Objective To explore the relationship between peritoneal lavage cytology in gastric carcinoma and lymph node metastasis.Methods From June 2012 to May 2014,intraoperative peritoneal lavage for cancer cells was carried out in 226 gastric cancer patients undergoing gastrectomy.During the process 63 patients were irrigated with 500 ml of normal saline,while the others were using 1 000 ml.D2+ lymph nodes dissection was performed to evaluate the relationship between peritoneal lavage cytology in gastric carcinoma and lymph nodes metastasis.Results The positive rates of exfoliative carcinoma cells were 11.1％ in the 500 ml group and 9.2％ in the 1 000 ml group (x2 =0.188,P=0.695).In both groups,rate of exforliative cancer cells were positively related to lymph node metastasis,the numbers of positive lymph nodes,the station of lymph nodes metastasis,the rate of the lymph nodes metastasis and that of the second station (all P ＜ 0.05),but not to the numbers of the lymph node cleaned (P ＞ 0.05).Conclusions Lymph nodes metastasis was an important risk factor that contribute to exfoliated carcinoma cells in patients with gastric carcinoma,and especially in those with lymph nodes metastasis at the second station.

Objective: To observe the effect of 70% ethanol extract from Huanglian Jiedu Decoction on expression of S180 tumor cell apoptosis factor in MDR model mice, and to research the molecule biology base fot directing clinic. Methods: simulate Clinic PFC project was simulated, the mice model of multi-drug resistance of S180 tumour cell was established. 70% Ethanol extract from Huanglian Jiedu Decoction were given for 10 days. The flow cytometry was used to observe Fas, Trail, CD54.,et al. Resluts: 70% Ethanol extract from Huanglian Jiedu Decoction can increase expression rate of Fas, Trail and improve apoptosis of S180 cell, at the same time it can decrease expression of CD54.Conclusions: 70% Ethanol extract from Huanglian Jiedu Decoction improve high level expression of apoptosis factor, and it maybe one of pass reverse multi-drug resistance of tumour.

Objective To study the chemical constituents in the leaves of Mallotus apelta. Methods Constituents isolation and purification were carried out on silica gel and polyamide column. Their structures were identified by physicochemical properties and spectral analysis. Results Five compounds were isolated and elucidated as taraxerol (Ⅰ), ?-sitosterol (Ⅱ), 5, 7-dihydroxy-6-prenyl-4′-methoxy-flavanone (Ⅲ), apigenin (Ⅳ), and apigenin-7-O[WTBZ]-?-D-glucoside (Ⅴ). Conclusion Compound Ⅲ is a new compound named as mallotusin. Compounds Ⅰ and Ⅲ-Ⅴ are isolated from the leaves of M. apelta for the first time.

This study was aimed to observe the influence of water-solubility nipponica saponin on activation of TNF-α+IL-17-induced rat fibroblast-like synovial cell line RSC-364 cellular model nuclear transcription factor NF-κB pathway as well as TNF-α, IL-1, ICAM-1, MMP-2, MMP-3 secretion. IL-17+ TNF-α were used for stimulating RSC-364 to establish rheumatoid arthritis (RA) cellular model. Water-solubility nipponica saponin in different con-centrations was used for intervention. The influence of water-solubility nipponica saponin in different concentrations on cell viability was detected by semi-quantitative RT-PCR method. Changes in the level of TNF-α, IL-1, ICAM-1, MMP-2, and MMP-3 of culture supernatant were detected by ELISA. The results showed that the activation of NF-κB p65 in RSC-364 stimulated by TNF-α+ IL-17 can be inhibited by water-solubility nipponica saponin ac-cording to its concentration. It improved IκB-α expression, and inhibited TNF-α, IL-1, ICAM-1, MMP-2 and MMP-3 secretion. It was concluded that water-solubility nipponica saponin can inhibit the activation of NF-κB pathway, hinder the secretion and activation of multiple downstream genes, which may be its effect in inhibiting syn-ovial inflammation in RA.

Objective To investigate the effect of different sealing methods of urokinase plus heparin on long-term dialysis catheter thrombolysis.Methods63 patients were treated with maintenance hemodialysis from central venous catheters with catheter thrombosis as a clinical study.The patients were divided into observation group and control group by simple random method.In the observation group, 31 cases were treated with urokinase and heparin mixed solution from the ends of the arteriovenous catheter of permanent double-laryngeal dialysis tube for 24 hours for 3 consecutive days.32 patients in the control group, from the permanent dual-chamber dialysis catheter arterial and vein at both ends with a micro pump pumped urokinase, maintained for 2hours.ResultsThere was no significant difference in thrombolytic success rate between the two groups.The catheter retention time in the observation group was significantly longer than that in the control group, the dialysis blood flow rate, the solute clearance index and the urea clearance index were significantly higher than those in the control group.The incidence of venous pressure and hemorrhagic adverse events was significantly lower than that of the control group (P<0.05).ConclusionUrea kinase plus heparin mixture is simple and easy to operate, which avoids the risk of excessive localized or systemic hemorrhage caused by excessive urokinase into the blood circulation of patients.It is worthy of popularization.

Objective To explore the level and the significance of amino-terminal propeptide of procollagen type Ⅲ(P Ⅲ NP)in the serum of hypertrophic scar patients at excessive stages.Methods The serum samples of 74 inpatients admmitted in Affiliated Fosham Hospital of Sun Yat-sen University from August 2007 to August 2009 suffering from long-persisting post-burn hypertrophic scar at various stages were collected.Serum samples of 12 were normal persons were also collected and used as control group.Hypertrophic scar group were divided into 4 subgroups according to the phase of scar and the serum concentrations of P Ⅲ NP were detected using the sensitive RIA method.Results The level of PⅢ NP increases gradually during the process of immature hypertrophic scar to mature scar before it peaking in 4 to 6 months scar subgroup.The concentration of PⅢ NP degreased gradually with the maturation of hypertrophic scar.Conclusions The high concentration of PⅢNP can reflect the high level of the synthesis of type Ⅲ collagen in the tissue of post-burn hypertrophic scar.The level of P Ⅲ NP is synonymous with the ongoing process of hypertrophic scar.PⅢ NP may be a satisfactory marker in discerning the growth and development of post-burn hypertrophic scar.

OBJECTIVETo explore the clinicopathological factors affecting positive cells in peritoneal lavage of gastric carcinoma.

METHODSClinicopathological data of 163 patients undergoing radical operation for gastric carcinoma and receiving cytology examination of peritoneal lavage (1000 ml normal saline) in our department from June 2013 to May 2014 were analyzed retrospectively. Pathology and immunohistochemistry were performed for resected lesions and harvested lymph nodes. Affecting factors of peritoneal lavage cytology were evaluated with univariate and multivariate logistic analyses.

RESULTSThe positive rate of exfoliative carcinoma cells was 9.2%(15/163). Univariate analysis showed that pathologic staging, depth of invasion, N staging, lymph node metastasis, station of positive lymph node, metastatic rate of lymph node, metastatic rate of the second station of lymph node, and carcinoma differentiation degree were associated with the positive rate of peritoneal lavage cytology (all P<0.05). Multivariate analysis revealed only the metastatic rate of the second station of lymph node was independent risk factor of positive exfoliative cells in peritoneal lavage.

CONCLUSIONThe metastatic rate of the second station of lymph node is an independent risk factor of positive exfoliative cells in peritoneal lavage for gastric cancer patients.

Objective To investigate the medium- and long-term effects and safty of Pipeline embolization device ( PED) for the treatment of large and giant intracranial anterior circulation aneurysms. Methods From December 2014 to December 2016,the data of 36 consecutive patients with large and giant aneurysm ( 36 large and giant intracranial anterior circulation aneurysms ) treated with PED in Donglei Brain Doctor Group were analyzed retrospectively. The diameter of the aneurysms was 12 -33 mm, (mean16.6±4.5mm),andthenecksizewas4-10mm(mean6.1±1.5mm).Eightaneurysmswere located in the carotid cavernous sinus segment,22 in the ophthalmic artery segment,5 in the internal carotid artery posterior communicating segment, and 1 in the M1 segment of middle cerebral artery. Seven aneurysms were only treated by PED,28 aneurysms were treated by PED in combination with coil embolization,and 1 aneurysm was treated by double PEDs. The modified Rankin scale ( mRS) score was used to evaluate the prognosis of the patients. Results (1) The clinical prognosis of the patients was followed up by telephone and outpatient department for 6-33 months. Twenty-five patients were followed up by DSA,23 aneurysms (92%) were occluded totally (Raymond gradeⅠ) and 2 (8％) were occluded near totally ( Raymond grade Ⅱ) . ( 2 ) Seven patients were treated with PED alone. Four patients were cured totally after 6 months follow-up,1 was occluded subtotally,2 were not cured;6 were cured in the last follow-up (33 months),and the other aneurysm was gradually reduced;17 of 28 patients treated with PED in combination with coils received DSA follow-up. They were followed up for 6-8 months. All the aneurysms were totally occluded ( Raymond grade Ⅰ) . 1 aneurysm was treated by 2 PEDs, DSA revealed micro-aneurysm-like development at 8 months after procedure. The aneurysms were basically occluded after 15-month follow-up. (3) MRI confirmed after operation that 10 patients had asymptomatic scattered spotted ischemic foci,4 had cerebral parenchymal hemorrhage,1 of them died,1 recovered well after treatment (mRS 1),and the other 2 were asymptomatic cerebral hemorrhage. The occupying effect of 24 cases disappeared, 8 had obvious improvement,and 3 did not have any obvious change. Conclusions The occlusion rate of the treatment of large and giant intracranial aneurysms with PED was high. The results of medium-term follow-up showed that the occlusion rate of PED in combination with coils in the treatment of aneurysms was higher than that of PED alone. The long-term follow-up results showed that the occlusion rate of patients treated with PED alone (including one or more) was gradually increased with time. The safety of the surgery needs to be further confirmed by a large sample study.

PURPOSE: Fibrinogen and platelets have been reported to play important roles in tumorigenesis and cancer progression. The aim of this research was to investigate the combination of functions of fibrinogen, platelets, and mean platelet volume (MPV) in predicting the survival of patients with gastric cancer (GC). MATERIALS AND METHODS: A retrospective study was conducted with 1,946 patients with GC and 299 patients with benign gastric tumor to analyze their fibrinogen, platelet, and MPV levels, and other clinicopathological characteristics along with their prognoses. Several indicators were evaluated along with fibrinogen, platelets, and MPV and their prognostic abilities were assessed. Univariate and multivariate survival analyses were conducted to determine the independent risk factors for overall survival. RESULTS: Increased levels of fibrinogen, platelets, and MPV were observed with the progress of the GC stages. Elevated fibrinogen, platelets, and the combined indicators, including fibrinogen*MPV (FM), platelet*fibrinogen*MPV (PFM), fibrinogen/MPV (FMR), platelet*fibrinogen (PF), platelet*fibrinogen/MPV (PFMR), platelet*MPV (PM), and platelet/MPV (PMR), foreboded poor prognosis. Meanwhile fibrinogen and FMR can be considered as independent risk factors for overall survival in patients with non-metastatic GC. But these indicators can hardly predict survival of patients in stage IV. CONCLUSIONS: Elevated fibrinogen, platelets, and MPV levels were in accordance with advanced stages, and fibrinogen, platelet, and MPV, in combination, can be used to predict survival of patients with non-metastatic GC. FMR was an independent prognostic factor for overall survival of patients with GC.
Blood Platelets ; Carcinogenesis ; Fibrinogen* ; Humans ; Mean Platelet Volume* ; Prognosis ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms*

Objective To evaluate the prognostic value of prognostic nutritional index (PNI) in gastric cancer patients with peritoneal metastasis.Methods 287 gastric cancer patients with peritoneal metastasis were enrolled from Jan 2010 to Dec 2016.Results Compared with PNI ＞ 45,patients in PNI≤45 group were elder [(59 ± 11) vs.(54 ± 11),t =3.734,P =0.000],lower albumin [(35 ± 4) g/L vs.(42 ± 4)g/L,t =15.988,P =0.003)],lower plasm hemoglobin concentration [(110 ± 22)g/L vs.(129 ±24) g/L,t =6.245,P =0.000),higher platelet count/lymphocyte count ratio [PLR,(210 ± 89) vs.(150 ± 66),t =6.547,P =0.000],higher neutrophil count/lymphocyte count ratio [NLR,(3.7 ± 2.9)vs.(2.4 ± 1.2),t =4.628,P =0.000],lower percentage of pallative gastrectomy (45.5％ to 58.5％,x2 =4.45,P =0.035).Logistic regression analysis showed that age ＞ 58-years,NLR ＞ 2.87,PLR ＞ 170,hemoglobin ≤ 130 g/L,local organ infiltration were risk factors leading to low-PNI (all P ＜ 0.05).The median survival time for all patients was 8.7 months.Univariate analysis revealed that,PNI ＞ 45,serum albumin ＞ 40 g/L,no ascites,lower-grade of peritoneal metastasis,pallative gastrectomy,postoperation chemotherapy were positively associated with better prognosis (all P ＜ 0.05).Multivariate analysis demonstarted that,PNI (HR =0.717,P =0.039).Grade of peritoneal metastasis (HR =1.206,P =0.044),pallative gastrectomy (HR =1.529,P =0.001) were independent prognostic risk factors for the patients with peritoneal metastasis.Conclusion PNI are both predictors of nutrition assessment and of prognosis for gastric cancer patients with peritoneal metastasis.