It is confirmed that expression of gastrins in some colorectal neoplasms cells and their tissue is abnormal. The abnormal expression of gastrins have close relationship with the occurrence and the develop-ment of colorectal neoplasms. Gastrins binding with receptor can regulate ceramides content and promote cells proliferation by series of signal transduction pathways. Blocking these signal transduction pathways may provide a novel therapeutic approach for colorectal neoplasms prevention and treatment.

Gastrectomy ; methods ; Humans ; Laparoscopy ; Stomach Neoplasms ; surgery

BACKGROUND: Recently, there are some researches show that the nutrition and control of nervous system play an important role in the growth of bone and healing of bone fracture.OBJECTIVE: To probe into the effects of brain-derived neurothophic factor on bone fracture healing and its biomechanic features.DESIGN: Randomized controlled study of experiment animals.SETTING: Traumatic orthopaedic and hematology department of a military medical university.MATERIALS: There were 16 SD rats with transverse fracture of shin,which were set up as intramedullary nail internal fixation. They were randomly divided into experiment group and control group with each of 8 mice.INTERVENTIONS: Rats in the experiment group were taken subcutaneous injection of brain derived neurotrophic factor(BDNF) every other day while control group was injected of saline. The shin of mice was collected to observe in the 2nd, 3rd, 4th and 5th weeks.MAIN OUTCOME MEASURES: Gross comparison of fracture healing of each group, biomechanical test and electro microscopic observation.RESULTS: It can be seen by gross observation 2 weeks after operation that the fracture area was linked by connective tissue in both groups and there was obvious movement. In the 3rd week, woven like bone healing could be seen in the experiment group whereas there was obvious fracture end movement in the control group. In the 4th week, bone healing could be seen in both groups, but the bone callus in the experiment group was much smaller with mild angled malformation. In the 5th week, the fracture line in the experiment group already disappeared and the molding of bone fracture was good while there was bigger bone callus in fracture end of the control group. The angle formed by sagittal planes of fracture in the 3rd, 4th and 5th week was(25.00 ± 1.82)°, (24.75 ± 2.50)°, (23.25 ± 3.77)° respectively in the experiment group and(32.00 ±2.45)°, (33.00 ±5.72)°, (29.25± 2.22)° respectively in the control group( P ＜ 0. 05) . The anti-fracture stress in each stage of the experiment group was better than that of the control group( P ＜ 0.05).CONCLUSION: Applying BDNF early and incessantly can stimulate all the stages of bone fracture healing.

Objective To compare the lateral decubitus and supine position in the treatment of femoral intertrochanteric fractures with femoral proximal nail antirotation (PFNA).Methods A retrospective analysis was performed of the 85 patients with intertrochanteric fracture who had been treated at our hospital between September 2013 and September 2014.They were 24 men and 61 women,28 to 99 years of age (average,78.5 years).By Evans-Jensen classification,one case was type Ⅰ,15 cases were type Ⅱ,40 type Ⅲ,23 type Ⅳ,and 6 type Ⅴ.All the patients were treated with internal fixation with PFNA.Lateral decubitus position was adopted in 45 cases and supine position in 40.The 2 groups were compared in terms of operation time,intraoperative bleeding volume,difference between preoperative and postoperative hemoglobin values,tip-apex distance (TAD),calcar tip-apex distance (Cal-TAD),fracture healing time,and Harris score of the hip joint.Results The 85 patients were followed up for 9 to 21 months (average,13.6 months).Both 2 groups obtained fracture healing,with no screw cut-out.The lateral decubitus group had significantly less operation time (60.3 ± 17.5 min) and intraoperative bleeding volume (70.8 ± 37.8 mL) than the supine position group (72.7 ± 19.7 min and 90.3 ± 20.9 mL,respectively) (P ＜ 0.05).The former also had a significantly smaller difference between preoperative and postoperative hemoglobin values (24.1 ± 5.7 g/L) than the latter (28.2 ± 8.5 g/L) (P ＜ 0.05).There were no significant differences between the 2 groups in TAD,Cal-TAD,fracture healing time (3.7 ± 0.9 months versus 3.7 ± 1.0 months),or Harris hip score (73.4 ± 10.7 versus 75.5 ± 9.5) (P ＞ 0.05).Conclusion In the treatment of femoral intertrochanteric fractures with PFNA,lateral decubitus position may be associated with shorter operation time and less intraoperative blood loss compared with supine position.

Objective To conduct a hiomechanical comparison of the four common internal fixation methods for the anterior eruciate ligament(ACL)avulsion fractures of displaced tibial eminence.Methods Sixteen fresh cadaver knee joints were used and randomized into four equal groups of four fixation methods:antegrade wiring group, retrograde wiring group,suturation group,and intramedullary screw group.The knee joint specimens were fixed at flexion of 30?and subject to continuous stretch stresses of 30 N,60 N and 90 N respectively on a material testing machine(MTS 858 Bionix test system,USA)which conducted a simulated Lachman test.The specimens were scanned at different angles by a three dimensional laser scanner.Data were recorded and processed by image software to es- tablish three-dimensional structure models of femur,tibia and knee joint.The test results were analyzed statistically on a computer.Results There were no obvious differences between each fixation group in the length change of ACL when the stresses were 30 N and 60 N(P＞0.05).Under 90 N stress,however,the mean length change between the femoral and tibial attachments of ACL was the smallest(4.8?1.7)mm(2.5 to 6.2 mm)in the suturation group(P＜0.05). There were no distinct differences between the intramedullary screw group and the retrograde wiring group in the changes of A CL shift(P=0.214).The average front shift in the retrograde wiring group was(6.2?1.2)mm(4.8 to 8.2 mm) and significantly smaller than that in the antegrade wiring group(P＜0.05).The antegrade wiring group made the largest average front shift under different stresses and its average front shift was(7.2?1.3)mm(5.6 to 8.7 mm). Conclusions The knee joint stability provided by the suturation fixation is distinctly better than that by the other three fixation methods.The antegrade wire fixation provides the poorest knee joint stability.There is hardly any difference between intramedullary screw fixation and retrograde wiring fixation.

Background Recombinant hirudin variant Ⅲ(rHV3) can effectively prevent galactose-induced human lens epithelial cells LECs injury,but little is known about the molecular mechanism of its action.Objective The present study was to investigate the effects of rHV3 on the expression of apoptosis-related genes in damaged LECs induced by galactose.Methods The rHV3 was extracted by our research group,and the biological activity of rHV3 was identified by titration of thrombase according to Markwardt's method.Human LECs (SRA01/04) were cultured using 125×10-3 mol/L D-galactose+10% FBS+D/F12 medium to establish the damaged human LECs model.rHV3 was added into the medium of the damaged human LECs model.Human LECs were cultured in D/F12 medium containing 10% FBS as normal control.The expression of apoptosis-related genes,such as aldose reductase (AR),bax,bcl2 and p53,in LECs at the mRNA level was detected using RT-PCR.The abundance ratio of target genes was presented with the absorbance (A) of gene mRNA/GAPDH mRNA.Results Compared to the normal control group,the A values of AR mRNA/GAPDH mRNA,bax mRNA/GAPDH mRNA and p53 mRNA/GAPDH mRNA were significantly elevated in model group (t=3.90E-06,t=8.44E-04,t=5.15E-08,P＜0.01).However,in the rHV3-treated group,the A values of AR mRNA/GAPDH mRNA,bax mRNA/GAPDH mRNA and p53 mRNA/GAPDH mRNA were lower than those of model group (t=5.90E-06,t=1.51E-04,t=3.42E-06,P＜0.01).The bcl2 mRNA/GAPDH mRNA was markedly downregulated in the model group when compared with the normal control group (t=1.86E-05,P＜0.01);while after rHV3 addition,bcl2 mRNA/GAPDH mRNA increased in comparison with the model group (t=8.56E-05,P＜0.01).Conclusion 125×10-3mol/L D-galactose induces the damage and apoptosis of human LECs.rHV3 likely plays a protective function on D-galactose-induced damage of human LECs by inhibiting the polyol pathway and mitochondria-mediated pathway.

Objective To investigate the correlation between acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) scores and delirium probability of senile severe pneumonia patients undergoing invasive mechanical ventilation (MV).Methods A retrospective study was conducted. Eighty-nine senile severe pneumonia patients undergoing invasive MV admitted to intensive care unit (ICU) of Hunan Provincial People's Hospital from January 2015 to March 2017 were enrolled. APACHE Ⅱ scores were collected 24 hours before invasive MV. Consciousness assessment method-ICU (CAM-ICU) was used to diagnose delirium, and the patients were divided into delirium group and non-delirium group. The first delirium occurrence time, duration of MV and the length of ICU stay were recorded. The patients were divided into ≤15, 16-20, 21-25, 26-30, 31-35, 36-40 groups according to APACHEⅡ score, and the incidence of delirium in all groups were observed. The linear regression and Pearson correlation were used to analyze the correlation between APACHE Ⅱ scores and delirium probability. Receiver operating characteristic (ROC) curve was plotted to analyze the predictive effect of APACHEⅡ score on delirium.Results Eighty-nine patients were enrolled in the final analysis, of which 35 had delirium, and 54 had no delirium, with delirium incidence of 39.33%, and the first delirium occurrence time of (1.85±1.30) days. The duration of MV and the length of ICU stay of delirium group were significantly higher than those of non-delirium group [duration of MV (days): 9.43±4.77 vs. 6.08±3.30, length of ICU stay (days): 14.60±6.59 vs. 9.69±4.61, bothP < 0.01]. The APACHE Ⅱ score in delirium group was significantly higher than that in non-delirium group (29.89±5.45 vs. 21.48±4.76,P < 0.01). With the increase in APACHE Ⅱ scores, the delirium incidence was gradually increased. Correlation analysis showed that there was a negative correlation between APACHE Ⅱ scores and first delirium occurrence time (r = -0.411,P = 0.014), and a significant linear positive correlation between APACHE Ⅱ scores and delirium incidence in all patients was found (r = 0.982, P = 0.000), which indicated the higher APACHE Ⅱ scores, the higher delirium incidences and the earlier first delirium occurrence time was. ROC curve analysis showed that the area under ROC curve (AUC) of APACHE Ⅱ scores on predicting delirium occurrence was 0.877, when the cut-off value of APACHE Ⅱ score was over 27, the sensitivity was 92.59%, the specificity was 71.43%, the positive predictive value was 83.33%, and the negative predictive value was 86.21%.Conclusions With the increase in APACHE Ⅱ score, the incidence of delirium was increased gradually in senile severe pneumonia patients receiving invasive MV. APACHE Ⅱ score played an important clinical value in evaluating the delirium probability of these patients

Objective: To examine the effect of early comprehensive interventions on the physical growth and nerve development among premature infants, so as to provide insights into the follow-up management of premature infants after discharge from hospital. Methods: A total of 130 premature infants delivered in Shaoxing Municipal Maternal and Child Health Care Hospital from 2019 to 2021 were selected and divided into high- and low-risk groups according to gestational age and birth weight, while 306 full-term normal infants in the same hospital during the study period served as controls. All premature infants were given early comprehensive interventions until age of 12 months, including nutritional support and parental guidance of children's feeding and development, and all normal infants received periodical health checkup according to the basic public health service program. All infants received periodical measurements of height, weight and head circumference, and the 12-month intellectual and motor development ability was measured using the Bayley Scales of Infant Development revised in Chinese cities was used to assess. Infants' physical growth, mental development index (MDI) and motor development index (PDI) were compared among groups. Results: There were 130 premature infants with gestational ages of 28 to 36 weeks and birth weight of 1 200 to 3 440 g, including 79 male infants, and there were 80 infants in the low-risk group and 50 infants in the high-risk group. The full-term infants had a gestational age of 37 to 42 weeks, and birth weights of 2 500 to 4 000 g, including 162 male infants. There were significant differences in height (Wald χ2=28.664, P<0.001) and head circumference growth (Wald χ2=19.312, P=0.013) among the three groups as revealed by the generalized estimating equation; however, no significant differences were seen in the 12-month weight (F=0.639, P=0.528), height (F=1.051, P=0.350) or head circumference (F=0.318, P=0.728) among the three groups. The percentages of abnormal MDI were 2.00%, 0 and 1.31% among the high-risk premature infants, low-risk premature infants and full-term infants at ages of 12 months (χ2=1.319, P=0.517), while the percentages of abnormal PDI were 20.00%, 7.50% and 5.56% among the three groups at ages of 12 months (χ2=12.818, P=0.002). Conclusions Following implementation of early comprehensive interventions, the premature infants have favorable physical growth and comparable MDI with full-term infants; however, a high percentage of abnormal PDI is seen in high-risk premature infants. An improvement in the motor development among high-risk premature infants is recommended to be emphasized during the management of premature infants.

Objective To analyze the current situation of institutional care for people with disabilities in Shanghai, China. Methods Sec-ondary data were collected from the synthetical information platform of Shanghai Disabled Persons' Federation, including data about the res-idential institutions and people with disabilities living in the institutions from 2004 to 2015. Results The number of residential institutions and people with disabilities showed an increasing tendency from 2004 to 2015. At the end of 2015, there was 368 residential institutions in Shanghai, providing institutional care for 5821 people with disabilities. People in the institutions were mainly with intelligence disability and mental disability, and mainly in 35 to 59 years old. Conclusion The institutional care for people with disabilities was generally in a good condition in Shanghai and met people's needs.

AIM: To investigate the effect of sitagliptin on the autopaghy and the expression of extracellular matrix in mesangial cells induced by advanced glycation end products (AGEs).METHODS: The cells were divided into 5 groups: control group, AGE group, and sitagliptin (5, 10 and 20 μmol/L) groups.After 48 h, the cell viability was measured by MTT assay, and the content of collagen (Col) Ⅳ in the supernatant of the cell culture was detected by ELISA.The protein levels of beclin-1, adenosine monophosphate-activated protein kinase (AMPK), p-AMPK, p70S6K and p-p70S6K were determined by Western blot.RESULTS: Compared with control group, the viability and the expression of Col IV induced by AGEs in the cultured mesangial cells were significantly increased (P<0.01).Sitagliptin decreased the viability and the expression of Col IV induced by AGEs in the mesangial cells in a dose-dependent manner.AGEs significantly inhibited the protein levels of beclin-1 and p-AMPK, but significantly increased the protein level of p-p70S6K.Compared with AGE group, sitagliptin significantly reversed the above results in a dose-dependent manner.CONCLUSION: Autophagy may mediate the protective effect of sitagliptin on mesangial cells induced by AGEs.