSAccording to Response Evaluation Criteria in Solid Tumors, none of the 71 patients in the NAC followed by surgery group showed complete response, 36 showed partial response, 25 had stable disease, and 10 had progressive disease. The chemotherapy response rate was 50.7%; the disease control rate was 85.9%. Grade 3/4 adverse events were seen in less than 20% patients, with acceptable toxicities. No difference was found in the overall postoperative complication rates between the two groups (7 versus 22 cases, P=0.18). Median survival time was significantly different, at 54 months in the NAC combined with surgery group and 25 months in the surgery-only group (P=0.025).

CONCLUSIONIn patients with operable gastric adenocarcinomas, NAC can significantly improve overall survival without increasing surgical complications.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Neoadjuvant Therapy ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; drug therapy ; mortality ; pathology

Human gut microbiota plays a key role in the development of obesity. Intestinal flora can regulate energy absorption and nutrition metabolism, increasing the energy harvesting from diet. Alteration of gut flora produces excessive lipopolysaccharide, which, when absorbed into the blood, can induce inflammatory reactions and promote the high-fat diet-associated obesity and metabolic syndrome. Intestinal flora increase visceral fat deposition by lowering the expression of Fiaf in intestinal mucosa. Different immune status also affects the intestinal flora.The gut microbiota is hypothesized to be an environmental factor that contributes to obesity; by interacting with factors such as host and diet, it adjusts the energy metabolism. Antibiotics or probiotics may alter the composition of intestinal microflora and improve the metabolic syndrome, and thus provides new treatment options.
Animals ; Diet, High-Fat ; Gastrointestinal Tract ; microbiology ; Humans ; Inflammation ; etiology ; Mice ; Obesity ; microbiology ; therapy ; Probiotics ; therapeutic use

Iodine, an essential component of the hormones produced by the thyroid gland, is widely but unevenly distributed in the earth's environment. Great difference exists in the iodine nutritional status of populations residing in different region. Both iodine deficiency and iodine excess can injure the thyroid gland. Iodine deficiency tigers endemic goiter, cretinism, and hyperthyroidism, while iodine excess can result in high iodine goiter, chronic lymphocytic thyroiditis, iodine-induced hyperthyroidism, and hypothyroidism; also, iodine deficiency or excess may affect the histological type of thyroid cancer. In 1996, China began to implement the universal salt iodization policy, which has basically eliminated the iodine deficiency disorders nationwide; however, it also caused the changes in the spectra of other thyroid diseases including iodine-induced hyperthyroidism, autoimmune thyroid disease, and papillary thyroid carcinoma. Individualized iodine nutritional status assessment for the populations, particularly those with thyroid diseases, will be beneficial.
China ; epidemiology ; Humans ; Iodine ; administration & dosage ; adverse effects ; deficiency ; Sodium Chloride, Dietary ; adverse effects ; Thyroid Diseases ; epidemiology ; etiology

Bariatric surgery is an effective way to achieve long-term weight reduction in severely obese patients. This article illuminates the indications, procedures, complications, and results of bariatric surgery for severe obesity.
Bariatric Surgery ; methods ; Gastric Bypass ; methods ; Gastroplasty ; methods ; Humans ; Obesity, Morbid ; surgery

OBJECTIVETo analyze the risk factors of colorectal cancer-related anemia.

METHODThe clinical data of 319 patients with colorectal cancer were retrospectively analyzed for the possible risk factors of tumor-related anemia including tumor location, clinical stage, clinical symptoms, pathology, gender, and age.

RESULTSOf these 319 cases, 141 (44.20%) had anemia. The incidence of anemia was 62.20% among patients with right hemicolon cancers (including caecum cancer), and was 23.82% among patients with rectal cancer and 36.23% among those with transverse descending or sigmoid colon cancer. Cardia insufficiency, melena, tumor location, T staging, hypoproteinemia were also found to be related with anemia. Anemia and hypoproteinemia were the risk factors for perioperative blood transfusion (odds ratio = 3.004, odds ratio = 8.356, respectively).

CONCLUSIONSThe colorectal cancer-related anemia is not associated with the clinical stage of the tumor, while cardiac insufficiency, melena, tumor location, tumor stage, and hypoproteinemia constitute the possible risk factors. Anemia and hypoproteinemia are the risk factors of perioperative blood transfusion.

Adult ; Aged ; Aged, 80 and over ; Anemia ; etiology ; Colorectal Neoplasms ; complications ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors

OBJECTIVETo summarize early experience in combined thoraco-laparoscopic esophagectomy with two-field lymph node dissection for esophageal carcinoma.

METHODSA total of 150 patients with thoracic esophageal cancer who underwent combined thoracoscopic and laparoscopic esophagectomy in Union Hospital, Fujan Medical University, were enrolled in this study.

RESULTSLocations of the tumors included upper esophagus (n=14), middle esophagus (n=95), and lower esophagus (n=41). Pathological type showed squamous cell cancer (n=142) and other types of cancer (n=8). There was no intraoperative death. Conversion to open thoracotomy was required in 6 patients and conversion to open laparotomy in 2 patients. The average total operative time was( 258±45) min. The average operative thoracoscopic time was (140±33) min. The average time for gastric mobilization and neck esophagogastric anastomosis was (119±28) min. The average blood loss during the procedure was (207±130) ml. The average number of harvested lymph node with the specimen was 23.3±8.2. The tumor staging included stage I (n=39), II (n=58) and III (n=53). Postoperative complications occurred in 48(32%) patients including pneumonia (n=17), recurrent laryngeal injury (n=13), anastomotic leak (n=9), arrhythmias (n=9), chyle chest (n=5), delayed gastric emptying (n=5), ileus (n=2), volvulus (n=1), and thrombocytopenia (n=1). Two patients died postoperatively due to respiratory failure resulting from pneumonia.

CONCLUSIONThoraco-laparoscopic two-field lymph node dissection of esophageal cancer is a feasible minimally invasive approach.

Adult ; Aged ; Aged, 80 and over ; Esophageal Neoplasms ; surgery ; Esophagectomy ; methods ; Female ; Follow-Up Studies ; Humans ; Laparoscopy ; methods ; Lymph Node Excision ; methods ; Male ; Middle Aged ; Retrospective Studies ; Thoracoscopy ; methods