Objective Liver function in perioperative periods, postoperative complications, and pathological changes in the liver were studied and compared between patients undergoing emergent and elective surgical intervention (extensive esophagogastric devascularization, EED) for portal hypertension (PTH), with the purpose to elucidate the pathogenesis of PTH. Methods The clinical data and liver biopsies from 150 cases of inpatients with hepatis cirrhosis and PTH who underwent either emergent (28 cases) or elective (100 cases) surgical intervention including extensive esophagogastric devascularization (EED) in 302 th Hospital of PLA were analysed. Liver biopsy was done in 128 patients, and the expression of ?-smooth muscle actin (?-SMA), tubulin?and ?in hepatic stellate cells (HSCs), and endothelin-1 (ET-1) was histochemically studied in the liver tissue. Results It was found that the mean internal diameter of portal veins before surgery was larger and the incidence of pre-operative acute variceal haemorrhage was significantly higher in the emergent EED group than those in the elective EED group (P

Objective To assess the efficacy of extensive esophagogastric devascularization with splenectomy for surgical treatment of portal hypertension complicating cirrhosis of liver, and to explore the pathogenesis of chronic congestive splenomegaly. Methods A retrospective analysis of clinical data of 232 patients of portal hypertension complicating cirrhosis of liver having undergone extensive esophagogastric devascularization with splenectomy was made. Pathological alterations and extracellular matrix productive cells of the congestive splenomegaly were studied both immunohistochemically and histologically. Results The functional markers including the numbers of PLT, WBC, and PTA in the peripheral blood and serum Alb were significantly improved after the operation compared with that of before the operation. Careful pre-operation preparation, replenishment of blood loss during the operation, postoperative drainage of the splenic bed, and prevention of complications were efficiently carried out. The mean volume of CCS spleens was 1 423.67?738.69cm 3. There was an obvious increase in the numbers of vimentin-, ?-SMA-positive cells in the CCS tissues, as well as CD68-positive macrophages. Conclusions The results indicated that extensive esophagogastric devascularization with splenectomy was a reasonably effective alternative therapy for patients with portal hypertension complicated by esophageal varices and congestive splenomegaly. Adequate replacement of blood lost in prevention of operation and postoperative complications were essential for satisfactory recovery of the petient. The activation of macrophagic system, with proliferation of fibroblasts and myofibroblasts, might participate in the pathogenesis of congestive splenomegaly.

Objective To evaluate the morbidity,clinical manifestation,risk factors and prognosis of diffuse large B-cell lymphoma(DLBCL)patients with central nerve system(CNS)infiltration.Methods Clinical data of DLBCL patients with CNS infiltration between Jan 2005 and Jan 2012 were reviewed.Results Among 168 DLBCL patients,11 patients(6.5 ％)had CNS infiltration.ECOG scores ≥ 2,elevated lactate dehydrogenase(LDH)＞ 2 times of normal range and the involvement of ≥ 2 extranodal sites were clinical risk factors associated with CNS inflitration(x2 =11.6,4.61,3.92,all P ＜ 0.005).Median survival time after CNS infiltration was 4.5 months.Conclusion DLBCL patients with CNS infiltration are not rare,the patients demonstrate significantly bad prognosis.

The level of serum fibroblast growth factor-21 (FGF-21) in patients with type 2 diabetes mellitus complicated with non-alcoholic fatty liver disease (NAFLD) was determined by ELISA.The results showed that serum FGF-21 level in these patients was higher than that in type 2 diabetic patients [(266.55 ± 21.24 vs 220.32 ± 22.68) ng/L,P＜ 0.01].Serum FGF-21 levels in both groups were significantly higher than that in normal control group [(173.52 ± 16.18) ng/L,P＜0.01].Serum FGF-21 level was positively correlated with waist circumference,blood glucose,and triglyceride.FGF-21 may contribute to the development of NAFLD in the patients with type 2 diabetes mellitus.

Objective:To investigate Intraflagellar Transport 80 (IFT80) protein expression in bone, lung, pancreatic, stomach, in-testinal, prostate, breast, and ovarian cancers to explore its mechanism in cancer cell proliferation and to diagnose and identify new tar-gets in cancer treatment. Methods:Immunohistochemistry was used to investigate the expression of IFT80 in gastric cancer tissue of different stages and in eight other kinds of human cancer tissues. We studied the relationship between cancer cell proliferation and inhi-bition of IFT80. Immunofluorescence method and cell culture were used to study the cilia and IFT80. Results:Results showed the fol-lowing:a) the expression of IFT80 was high in gastric and lung carcinoma tissues, moderate in breast and colorectal cancers, low in bone and ovarian cancers, and nearly absent in prostate and pancreatic cancers;b) inhibition of IFT80 in the A549 cancer cell line accel-erated cell proliferation and resulted in shorter, lower quality cilia;and c) IFT80 was abundantly expressed in cancer tissues of well-dif-ferentiated stage-IIA gastric cancer and normal gastric tissues, but was hardly expressed in late-stage, poorly differentiated gastric can-cer. IFT80 could have various degrees of expression in gastric carcinoma of other stages and differentiation. Conclusions:Different can-cer organs showed variation in IFT80 expression. IFT80 can be distributed in the organs with mechanical motion function, such as lungs and stomach. IFT80 is distributed on the cell cilia and can adjust the number and length of the cilia by reducing IFT80 protein ex-pression. Through a variety of ways, IFT80 directly or indirectly participates in the proliferation of cancer cells. Thus, the lowest or nearly zero expression of IFT80 can be seen in cancer tissues of high-grade malignancy, such as advanced cancers with poor differentia-tion.

OBJECTIVETo investigate the theoretical model of the three-dimensional structure of mosquitocidal Cry30Ca2 and its molecular docking with N-acetylgalactosamine.

METHODSThe theoretical model of Cry30Ca2 was predicted by homology modeling on the structure of the Cry4Ba. Docking studies were performed to investigate the interaction of Cry30Ca2 with N-acetylgalactosamine on the putative receptor.

RESULTSCry30Ca2 toxin is a rather compact molecule composed of three distinct domains and has approximate overall dimensions of 95 by 75 by 60Å. Domain II is a helix bundle, Domain II consists of three antiparallel β-sheets, Domain III is composed of two β-sheets that adopt a β-sandwich fold. Residue 321Ile in loop1, residues 342Gln 343Thr and 345Gln in loop2, residue 393Tyr in loop3 of Cry30Ca2 are responsible for the interactions with GalNAc via 7 hydrogen bonds, 6 of them were related to the oxygen atoms of hydroxyls of the ligand, and one to the nitrogen of the ligand.

CONCLUSIONThe 3D structure of Cry30Ca2 resembles the previously reported Cry toxin structures but shows still some distinctions. Several residues in the loops of the apex of domain II are responsible for the interactions with N-acetylgalactosamine.

Acetylgalactosamine ; chemistry ; Amino Acid Sequence ; Animals ; Bacterial Proteins ; chemistry ; pharmacology ; Catalytic Domain ; Culicidae ; drug effects ; Endotoxins ; chemistry ; pharmacology ; Hemolysin Proteins ; chemistry ; pharmacology ; Insecticides ; chemistry ; pharmacology ; Models, Molecular ; Molecular Sequence Data ; Protein Conformation

BACKGROUND: There have been many methods of fixation between lumbar-sacral spine and pelvis. However, a safe, firm, and ideal method of internal fixation has not been found.OBJECTIVE: This study was designed to investigate the stability of the fixation between lumbar-sacral spine and pelvis with the connectible skills using iliac screw and lumbar-sacral spine pedicle screw.DESIGN, TIME AND SETTING: This study, a control experiment, was performed at the Institute of Biomechanics, Sun Yat-sen University, Guangzhou, Guangdong Province, China between January 2006 and December 2007.MATERIALS: The lumbar-sacral spine and pelvis specimens were collected from six freshly cryo-preserved male adult corpses caused by trauma. Iliac screw (8.5mm×100mm), L5 pedicle screw (6.5mm×45mm), and S1 pedicle screw (6.5mm×35mm) were provided by Sofamor Company, USA. MTS 858 Bionix Material Testing System (USA) was also used.METHODS: The lumbar and iliac vertebrae, pelvis from six fresh frozen cadaveric specimens were operated in three different ways of fixation respectively: iliac ala lag screw, L5-S1 pedicle screw rod system, iliac screw and L5 pedicle screw connecting system. Three ways of fixation as mentioned above were compared with the intact group in biomechanical stability.MAIN OUTCOME MEASURES: The mobility of whirl, lateral bending, proneness, and backward stretching among groups.RESULTS: Using iliac screw for the fixation between lumbar-sacral spine and pelvis turned out to be the best in stability. The range of motion (ROM) decreased obviously in each situation. The three-dimensional mobility in the 6.4Nm moment of force was (1.07±0.86)° for whirl, (0.95±0.47)° for lateral bending, (1.22±0.67)° for proneness, and (1.80±0.73)° for backward stretching. There was significant difference between the intact group and the group carried out by iliac screw and L5 pedicle screw for the fixation between lumbar-sacral spine and pelvis (P<0.01).CONCLUSION: The connectible skills using iliac screw and the lumbar-sacral spine pedicle screw possesses the biomechanical advantages of maintaining the stability between lumbar-sacral spine and pelvis.

OBJECTIVETo explore the effect of Shengjiang Xiexin Decoction (SXD) on the intestinal mucosal and functional cells of rats after irinotecan (CPT-11) chemotherapy.

METHODSTotally 24 healthy Sprague-Dawley (SD) male rats were divided into three groups, the normal control group, the CPT-11 group, the SXD combined CPT-11 group according to random digit table, 8 in each group. CPT-11 was injected at the daily dose of 150 mg/kg to rats in the CPT-11 group and the SXD combined CPT-11 group from the caudal vein on the 4th day, once daily for 2 successive days to duplicate delayed diarrhea model. Equal volume of normal saline was injected to rats in the normal control group from the caudal vein. SXD at 2 g/mL (10 g/kg body weight) was administered to rats in the SXD combined CPT-11 group by gastrogavage for 9 successive days. Deionized water was administered to rats in the CPT-11 group and the normal control group. Diarrhea was observed at 48, 60, 72, 84, 96, and 108 h to calculate the incidence rate of diarrhea. Meanwhile, scoring for diarrhea was performed by referring methods of Akinobu Kurita. Rats were killed on day 10, ileum, cecum, and colon tissues were collected and fixed in 10% formalin solution. HE staining was performed. Intestinal mucosa injuries were graded under light microscope according to the criterion of Chiu's score. The expressions of goblet cells and Paneth cells were observed by PAS stain. Enteroendocrine cells were observed by immunohistochemical CgA staining. Positive cells were counted and cumulative optical density (IOD) analyzed by Image-Pro-Plus 6.0.

RESULTSNo diarrhea occurred in rats of the normal control group at each time point. The incidence rate of diarrhea was 75.0% (6/8) at 48 h, 100.0% (8/8) at 60 h, 100.0% (8/8) at 72 h, 87.5% (7/8) at 84 h, 75.0% (6/8) at 96 h, and 75.0% (6/8) at 108 h in the CPT-11 group. The incidence rate of diarrhea was 25.0% (2/8) at 48 h, 50.0% (4/8) at 60 h, 12.5% (1/8) at 72 h, 0.0% (0/8) at 84 h in the SXD combined CPT-11 group. Compared with the same group at 60 h, scores for diarrhea at 48, 84, 96, and 108 h obviously decreased in the CPT-11 group, and scores for diarrhea at 48, 72, 84, 96, and 108 h obviously decreased in the SXD combined CPT-11 group (P < 0.05, P < 0.01). Compared with the same group at 72 h, scores for diarrhea at 84, 96, and 108 h obviously decreased in the CPT-11 group (P < 0.05, P < 0.01). Compared with the normal control group, scores for diarrhea increased in the CPT-11 group at each time point (P < 0.01); grading of ileum, cecum, and colon mucosal tissues increased (P < 0.05, P < 0.01); expressions of ileum and cecum mucosal epithelial goblet cells obviously decreased (P < 0.05); the number and expressions of ileum and cecum mucosal epithelial Paneth cells increased (P < 0.01). Expressions of ilium endocrine cells increased, while those of cecum and colon endocrine cells decreased in the CPT-11 group (P < 0.01). Compared with the CPT-11 group, scores for diarrhea were obviously lowered (P < 0.05, P < 0.01), grading of ileum, and cecum mucosal tissues decreased (P < 0.05, P < 0.01); expressions of ileum, cecum, and colon mucosal epithelial goblet cells obviously increased (P < 0.05, P < 0.01); the number and expressions of ileum cecum mucosal epithelial Paneth cells increased (P < 0.05); expressions of cecum and colon endocrine cells increased (P < 0.05, P < 0.01) in the SXD combined CPT-11 group.

CONCLUSIONSXD played roles in preventing and treating CPT-11 induced delayed diarrhea by improving CPT-11 chemotherapy induced apoptosis and necrosis of intestinal mucosal and functional cells.

Animals ; Apoptosis ; Camptothecin ; adverse effects ; analogs & derivatives ; Colon ; Diarrhea ; Drug Therapy ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Ileum ; Intestinal Mucosa ; drug effects ; Male ; Rats ; Rats, Sprague-Dawley ; Wound Healing ; drug effects

OBJECTIVEThis study aims to explore the method that uses primary tumor contralateral facial artery musculocutaneous (FAMM) flap to reconstruct defects of the tongue and floor of mouth.

METHODSSix cases were selected for the use of primary tumor contralateral FAMM flap to reconstruct tongue and floor of mouth defects after tumor resection.

RESULTSThe FAMM flap of the six cases had a long pedicle that could reach the contralateral tongue and floor of mouth. All flaps were intact until post-operation. All patients experienced post-operation complications, such as temporary facial tension and limited mouth opening, which improved after 3 months. Half a year later, the flaps still did not show signs of shrinking.

CONCLUSIONFeatures of the primary tumor contralateral FAMM flap include the tissue-like material provided for reconstructing tongue or floor of mouth defects, easy acquisition, and high survival rate with minimal donor site morbidity. As such, it is an ideal material for repairing tongue and floor of mouth defects.

Arteries ; Face ; Humans ; Mouth Neoplasms ; Myocutaneous Flap ; Reconstructive Surgical Procedures ; Surgical Flaps ; Tongue ; Tongue Neoplasms

Objective To assess the clinical application of Cylex ImmuKnow assay in patients with renal dysfunction after liver transplantation for individualized immunosuppressive therapy.Method Twenty adult patients undergoing liver transplant between January 2009 and December 2011 received regular ImmuKnow assay monitoring combined with determination of serum tacrolimus trough concentration to guide immunosuppressive regimens,all of whom showed sustained renal dysfunction 6 months after transplant with normal and stable liver function.Clinical data were collected to observe the changes of renal function in those patients after treatment.Results The recipients were followedup for 15-54 months,received ImmuKnow assay 61 times and the results fluctuated 33-943 μg/L [median 282 μg/L,interquartile range (IQR) 267 μg/L].After ImmuKnow monitoring,serum creatinine level in patients was decreased significantly from median 151.8 μmol/L with IQR 44.9 μmol/L to median 114.9 μmol/L with IQR 35.3 μmol/L (Z =-3.845,P =0.000),and estimated glomerular filtration rate (eGFR) was increased significantly from median 0.746 mL/s with IQR 0.025 mL/s to median 1.005 mL/s with IQR 0.454 mL/s (Z =-3.771,P =0.000).ImmuKnow results showed a linear correlation with the white blood cell count in patients (Spearman correlation coefficient r =0.429,P =0.001),but no linear correlation with the patients' age,primary disease before transplantation,postoperative time,serum tacrolimus trough concentration,lymphocyte count,CD3+ T lymphocyte count,CD4+ T lymphocyte count or CD4+/CD8+ T lymphocyte ratio (P＞ 0.05).Conclusion Cylex IrmmuKnow assay can be applied in patients with renal dysfunction after liver transplantation for individualized immunosuppressive therapy monitoring,which is of certain clinical value.