Objective To investigate whether SUMO-1 enhances the apoptosis induced by wild-type p53 plasmid transfection in HepG2 cells. Methods The HepG2 cells were transfected respectively or simultaneouly with the following expressional plasmids as pcDNA3-wtp53(pwtp53,including human wild-type p53 gene),pCMV-HDM1B(pMDM2,including HDM2 gene, homologous gene as murine double minute gene 2),pcDNA3-His6-SUMO-1(pSUMO-1 ,including small ubiquitin-like modifier-1 gene)and plasmid pcDNA3.The proteins expressed in cells were detected by means of Western blotting and the apoptosis rates of cells were measured by flow cytometry. Results The protein bands of p53 and MDM2 could be seen in cells transfected with pwtp53 and pMDM2. Meanwhile,the relative larger molecular weight bands were also seen in cells transfected with pSUMO-1 which represented the p53 and MDM2 protein modification by SUMO-1. Merely the trace of p53 protein was detected in cells not transfected with any plasmid or only transfected with empty plasmid and pSUMO-1. In cells transfected with pwtp53 and pwtp53+pSUMO-1,the apoptosis rates were (16.79?1.62)% and (18.15?1.36)%. When transfected with pwtp53+pMDM2,the rate decreased to (5.17?1.23)%. The apoptosis rate would come up again to (14.06?1.84)% after transfected with pwtp53+pMDM2+pSUMO-1 and the difference of rates were significant compared to the cells transfected with pwtp53+pMDM2 (P

Objective To evaluate the efficacy of transanal local resection for early low rectal cancer. Methods The clinical data of 72 patients with early low rectal cancer who had been admitted to Union Hospital of Fujian Medical University from January 1997 to April 2009 were retrospectively analyzed. Patients were divided into 2 groups, and they received transanal local resection (group A, n = 31) and radical resection (group B, n =41), respectively. Postoperative local recurrence and distal metastasis were analyzed by Fisher exact test, the survival was analyzed by life table method. The difference in survival between the 2 groups was analyzed by Wilcoxon test. Results Three patients were found to have surgical complications in group B, while no complication was detected in group A. The local recurrence was 6% (2/31) in group A and 0 (0/41) in group B (P < 0.05); the distal metastasis was 6% (2/31) in group A and 2% (1/41) in group B, with no significance difference between the 2 groups (χ~2 =0. 062, P >0.05). The 3- and 5-year survival rates were 93%, 87% in group A, and 95%, 91% in group B, with no significant difference between the 2 groups (χ~2 =0.099, 0.144, P >0.05). Conclusions The prognosis of patients with early low rectal cancer who received transanal local resection is similar to those who received radical resection. Transanal local resection is safe and feasible when the indications are strictly followed.

ObjectiveTo investigate clinical features,diagnosis and treatment of hyperlipidemic severe acute pancreatitis(HSAP) in late pregnancy. MethodsA retrospective analysis was made on 12 HSAP cases. ResultsHSAP accounting for 20%(12/60) of severe acute pancreatitis (SAP) cases, develops during the period of 28~36 weeks of pregnancy. There were 5 cases in SAP type Ⅰand 7 cases in SAP type Ⅱ. Multiple organ dysfunction syndrome (MODS) was complicated in 4 cases. HSAP is featured with severe hypertriglyceridemia (29?14)mmol/L, significant systemic inflammatory response syndrome (SIRS), large amount of lipidemic bloody ascites. All cases underwent successful. Cesarean section followed by pancreatic operation and were cured. ConclusionHSAP in late pregnancy is a specific type of SAP with fulminant clinical course leading to fetal distress. Effective management of pregnant hypertriglyceridemia helps to prevent HSAP.

Summary: In order to investigate the effect of small ubiquitin-like modifier-1 (SUMO-1) on the p53-induced HepG2 cell apoptosis, HepG2 cells were transfected by recombinant plasmids as pwtp53, pMDM2 and pSUMO-1 respectively. Western blot was employed to detect the protein expression of the transfected recombinant plasmids and the rate of apoptosis was measured by flow cytometry. The results showed that in cells transfected with pwtp53 and pwtp53+pSUMO-1, the apoptosis rate was (16.79±1.62) % and (18.15±1.36) % respectively, while transfected with pwtp53+pMDM2, the rate was decreased to (5.17±1.23) %. The apoptosis rate was (14.06±1.84) % in the cells transfected with pwtp53+pMDM2+pSUMO-1, significantly higher than that in the cells Transfected with pwtp53+pMDM2 (P<0.01). The apoptosis rates in the cells were all less than 2 % and had no significant difference among the groups. It was suggested that in the HepG2 cells, SUMO-1 can increase the apoptosis induced by wild-type p53 through binding to p53 protein, post-translational modification and inhibiting the p53 degradation by MDM2.

Objective Using the third high sensitive cardiac troponin I assay to establish the reference intervals of serum cardiac marker high sensitivity cardiac troponin I ( hs-cTnI ) in apparently healthy subjects of Beijing area, and to explore the relationship between cTnI and other parameters.Methods Using random selection method, a total of 440 serum samples were collected from apparently healthy subjects of Beijing area.Among them, 217 cases were male, average age was (50.0 ±14.3) years old;223 cases were female, average age was ( 49.0 ±14.0 ) years old.All of these serum samples were detected hs-cTnI using i2000 Abott biochemical analyzer and ARCHITECT STAT Abbott assay kit.And the 99th percentile upper reference limit was used as the reference interval.Non-parametric tests were used to compare the different groups, the U Mann-Whitney test was used between two groups, the Kruskal-Wallis test was used in many groups, and the correlation analysis was used Spearman method.Results The 99th percentiles of hs-cTnI in 440 apparently healthy subjects is 9.66 ng/L.While the male group is 9.66 ng/L, and the female group is 8.25 ng/L.The serum hs-cTnI level of male is higher than female ( 9.95 ng/L vs 8.25 ng/L, P<0.05 ).According to the spearman correlation analysis, the serum hs-cTnI level appears positive correlation with age, brain natriuretic peptide (BNP), alanine aminotransferase (ALT),aspartate transaminase ( AST) ,gamma-glutamyl transferase ( GGT) ,total bilirubin ( TBIL) ,serum creatinine ( SCR) , hemoglobin (HGB)(P<0.05,R>0),and appears negative correlation with platelet (PLT)(P<0.05,R<0).Conclusion The serum hs-cTnI level apparently differents with gender, so it is necessary to establish reference intervals among different gender group of Beijing area.

Objective:Through a study on knowledge, attitudes, and practice of tobacco control of medical staff in Gansu Province, the paper aims to analyze the issues of participation, community tobacco control leadership and other aspects that impact the creation of a smoke-free healthcare system in order to provide a basis for the formulation of policies to improve the health professional mechanism of tobacco control. Methods:The stratified cluster sampling method was adopted to select 34 companies, accounting for a total of 805 medical staff as the study population in all kinds of health institutions. A self-designed questionnaire was adopted to investigate their knowledge, attitudes, and practice via on-site self-administered surveys. Results:the medical staff lacks knowledge as to the depth and breadth of damage from the use of tobacco. Although their attitude towards tobacco control is positive, the comprehensive to-bacco control service capabilities are insufficient. Logistic regression analysis showed that tobacco control capabilities of medical staff is related to their attitude toward smoking and whether or not they discourage smoking or asking about smoking . Conclusion:The key to the creation of a smoke-free health system to lead the community in tobacco control is the targeted tobacco cessation knowledge and skills training of medical staff to reduce smoking rates among medical staff and enhance the awareness of administrative staff.

OBJECTIVETo evaluate the efficacy and safety of covered self-expanding metallic stents (CSEMS) implantation as a treatment option in patients with anastomotic leakages after colorectal cancer surgery.

METHODSShort-term outcomes of 12 patients with anastomotic leakage after colorectal cancer surgery undergoing CSEMS implantation between May 2013 and November 2014 were analyzed retrospectively.

RESULTSThe mean time to diagnosis of anastomotic leakage was 6.3 days (range 2-13). The median time of CSEMS implantation after anastomotic leakage was 8 days (range 2-55). Clinical success without reoperation was achieved in 10 of 12 cases (83.3%) and there was no mortality. The median time to healing of the anastomotic leakage after CSEMS implantation was 13 days (range 10-33). The complications were stent migration (66.7%, 8/12), anorectal pain (58.3%, 7/12), fecal incontinence (25.0%, 3/12) and enterocolic fistula (8.3%, 1/12).

CONCLUSIONStent implantation one week after relief of peritonitis of postoperative colorectal anastomotic leakages, combined with other conservative therapy (early indwelling of transanal double catheterization cannula and pelvic double catheterization cannula with persistent bathe and negative pressure aspiration) in the management of patients with early diagnosed anastomotic leakages is safe and effective.

Anastomotic Leak ; Colonoscopy ; Colorectal Neoplasms ; Digestive System Surgical Procedures ; Humans ; Metals ; Postoperative Complications ; Reoperation ; Retrospective Studies ; Stents

OBJECTIVETo introduce the diagnosis and the treatment of the long-segment bowel stenosis above the anastomosis and bowel obstruction caused by the radiation-induced pelvic wall and bowel fibrosis.

METHODSBetween January 2008 and June 2014, 468 patients with rectal carcinoma underwent sphincter-preserving operation after neoadjuvant chemoradiotherapy in Fujian Medical University Union Hospital. Among 241 patients without postoperative anastomotic leakage, anastomosis stenosis, local recurrence and small bowel obstruction, severe pelvic and bowel fibrosis with obstruction during follow-up was found in 14 patients(SFO group). Associated data of these 14 patients were retrospectively collected. Clinical and image characteristics, and treatment outcomes of these 14 patients were analyzed and compared to those of other 227 patients without fibrosis and obstruction (control group).

RESULTSCompared to control group, SFO group had lower BMI(19.7±2.3 vs. 22.5±3.2, P=0.000), higher ratio of male (92.9% vs. 63.9%, P=0.039) and smoking patients(78.6% vs. 32.2%, P=0.001), shorter preoperative distance from lower edge of tumor to anal verge [(4.9±0.7) cm vs. (5.7±1.4) cm, P=0.043), and longer time from the end of radiation to operation [(9.4±2.3) week vs. (8.1±1.7) week, P=0.024). The largest thickness of the bilateral obturator internus increased significantly after chemoradiotherapy (left side: P=0.030, right side: P=0.020) as compared to pre-chemoradiotherapy on MR image. Patients of SFO group received corresponding treatments according to the status of bowel stricture, and the outcomes were all satisfactory.

CONCLUSIONSReconstructed rectum stricture can be caused by the radiation-induced fibrosis of pelvic wall soft tissue and proximal colon. Severe stricture can be treated with corresponding methods to relieve symptoms.

Objective: To investigate the protective effect and mechanism of Xuebijing (XBJ) on paraquat (PQ) -induced apoptosis in Human kidney cell line-2 (HK-2) cells. Methods: Routinely cultured HK-2 cells, (1) Cell growth inhibition experiment after PQ and XBJ intervention: PQ was divided into 0、200、400、800、1600 and 3200 μmol/L PQ groups, and the cell survival rate was detected after intervening 24、48 and 72 h. XBJ was divided into 0、5、10、20、40 mg/ml XBJ groups, and the cell survival rate was detected after intervening 24、48 and 72 h.To determine the rational drug concentration and the duration of action of XBJ and PQ. (2) PQ-induced HK-2 cell growth inhibition experiment antagonized by XBJ: The cells were divided into normal control group, PQ group (800 μmol/L) and PQ+XBJ group (The cells were pretreated with 5、10 and 20 mg/ml XBJ for 1 h, then cultured with PQ of 800 μmol/L) , After cultured 24 h、48 h and 72 h separately, the cell survival rate was detected. (3) HK-2 cells were divided into normal control group、PQ group (800 μmol/L PQ cultured for 24 h) 、PQ+XBJ group (pretreated with 10 mg/ml XBJ for 1 h, and then 800 μmol/L PQ cultured for 24 h) and XBJ group (10 mg/ml XBJ cultured 24 h). The apoptosis of cells was detected by flow cytometry. The protein expression of Bcl-2 and BAX in each group was detected by Western blotting. The expressions of caspase-3 and caspase-9 were detected by caspase-3 and caspase-9 activity kit active. Results: (1) PQ could significantly reduced the survival rate of HK-2 cells and showed time and concentration dependence. The survival rate of HK-2 cells was about 55% after 800 μmol/L PQ contacted 24 h, XBJ under 20 mg/ml was no significant effect on the survival rate of HK-2 cells after cultured 72 h. (2) Compared with the PQ group, the survival rate of HK-2 cells of PQ+XBJ group was significantly increased (P<0.05). (3) Compared with the normal control group, the cell apoptosis rate of PQ group was significantly increased (P<0.05). Compared with the PQ group, the cell apoptosis rate of PQ+XBJ group was significantly decreased (P<0.05). (4) Compared with the normal control group, Bcl-2 protein expression in PQ group was significantly decreased and BAX protein expression in PQ group was significantly increased (P<0.05) ; compared with PQ group, Bcl-2 protein expression in PQ+XBJ group was significantly increased, BAX protein expression in PQ+XBJ group was significantly decreased (P<0.05). (5) Compared with the normal control group, the activities of caspase-3 and caspase-9 in PQ group were significantly increased (P<0.05). Compared with PQ group, the activities of caspase-3 and caspase-9 in PQ+XBJ group were decreased significantly (P<0.05) . Conclusion XBJ (10 mg/ml) has obvious protective effect on HK-2 cell injuried by PQ (800 μmol/L) , It can improve the survival rate of cells through reducing the apoptosis of HK-2 cells which induced by PQ.

OBJECTIVETo establish a nomogram to predict long-term survival in non-metastatic colorectal cancer patients.

METHODSA retrospective analysis was conducted in patients with non-metastatic colorectal cancer who underwent radical surgery in the Department of Colorectal Surgery of Affiliated Union Hospital of Fujian Medical University between January 2000 and December 2014. Univariate and multivariate analyses on disease-free survival (DFS) were performed using the Cox proportional regression model. Based on the multivariate analysis results, a prognostic nomogram was formulated to predict the probability for DFS. Concordance index was applied in predictive evaluation of the nomogram and calibration curves were drawn to test the nomogram's prediction and actual observation of the 5-year DFS rate. The predictive ability of nomogram was compared with AJCC-7 staging system.

RESULTSA total of 2 641 patients were identified. The median age was 59.3 years old, and 60.3% of cases were men. The number of patients with TNM stage 0, I(, II( and III( was 96, 505, 923 and 1043, respectively. The most common tumor site was the rectum, accounting for 43.2%. A total of 413 (15.6%) patients underwent neoadjuvant treatment. The most common gross type of tumor was ulcerative type, accounting for 79.5%. The 3- and 5-year DFS rate was 85.8% and 79.8%, respectively. Based on the Cox proportional regression model, the following six factors were independently associated with reduced DFS rate and were selected for the nomogram: older age, higher pathologic T stage, higher pathologic N stage, higher preoperative serum CEA level, infiltrative gross type and perineural invasion. The results of the nomogram showed that the score of T0, T1, T2, T3 and T4 stage was 0, 2.2, 3.9, 4.1 and 6, respectively, and the score of N0, N1 and N2 was 0, 3.8 and 9.3, respectively. For gross type, the score of expanding type, ulcerative type and infiltrative type was 6, 9 and 10, respectively. The score of perineural invasion was 5.2. Higher scores were added to older age and higher CEA level. The total scores were calculated by taking the sum of the points from all predictors. Higher total score was associated with poor DFS. The prognostic nomogram differentiated well and showed a concordance index of 0.718, which was better than AJCC-7 staging system (concordance index=0.683). Also, the calibration of nomogram predictions was good.

CONCLUSIONSA nomogram based on 6 independently prognostic factors to predict long-term survival in non-metastatic colorectal cancer patients is established successfully. The nomogram can be conveniently used to facilitate the accurate individualized prediction of DFS rates in patients with non-metastatic colorectal cancer.