Objective To explore the safety and clinical efficacy of the purse string suture stitched in gastric wall of anastomotic stoma for intrathoracic esophagogastric apparatus anastomosis.Methods The clinical data of 238 patients with thoracic esophageal carcinoma and 24 patients with carcinoma of the esophagogastric junction received intrathoracic apparatus anastomosis at the Sichuan Provincial People's Hospital from January 2008 to December 2011 were retrospectively analyzed.There were 122 patients received conventional intrathoracic esophagogastric anastomosis (conventional group) and 140 patients received purse string suture stitched in gastric wall of anastomotic stoma before intrathoracic esophagogastric anastomosis (improvement group).The incidences of anastomotic fistula and stenosis of the 2 groups were compared.All data were anlayzed using the t test,chisquare test or Fisher exact probability.Results There were no significant differences in the operation time,intraoperative blood loss,volume of drainage of peritoneal effusion within 24 hours after operation,postoperative hospital stay and postoperative pTNM staging between the 2 groups (t =0.410,0.798,0.634,0.362,x2=0.605,P ＞ 0.05).There were no significant differences in the anastomotic location,stapler type,the weight of stapler esophageal end tissue between the 2 groups (x2 =0.118,0.221,t =0.459,P ＞ 0.05).There were no significant differences in the incidences of pulmonary complication,arrhythmia and mortality between the 2 groups (P ＞ 0.05).The weight of stapler stomach end tissue in the improvement group was significantly greater than that of the conventional group,while the incidences of postoperative anastomotic fistula and stenosis of the improvement group were significantly lower than those of the conventional group (t =13.856,P ＜ 0.05).Conclusion The purse string suture stitched in gastric wall of anastomotic stoma for intrathoracic esophagogastric apparatus anastomosis is simple and safe,and could effectively reduce the rate of anastomotic fistula and stenosis.

Humans ; Occupational Diseases ; epidemiology ; prevention & control ; Risk Assessment

Objective: To study the clinicopathological characteristics，diagnosis，multiple modality therapy and prognosis of accessory breast cancer. Methods: Clinical data of 38 patients with accessory breast cancer seen in our hospital between October 1985 and November 2007. Results: The 38 cases of accessory breast cancer accounted for 0.15% of all 26,078 breast cancer cases during the same period.Six patients of stage Ⅰ and 3 patients of stage Ⅱ underwent breast-conserving local wide excision of the tumor plus axillary lymph node dissection,with the resection margins pathologically negative.The other 9 cases of stage Ⅱ patients were treated with Auchincloss mastectomy.Stage Ⅲ and stage Ⅳ patients were treated with Auchincloss or Halsted mastectomy.The most common histological type of accessory breast cancer was infiltrating ductal Carcinoma for 18 patients(47.4%)，of which 3 cases were associated with adenoma of the nipple tube.There were 6 cases of carcinoma simplex，6 cases of intraductal Carcinoma，3 cases of adenocarcinoma with focal squamous cancer cells differentiation，3 cases of medullary carcinoma，and 2 cases of mucinous adenocarcinoma.The most common pathological stages(according to AJCC staging of breast cancer,2002.6th edition)were stage Ⅱ and Ⅲ in 12 cases(31.6%)，stage Ⅰ in 6 cases，and stage Ⅳ in 8 cases.All patients were followed-up for 1 to 23 years.The median follow-up time was 6 years and 7 months，and the follow-up rate was 100%.Until November 2008，12 patients died of metastasis and the other 26 patients were still alive.The 5-year overall survival rate was 35.3%.significantly lower than that of breast cancer patients(66.8%).The 3-year survival rate was 77.8%.The 5-year disease free survivaI rate was 28.6%and the 3-year disease free survival rate was 63.6%. Conclusion: Accessory breast cancer is rarely seen but is aggressive.The diagnosis mainly depends on clinical characteristics，postoperative pathology and imaging examinations.Early diagnosis is essential.Surgery combined with other adjuvant therapies can improve patient survival.

Objective To observe the postconditioning cardioprotective effects of atorvastatin (ATV) on ischemia-re?perfusion injury in isolated rat heart, and the role of phosphatidylinositol-3-kinase , protein kinase B(PI3K-Akt), mitochon?drial ATP-sensitive potassium (mito-KATP channel) and mitochondrial permeability transition pore (mPTP) thereof. Meth?ods Healthy male Wistar rats were randomly divided into 9 groups:ischemia reperfusion (I/R) control group, atorvastatin postconditioning (ATV) group, ATV plus PI3K inhibitor LY294002 (ATV+LY294002) group, LY294002 group, ATV plus mi?to-KATP channel inhibitor 5-hydroxydecanoate (ATV+5-HD) group, 5-HD group, ATV plus mPTP inhibitor ATR (ATV+ATR) group, ATR group and ethanol group. Model rats were given 30-min ischemia followed by 120-min reperfusion. The myocardial infarction size, hemodynamic parameters, creatine kinase isoenzyme (CK-MB), lactate dehydrogenase (LDH), nic?otinamide adenine dinucleotide (NAD+) and the expression of myocardial protein kinase B (Akt) and myocardial phospho-pro?tein kinase B (p-Akt) were evaluated. Results Compared with the control group, atorvastatin reduced the myocardial in?farction size, CK-MB and LDH(P<0.05), increased NAD+(P<0.05). There were no significant differences in the myocardi?al infarction size, CK-MB, LDH and NAD+between ATV+LY294002 group, ATV+5-HD group and ATV+ATR group. The hemodynamic parameters were improved in ATV group compared with those in control group. Western blot analysis con? firmed the significant phosphorylation of Akt in ATV group, ATV+5-HD group and ATV+ATR group compared with those of control group. There were no significant differences in the phosphorylation of Akt between ATV +LY294002 group, LY294002 group, ATR group and 5-HD group. Conclusion Atorvastatin postconditioning could attenuate the ischemia-re?perfusion injury through activating the PI3K-Akt, promoting mito-KATP channel opening and inhibiting mPTP opening.

Objective:To investigate the expression of indoleamine 2,3-dioxygenase and the distribution of Treg cells in breast cancer and tumor draining lymph nodes (TDLNs) and to explore the relationship between them.Methods:26 cases of breast cancer and 10 cases of breast benign diseases were collected from Tianjin medical university cancer hospital.RT-PCR was used to detect the mRNA of IDO in breast cancer,TDLNs,benign diseases and normal breast tissues.Immunohistochemistry was used to detect the expression of IDO and Foxp3 proteins in the same tissues. Results:The mRNA and the percentage of IDO~+ cells [(19.59±7.65)%] in TDLNs were higher than in breast cancer [(13.16±7.82)%] (P<0.05),while in the breast cancer were higher than in benign diseases [(3.24±1.30)%] and normal breast tissue [(2.70±1.53)%] (P<0.05).Expression of IDO protein in breast cancer was associated with tumor clinical stage and lymph nodes metastasis while had no relationship with tumor diameter,ER,PR and Her2 status.The percentage of Foxp3~+ cells in breast cancer [(3.50±1.04)%] was higher than in benign diseases [(0.71±0.42)%] (P<0.05) and normal breast tissue [(0.55±0.34)%],and that of the TDLNs [(6.13±2.31)%] was higher than in breast cancer [(3.50±1.04)%] (P<0.05).The percentage of IDO~+ cells was positive correlated with the distribution of Treg cells in breast cancer(r~2=0.449,P<0.05)and TDLNs (r~2=0.454,P<0.05).Conclusion:Expression of IDO in breast cancer is upregulated.The high level expression of IDO is accompanied by increasing Treg cells in breast cancer and TDLNs,which suggests that breast cancer can recruit Treg cells by expressing IDO to participate the immune tolerance.

The Ca²⁺-activated monovalent cation selective transient receptor potential melastatin 4 (TRPM4) channel expressed in pancreatic β-cells is implicated in the β-cell function and insulin secretion, but how pharmacological function of TRPM4 channel affects membrane excitability of β-cells remains largely unknown. Here, we report that pharmacological inhibition of TRPM4 by specific inhibitor 9-phenanthrol attenuates electrical activities of pancreatic β-cells. In whole-cell current clamp recordings, 9-phenanthrol results in inhibition of action potential frequency induced by tolbutamide of the INS-1 pancreatic β-cells in a dose-dependent manner with an IC₅₀ value of 14.99 ± 7.93 μmol·L^-1. Similarly, 9-phenanthrol also inhibited action potential firing in INS-1 cells stimulated by current injection. Further recordings of β-cells demonstrate the significant inhibitory effects on action potential peak and action potential amplitude by 9-phenanthrol. Taken together, our results show the involvement of TRPM4 channel function in pancreatic β-cells depolarization and action potential, it provides pharmacological experimental methods and theoretical support for the study of TRPM4 channel in pancreatic β-cells.

s:Aim To study the effects of total gluco-sides of paeony ( TGP) on the differentiation of co-cul-tured osteoclasts and the mechanisms of how TGP influ-ences the osteoclasts. Methods The synovial fibro-blasts and monocytes of peripheral blood in adjuvant-induced arthritic rats were separated and co-cultured to induce osteoclasts. The cells were treated with different TGP dosages (5, 50, 500, 5 000 mg·L-1 , and 50 g ·L-1 ) for 48 h. The proliferation, the TRAP activi-ty, and the bone resorption of osteoclasts were ob-served. The levels of IL-1,TNF-α,M-CSF and RANKL in the supernatants of osteoclasts were detected using ELISA. Meanwhile, the expression of ERK, JNK and p38 was detected by real time PCR. Results The ex-periments revealed that 50, 500, 5 000 mg·L-1 TGP inhibited the osteoclast growth, the TRAP activity, and the resorption pit area in a dose-dependent manner. TGP also inhibited the levels of IL-1 , TNF-α, M-CSF and RANKL in the supernatants and the expression of ERK, JNK and p38 in osteoclasts. The appropriate concentrations were 50 mg·L-1 to 5 000 mg·L-1 and had dose-dependent effects within this range. Conclu-sions TGP regulates the differentiation and activity of co-cultured osteoclasts. The effects of TGP are related to its inhibiting the cytokines secretion of synovial fi-broblasts and the activity of MAPK pathways.

Objective To study the effect of repeated rectal exposure of low -dose simian immunodeficiency virus on the systemic cellular immunity in monkeys .Methods Eight 3-to 4-year old rhesus macaques ( Macaca mulatta) (male:female 1:1) were used in this study.The monkeys were inoculated with 10 TCID50 SIVmac239 virus through rectum twice a week for consecutive 6 weeks to establish a multiple rectal exposure model of SIVmac 239 virus infection.Then, plasma viral load, CD4+ T cell count, T cell subsets and IFN-γsecretion of the experiment monkeys were determined . Results Low-dose SIVmac239 virus induced some changes in the immune system through the rectal mucosa , but didn’t induce typical infection.Repeated rectal mucosal low-dose virus exposure can activate the cellular immune system . Conclusions This study defines the effect of repeated low -dose simian immunodeficiency virus exposure on the systemic cellular immunity, and provided basic information for HIV-1 vaccine research.

BACKGROUND:Exosomes are membrane vesicles secreted by mesenchymal stem cells. Increasing studies have shown that mesenchymal stem cells can secrete exosomes via paracrine function to play a role in tissue injury. However, reports on how to isolate and identify exosomes derived from human umbilical cord blood mesenchymal stem cells are few. OBJECTIVE:To extract, purify and identify exosomes derived from human umbilical cord blood mesenchymal stem cells. METHODS:The cellculture supernatant of human umbilical cord blood mesenchymal stem cells was col ected. Exosome was extracted and purified with ultrafiltration and gradient centrifugation methods. The morphology of exosome was observed by transmission electronic microscope, and the expressions of CD63, CD81, CD90, CD73, CD105, CD29, and CD166 in exosome of mesenchymal stem cells were analyzed by fluorescent activated cellsorting. RESULTS AND CONCLUSION:Mesenchymal stem cells from human umbilical cord blood secreted exosome which exhibited el iptic or saucer-like shape and its diameter ranged from 40 to 100 nm with membrane structure. Exosome could express the common surface adhesion molecules CD63, CD81 and the surface adhesion molecules CD90, CD73, CD105, CD29, CD166 of mesenchymal stem cells. These findings indicate that exosome may be secreted by mesenchymal stem cells of human umbilical cord blood, which contains plasma membrane proteins of umbilical cord blood mesenchymal stem cells.

Objective To study the effect of endothelial progenitor cells (EPCs) transplantation on CCl4 induced hepatic cirrhosis in rats. Methods Eight male SD rats were used as normal control. Thirty rats were induced liver cirrhosis by feeding with 25% CCl4/olive oil for 12 weeks, and then were subdivided into cirrhosis group (n = 10), EPCs transplanted group (n = 10) and saline control group (n = 10). EPCs were transplanted into the portal vein for 4 weeks in EPCs transplanted group. Rats in EPCs nontransplanted group were sacrificed at the beginning of the 12th week. Rats in EPCs transplanted group and saline control group were killed at the beginning of 16th week. Serum biochemical parameters were examined. The degree of liver cirrhosis was evaluated by Masson staining and by detecting the expression of α-SMA, Collagen Ⅲ and Ki67. Results The volumes of liver in cirrhosis group were twice as much as that in normal rats. 12 weeks after CCl4 administration, compared with saline control group, in EPCs transplanted group, hepatic activity index (HAI) ( F = 75. 062, P < 0. 01 ), the levels of ALT( F = 29. 942, P<0.05), AST(F=16.618,P<0.05) and TBIL(F=9.911 ,P<0.05) in serum decreased, the level of Alb ( F = 4. 944, P < 0. 05 ) and Ki67 ( F = 45. 966, P < 0. 01 ) was increased, the expression of α-SM A ( F = 7.86,P<0.05) and collagen Ⅲ (F = 135.787,P <0.01) decreased (P <0.05). Compared with untransplanted group, in EPCs transplanted group, the levels of ALT, AST and TBIL in serum were lower; In saline control group, the levels of ALT, AST and TBIL in serum were higher, the level of Alb and Ki67was lower, the expression of α-SMA and collagen Ⅲ were higher( P < 0. 05 ). Compared with normal rats, in saline control group, the levels of INR were higher (P < 0. 05 ). Conclusion EPCs transplantation improves hepatocye regeneration and ameliorates established hepatic cirrhosis.