Objective To report a new approach of splenic hilar lymph nodes dissection in radical gastrectomy for gastric cancer. Methods 193 cases of gastric cancer patient receiving radical resection of gastric cancer between May 2008 and October 2008 were studied. The tail and body of spleen and pancreas were thoroughly freed with retroperitoneal way retrogressively and extruded out of abdominal cavity in 80 cases. The other 113 cases received operation with routine way. Results In 80 cases who received operation with retroperitoneal approach retrogressively, the total splenic hilar lymph nodes were 519, the positive ones were 65, the positive rate was 12.5 %; In the other 113 cases the total splenic hilar lymph nodes were 565, the positive ones were 58, the positive rate was 10.3 %. The positive rate had statistic significance between these two groups. Conclusion Extruded splenic hilar lymph nodes dissection with retroperitoneal approach retrogressively is safe and has the same effect with splenectomy in gastric cancer operation.

Background Oxidative stress is a pathophysiological process of retina,so it is very important to explore a protective way against retinal oxidative stress.Studies determined that extract of ginkgo biloba (EGb) has antioxidant,anti-apoptosis,anti-thrombosis and anti-inflammatory effects,however,the effect of EGb on human Müller cells in oxidative stress is still below understood.Objective This study was to investigate the protection of EGb against oxidative stress of human retinal Müller cells induced by As2O3 in vitro.Methods Human retinal Müllercell line was cultured in DMEM/F12 with 10％ fetal bovine serum (FBS),2 μmol/L glutamine and 1％ antibiotics.As2O3 solution at the final concentration 5 mg/L was added in the medium for 24 hours to establish oxidative models,and then the EGb with the final concentrations of 5,10 and 20 mg/L was used to cell models for 24 hours,respectively.Cell viability was detected by MTT assay,and reactive oxygen species (ROS) levels in the cells were detected with CM-H2DCFDA fluorescent probe.The relative expression levels of caspase-3 mRNA in cytoplasm and cell nuclei were assayed by reverse-transcription PCR (RT-PCR),and the expressions of Nrf2 protein were quantitatively detected by Western blot.Results Müller cells adhered well 24 hours after cultured.At 6-7 days after culture,Müller cell body was large with abundant cytoplasm and mosaic-like arrangement.However,floating cells were seen after As2 O3 treatment.Cell viability (absorbance) was significantly different among the normal culture group,As2 O3-treated group,As2 O3 + 5 mg/L EGb group,As2 O3 + 10 mg/L EGb group and As2 O3 + 20 mg/L EGb group,with the strongest viability in the normal culture group and the weakest viability in the As2 O3-treated groups (F=163.57,P =0.00).The fluorescence intensity of ROS was the weakest in the normal culture group and the strongest in the As2 O3-treated group and was gradually weakened with the increase of EGb doses,showing a remarkable difference among the groups (F =4 013.61,P =0.00).The relative expression level of caspase-3 mRNA in the cells was gradually reduced with the increase of EGb doses,with a statistically significant difference among the groups (F =2 199.72,P =0.00).In addition,no considerable difference was seen in the expression level of Nrf2 protein (grey scale) in cytoplasm among the groups (F=15.42,P=0.40);while in the nuclei,the expression levels of Nrf2 protein were 100.01 ±0.04,46.59±0.63,54.51 ±0.62,59.93 ±0.17 and 67.60±0.24 in the normal culture group,As2 O3-treated group and As2O3+5 mg/L EGb group,As2O3+10 mg/L EGb group,As2O3+20 mg/L EGb group respectively,with a significant difference among them (F=7 271.72,P=0.00).Conclusions EGb can protect human retinal Müller cells against As2O3-induced damage in a dose-dependant manner by antioxidant and antiapoptotic effects in vitro,and the activities occur primarily in cell nucleus.

AIM To investigate the mechanism of apoptosis induced by oxymatrine on MCF 7 cell line METHODS Using light microscopy, electron microscopy, laser scanning confocal microscopy, flow cytometry (FCM) and DNA gel electrophoresis to demonstrate the presence of apoptosis RESULTS Morphological characteristics of apoptosis were observed on oxymatrine treated MCF 7 cells, such as condensation of nucleus, bubble of cytoplasm, fragment of nucleus, a ladder like pattern of DNA fragmentation in agarose gel eletrophoresis Laser scanning confocal microscopy showed decreasing of the content of DNA Sub G1 peak and increased S period ratio were analysed by FCM CONCLUSION Oxymatrine can induce the inhibition of cell growth by apoptosis and the mechanism of apoptosis is involved in blocking of S period cells

ObjectiveTo explore the imaging characteristics and the clinical and pathological diagnosis of gliomatosis cerebri in order to raise the awareness of the disease.MethodsThe images of 26 patients with gliomatosis cerebri were analyzed retrospectively.ResultsEight patients were treated with partial excision and 18 patients got stereotactic biopsy.The radiography examination included the plain and enhanced scan of CT and MRI.Twelve patients received 1H magnetic resonance spectroscopy (MRS).The disease in all the patients involved at least two cerebral lobes.There were 22 cases whose CT and MRI manifestations showed that there were large-sheet symmetry low-density image in brain and slightly long T1 and long T2 abnormal signals.And the enhanced scan showed that 20 cases had no obvious enhancement,2 cases had slight enhancement.There were 4 cases with large-sheet asymmetry lesions and no enhancement in enhanced scan.1H MRS examination of 12 cases showed that choline( CHO )/creatine(Cr) and CHO/N-acetyl aspartic acid (NAA) increased,NAA/Cr decreased with different degree,and 8 patients had lactate peak.ConclusionsMRI is the first choice to diagnose gliomatosis cerebri.1H MRS is very helpful for the diagnosis and pathological classification of the disease.MRI combined with biopsy can give out a definite diagnosis.

Objective To compare the outcomes of arthroscopic single-row and suture-bridge repair of medium-sized rotator cuff tears through clinical and MRI assessment.Methods Forty-five patients with medium-sized rotator cuff tears who underwent arthroscopic repair using single-row (SR,n=29) or suture-bridge (SB,n=26) technique between July 2014 to June 2015 in our hospital,were retrospectively enrolled in this study.All surgeries were performed by the same senior doctor.The functional outcomes were assessed using the rating scale of the University of California at Los Angeles (UCLA),American Shoulder and Elbow Surgeons shoulder index (ASES),Fudan University Shoulder Score (FUSS),visual analog pain scale score (VAS),and range of motion (ROM) before the operation and at the last follow-up.MRI examination was performed at the final follow-up.Results Finally 50 patients were followed up successfully,24 in SB group and 26 in SR group.There were no significant differences between the two groups in terms of age,sex,follow-up duration,and the affected side.Before the operation,no significant differences were observed between the 2 groups in all the measurements.After more than 1-year follow-up,significant improvement was found in all measurements for both groups,but without significant differences between them.MRI examination showed no re-tears in either group.According to the Sugaya's classification,there were more type Ⅰ patients in SB group than SR group (83.3％ vs 61.5％),but the difference was not significant.Conclusion Arthroscopic suture-bridge repairing of medium-sized rotator cuff tears results in safe and good early clinical outcomes.However,compared with the single-row technique,there was no significant advantage.Although the MRI examination showed a better result of rotator cuff healing in the early stage,its long-term outcomes need further studying.

Background Oxidative stress is a main cause of age-related macular degeneration (AMD).Lutein has a preventive role for AMD, but its antioxidant mechanism remains unclear.Objective Present study was to investigate the effect of lutein on oxidative stress of Müller cells and its signaling pathway.Methods Human Müller cells (human Müller cell strain) were cultured, and the cells at logarithmimic growth phase were incubated in 96 well plate overnightly.Oxidative stress cell models were established by adding 160 μmol/L H2O2, a median lethal dose for Müller cells.The models were divided into the model control group and 12.5,25.0,50.0 mg/L lutein groups,and the different concentrations of lutein were used to culture the cells for 24 hours, respectively.The routine cultured cells served as the blank control group.Growth of the cells was assayed by MTT method (absorbancy);the reactive oxygen species (ROS) content in the cells was assayed by flow cytometry;the mRNA and protein levels of nuclear factor-E2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) in the cells were detected by quantitative real-time PCR and Western blot, respectively.Results The inhibitory effects on the cells were gradually enhanced with the increase of H2O2 concentrations,showing a significant difference among the groups (F =43.890,P＜0.01).A significant difference was found in apoptotic rate of the cells among the blank control group,model control group and 12.5,25.0,50.0 mg/L lutein groups (F =346.770, P =0.000) , and the apoptosis rate was significant elevated with the increase of lutein dose (all at P＜0.05).The ROS contents in the cells were 1.92±0.18,64.89±2.86,52.70±2.80,32.61 ±4.20 and 5.68 ± 1.35 in the blank control group, model control group and 12.5,25.0,50.0 mg/L group, respectively, with significant difference among the groups (F =324.900, P =0.000), and the ROS content was gradually reduced as the increase of lutein dose (all at P＜0.05).The relative mRNA and protein expressions of Nrf2 and HO-1 were remarkedly higher in the 12.5,25.0,50.0 mg/L lutein groups than those in the model control group (F =236.960,242.620,186.830,263.120, all at P =0.000) , and no significant difference was seen in the relative expression level of nuclear Nrf2 protein among the groups (F =1.790, P =0.210).Conclusions Lutein can induce the expression of antioxidant enzymes by inducing the expression of nuclear translocation of Nrf2 and consequently inhibit the oxidative stress status.

Objective To investigate the changes of neuroglobin (Ngb) expression in the CA1 hippocampus after cerebral ischemia and the effect of limb ischemic preconditioning (LIP) on it in young and aged rats. Methods SD rats aged 3 months and 21-23 months with permanently occluding bilateral vertebral arteries were randomly divided into cerebral ischemic group and LIP + cerebral ischemic group, respectively. The expression of Ngb mRNA and protein in the hippocampus were investigated by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot methods. The profile of delayed neuronal death (DND) of pyramidal neurons in the hippocampus CA1 was evaluated by using thionin staining under light microscope by determining the neuronal density (ND) and histological grade (HG). Results Ngb mRNA and protein expressions were 0.16±0.02 and 0.32±0.07, 0.52±0.04 and 0.91±0.06, 0.09±0.01 and 0.22±0.08, 0.21±0.01 and 0.66± 0. 06 in young cerebral ischemia group, LIP + young cerebral ischemia group, aged cerebral ischemia group and LIP + aged cerebral ischemia group, respectively. The expressions of Ngb mRNA and protein after cerebral ischemia for 8 minutes in aged rats were decreased compared with those in the young rats which suffered an identical cerebral ischemia with the aged rats (P<0.05). LIP up-regulated Ngb mRNA and protein expressions in both young and aged rats which suffered cerebral ischemia (P<0.05). However, the up-regulation of Ngb expression in aged rats was significantly less than that in young rats (P<0.05). Neuropathological evaluation showed that ND was 38.8±10.9, 171.5±16.9, 21.2±12.2 and 102.7±15.4 in young cerebral ischemic group, LIP + young cerebral ischemic group, aged cerebral ischemic group and LIP + aged cerebral ischemic group, respectively. It showed that obvious DND of pyramidal neurons was found in young and aged rats after cerebral ischemia. Although LIP effectively protected the pyramidal neurons in the CA1 hippocampus against DND normally induced by ischemic insult, the neuroprotection of LIP for aged rats was less effective than that for young rats. Conclusions The expression of Ngb and the up-regulation effect of LIP on the expression in aged rats are significantly decreased compared to those in young rats when the rats suffer cerebral ischemia. These differences may be one of underlying reasons why the aged rats exhibit severe DND after cerebral ischemia and why the neuroprotective effect of LIP is less in the aged rats than that in the young rats.

Objective To investigate the underlying mechanisms of Miller-Fisher syndrome (MFS) and Bickerstaff' s brainstem encephalitis (BBE) by studying their clinical and electrophysiological characteristics.Methods The clinical and electrophysiological characteristics of 13 MFS and 7 BBE cases in Peking Union Medical College Hospital between 2000 and 2011 were retrospectively analyzed.The electrophysiological parameters included sensory and motor nerve conduction,electromyography,F wave,sympathetic skin response and brainstem auditory evoked potential and blink reflex.Results MFS and BBE had similar clinical characteristics:respiratory symptoms were the most common infectious symptoms before disease onset; Ophthalmoplegia,facial palsy and bulbar symptoms were common; They both had cerebrospinal fluid albuminocytological dissociation and positive serum anti-GQ1b antibody.However,BBE had more central nervous system lesion signs clinically such as conscious disturbance,positive Babinski' s sign and central facial palsy.Electrophysiologically,MFS and BBE also had similar electrophysiological features:sensory nerve abnormality ratios were 6/13,2/7 respectively,with prominently reduced sensory nerve active potential amplitude,normal or slightly slowed sensory conduction velocity; Motor nerves abnormality ratios were 2/13,1/7 respectively,with slightly prolonged distal motor latency and normal compound muscle action potential; Electromyography abnormality ratios were 1/7,0/4 respectively; F wave frequency abnormality ratios were 3/13,5/7 respectively,and in some cases,F wave frequency would restore; Sympathetic skin response abnormality ratios were 1/2,1/3 respectively; Blink reflex abnormalityratios were 1/2,1/1 respectively,with central involvement in BBE; Brainstem auditory evoked potential abnormality ratios were 3/5,1/4 respectively,with wave Ⅰ latency or amplitude abnormality.Conclusion The similarities of clinical and electrophysiological features suggest that MFS and BBE have the same mechanism and they form a continuous spectrum with variable central nervous system and peripheral nervous system involvement.

Objective To evaluate the clinical significance of serum thrombospondin-1 (TSP-1) in systemic lupus erythematosus (SLE), and explore its possible involvement in SLE pathogenesis. Methods One hundred and thirty-eight patients diagnosed with SLE, including 124 cases of females and 14 males, as well as 60 healthy controls were recruited into this study. Enzyme-linked immunosorbent assay (ELISA) was used to determine serum TSP-1 expression level between the two groups. Spearman correlation analysis method was used to analyze the correlation between TSP-1 level of complement 3, complement 4, anti-double-stranded DNA, Rheumatoid factor and systemic lupus erythematosus disease activity index (SLEDAI). Results TSP-1 level in healthy control group was much higher than that in SLE patients. TSP-1 serum levels in SLE patients was positively correlated with complement 3 (r=0.386, P<0.01), complement 4 (r=0.301, P<0.01), and negatively correlated with anti-double-stranded DNA (r=-0.221, P=0.009), RF (r=-0.186, P=0.029) and SLEDAI (r=-0.273, P=0.001). Conclusion TSP-1 may play an immune-regulatory role in the development of SLE by inhibiting inflammation and autoantibody production. It could become a potential therapeutic target for the treatment of SLE.

Objective:To compare the clinical effects of minimally invasive reduction through a bone tunnel combined with Jail screwing and those of posterolateral locking plating in the treatment of simple posterolateral tibial plateau fractures.Methods:A retrospective analysis was conducted of the data of 48 patients who had been operatively treated and completely followed up at Department of Orthopedics, Suqian Hospital of Nanjing Drum Tower Hospital Group for simple posterolateral tibial plateau fractures from October 2016 to October 2020. There were 26 males and 22 females, aged from 35 to 68 years. They were divided into a minimally invasive group (25 cases subjected to minimally invasive reduction through a bone tunnel combined with Jail screwing) and an incision group (23 cases subjected to posterolateral locking plating) according to their surgical methods. The operation time, incision length, intraoperative blood loss, fracture healing time, cumulative fluoroscopy time, hospital stay and posterior inclination angles of the tibial plateau and Hospital for Special Surgery (HSS) knee function scores at 1, 3, 6, 9, and 12 months after operation were compared between the 2 groups. Complications in the 2 groups of patients were recorded.Results:There was no significant difference in the preoperative general data between the 2 groups, showing comparability ( P>0.05). The 48 patients were followed up for 12 to 36 months (average 16.5 months). The minimally invasive group was significantly better than the incision group in operation time [(42.6±9.1) min versus (65.7±11.5) min], incision length [(4.0±0.4) cm versus (15.0±1.5) cm], intraoperative blood loss[(22.6±5.8) mL versus (31.5±8.8) mL], hospital stay [(7.6±1.4) d versus (11.1±2.4) d], and HSS score one month after operation [(84.8±1.9) points versus (72.9±4.1) points], but the cumulative fluoroscopy time in the incision group [(4.1±1.4) s]was significantly less than that in the minimally invasive group [(22.3±4.2) s] ( P<0.05). There were no significant differences in fracture healing time, HSS scores at 3, 6, 9, or 12 months after operation, or posterior inclination angle of the tibial plateau between the 2 groups ( P>0.05). There were no such complications as wound infection, vascular injury, internal fixation failure, nonunion or malunion of fractures in either of the 2 groups. Two cases in the incision group presented with symptoms of common peroneal nerve injury but recovered 3 months after operation. Conclusions:Although both minimally invasive reduction through a bone tunnel combined with Jail screwing and posterolateral locking plating can achieve satisfactory outcomes in the treatment of simple posterolateral tibial plateau fractures, the minimally invasive technique is preferable because it shows the advantages of a smaller incision, less bleeding, shorter operation time, a lower operation risk, quicker postoperative recovery and shorter hospital stay.