Objective To investigate the relationship between the expression of p53 and vascular endothelial growth factor (VEGF) to angiogenesis in gastric carcinoma. Methods The expression of p53、VEGF and microvascular density (MVD) in gastric carcinoma was examined by immunohistochemical staining in 60 cases.Results There was a close correlation between MVD, p53 as well as VEGF expression and several clinicopathological factors including tumor size(P

BACKGROUND:Hydrolysis in vivo is the key mechanism of degradation in DL-polylactic acid (PDLLA). When it is combined with hydroxyapatite (HA), could the biodegradation and weight loss rate be improved? OBJECTIVE: To observe the changes in the interface and structure of HA/PDLLA composite after in vivo implantation into rabbit femoral defects.DESIGN: Randomized grouping and controlled observation.SETTING: Biomedical Materials and Engineering Research Center, Wuhan University of Technology.MATERIALS: Forty healthy adult Japan White Rabbits of 2.0-2.5 kg, either male or female were provided by the Animal Experimental Center of Hubei Province (No. SCXK. 2003-0005).METHODS: The experiment was conducted in Biomedical Materials and Engineering Research Center, Wuhan University of Technology from June 2005 to March 2006. ①The rabbits were randomly divided into two groups: HA/PDLLA group and PDLLA control group with 20 animals in each group. After anesthetized with ketamine and proazamine, the sample rods of HA/PDLLA and PDLLA were respectively implanted into the drilled bone cavities (φ5 mm × 8 mm) among condyles of femur sites of the rabbits, and the rod could be slightly higher than the surface of bone substance. The samples were covered by periosteum and skin, and then the skin and periosteum were repositioned. ②The complete implants and peripheral bone tissues were taken out respectively after 3, 6, 12 and 24 weeks implantation. The changes in the interface and structure of HA/PDLLA composite after in vivo implantation were observed by using scanning electron microscope (SEM, JSM-5610LV, Japan).MAIN OUTCOME MEASURES: Changes in the interface and structure of HA/PDLLA composite after in vivo implantation.RESULTS: Totally 40 rabbits were involved in the result analysis. After the materials were implanted, HA granules shed from the material surface, some fibroblasts grew into the tissue and a little new osteotylus was formed, indicating HA/PDLLA composite had capabilities of bone-formation and bone-connection. After 24 weeks implantation, the material was divided and wrapped by tissues, neogenetic bone tissue grew into the material, and the fracture healed well,indicating HA/PDLLA composite had good biocompatibility. As for biodegradable PDLLA polymer, hydrolysis in vivo is the most main mechanism of degradation; the degradation speed was decreased owing to being compounded with HA.CONCLUSION: HA/PDLLA composite has capabilities of bone-formation and bone-connection; the biocompatibility of the composite is improved accordingly on account of the decrease of the degradation speed. HA/PDLLA composite is suitable for clinical application as absorbable materials for internal fixation.

Objective To summarize the puncture indications and the pathological type features of renal allografts biopsies in our center for evaluating its safety and diagnostic value .Methods The data of 773 percutaneous renal allograft biopsies in 629 kid‐ney transplants in the Pearl River Hospital of Southern Medical University from January 2005 to June 2014 were retrospectively an‐alyzed .Results The success rate of renal biopsy was 100% ,9 cases(1 .2% ) were complicated postoperative perirenal small hemato‐ma ,33 cases(4 .3% ) with gross hematuria and 1 case(0 .13% )with abdominal pain .Among the indications of 773 biopsies ,protein urine occured 205 cases(26 .5% ) of patient ,blood Cr increased in 187 cases(24 .2% )of patients ,protein urine simultaneously com‐plicating blood Cr increased ,in 313 cases of patients ,53 cases(6 .9% )had postoperative oliguria urinary ,and 15 cases(1 .9% )were get procedural biopsy .In the pathological types ,21 cases(2 .7% ) were normal ,179 cases (23 .2% ) were acute T cell‐mediated rejec‐tion after transplantation ,51 cases (6 .6% )were acute antibody‐mediated rejection ,205 cases (26 .5% ) were chronic T cell‐mediated rejection and 43 cases(5 .6% ) were chronic antibody‐mediated rejection;41 cases(5 .3% ) were drug toxicity ,29 cases(3 .7% ) were acute tubular necrosis(ATN) ,11 cases(1 .4% ) were relapsed or new nephropathy ;9 cases(1 .2% )were HBV related renal disease;39 cases (5 .0% ) were critical lesion and 145 cases(18 .8% )were others .Conclusion Rrenal allograft biopsy is safe ,it is important to the etiological diagnosis of renal disease after renal transplant ,which can guide the clinical treatment and improve the long term survival of renal graft and should be routinely carried out in clinic .

Objective To observe the expression of MicroRNA-21(miRNA-21)in kidney tissue of unilateral ureteral obstruc-tion (UUO)rats and explore mechanisms of miRNA-21 involved in TGF-β1/Smad3 signaling pathway in renal interstitial fibrosis (RIF).Methods Totally 20 adult male SD rats were divided into UUO group and Sham operation group.The left ureter of rats in UUO group were ligated,and the rats in sham group were dissociated left ureter only,but not to be obstructed.The left kidney tis-sue was collected at the 3rd、7th days after surgery.Real-time quantitative PCR analysed the expression of miRNA-21.Masson stai-ning,HE staining and immunohislochemistry staining were used to evaluate the degree of RIF.The expression of transforming growth factor-β1(TGF-β1)、Smad3,α-smooth muscle actin (α-SMA)、and collagenⅠ(Col-Ⅰ)were examined by immunohislochemis-try staining.Results The expression of miRNA-21 in kidney tissue was higher at 3rd、7th days after surgery in UUO groups than that in Sham group(P <0.01).The expression in UUO group at 7th day was higher than 3rd day after surgery(P <0.01).The fi-brosis score,positive TGF-β1、Smad3、Col-Ⅰ、α-SMA area in UUO group were significantly higher than those of Sham group at 3rd、7th days (P <0.01),Which at 7th day were higher than 3rd day in UUO group(P <0.01).The expressions of miRNA-21 in kidney tissue was positive correlations with the fibrosis score(r=0.888,P <0.01).The expressions of miRNA-21 in kidney tissue was positive correlations with TGF-β1、Smad3、Col-Ⅰ、α-SMA(r=0.799,0.849,0.882,0.896,P <0.01).Conclusion The expres-sion of miRNA-21 was upregulated in UUO kidney tissue after model establishment.The RIF degree might be positive correlations with miRNA-21 expression,and TGF-β1/Smad3 signaling pathway positively regulate miRNA-21 to mediate rats RIF.

Objective To investigate the effects of structured triglyceride and long chain triglyceride/medium chain triglyceride (LCT/MCT) on postoperative efficacies of elderly patients (≥70 years old) after total gastrectomy for gastric cancer.Methods The retrospective cohort study was conducted.The clinical data of 42 elderly patients who underwent total gastrectomy for gastric cancer in the Jiangsu Cancer Hospital between Sepember 2014 and September 2015 were collected.Twenty-two patients using structured triglyceride in postoperative parenteral nutrition and 20 using LCT/MCT in postoperative parenteral nutrition were allocated into the case and control groups,respectively.All the patients underwent total gastrectomy + Roux-en-Y esophagojejunostomy.Patients in the case and control groups received respectively 20％ structured triglyceride and 20％ LCT/MCT.Observation indicators:(1) postoperative recovery situation:time of gut exsufflation,changes of body mass at postoperative 5 days,postoperative anastomotic leakage and abdominal infection;(2) test of liver function indexes:aspartate transaminase (AST),alanine transaminase (ALT),total bilirubin (TBil),direct bilirubin (DBil) of liver function in fasting peripheral blood were tested at preoperative day 1 and at postoperative day 1 and 5;(3) test of nutritional indexes:serum total protein (TP),albumin (Alb) and prealbumin in fasting peripheral blood were tested at preoperative day 1 and at postoperative day 1 and 5;(4) test of immunological indexes:levels of IgG and IgA,CD3,CD4 and ratios of CD3/CD8 in fasting peripheral blood were tested at preoperative day 1 and at postoperative day 1 and 5.Measurement data with normal distribution were represented as x ±s.Repeated measures data were evaluated with the repeated measures ANOVA.Count data were analyzed using the chi-square test and Fisher exact probability.Results (1) Postoperative recovery situation:there was no special adverse reaction during support treatment of parenteral nutrition.Time of gut exsufflation,changes of body mass at postoperative 5 days,incidences of postoperative anastomotic leakage and abdominal infection were (46 ± 12)hours,(60±8) kg,0,0 in the case group and (50 ±14) hours,(58±9)kg,0,1 in the control group,respectively,with no statistically significant difference between the 2 groups (t =0.86,0.65,P＞0.05).(2) Test of liver function indexes:levels of AST and ALT from preoperation to postoperative day 5 were respectively from (24±9) U/L to (22±6)U/L,from (31±12)U/L to (20±8)U/L in the case group and from (23±8) U/L to (30± 10) U/L,from (30 ± 9) U/L to (32 ± 7) U/L in the control group,respectively,with statistically significant differences between the 2 groups (F =92.87,87.92,P＜0.05).Levels of TBil and DBil from postoperative day 1 to postoperative day 5 were respectively from (21±4) μmol/L to (19±4) μmol/L,from (7.0±2.0) μmol/L to (6.0±2.0)μmol/L in the case group and from (19±3) μmol/L to (20±4)μmol/L,from (7.0±2.0)μmol/L to (8.0±3.0)μmol/L in the control group,respectively,with no statistically significant difference between the 2 groups (F =1.48,0.81,P ＞ 0.05).(3) Test of nutritional indexes:levels of serum TP and Alb from postoperative day 1 to postoperative day 5 were respectively from (52±6)g/L to (56±5)g/L,from (34±3)g/L to (37±4) g/L in the case group and from (53±7)g/L to (52±4)g/L,from (33±3) g/L to (31± 3)g/L in the control group,respectively,with no statistically significant difference in changing trends between the 2 groups (F=0.47,0.54,P ＞ 0.05).Levels of prealbumin from postoperative day 1 to postoperative day 5 were respectively from (230±32)mg/L to (245±30)mg/L in the case group and from (228±28)mg/L to (222±26) mg/L in the control group,respectively,with a statistically significant difference in changing trend between the 2 groups (F=16.81,P＜0.05).(4) Test of immunological indexes:levels of IgG and IgA,CD3,CD4 and ratios of CD4/CD8 from postoperative day 1 to postoperative day 5 were respectively from (12±4) g/L,(2.20±0.20)g/L,52％±4％,30％±4％,1.30±0.20 to (18±5)g/L,(2.80±0.30)g/L,59％±4％,33％±4％,1.50±0.20 in the case group and from (12±3)g/L,(2.10±0.10)g/L,52％±4％,27％±4％,1.30±0.10 to (13±4)g/L,(2.30±0.20) g/L,51％±4％,26％ ±4％,1.20±0.20 in the control group,respectively,with statistically significant differences in changing trends between the 2 groups (F=25.07,29.42,33.53,22.19,33.47,P＜0.05).Conclusions The short-term usage of structured triglyceride or LCT/MCT in early period after operation can effectively improve postoperative recovery of elderly patients with gastric cancer,with a small impact on liver function.Structured triglyceride can improve immunologic function and nutrition status more effectively.

Objective:To investigate the expression of forkhead box protein O3(FOXO3) in pancreatic cancer and its effect on the motility and proliferation of pancreatic cancer cells.Methods:The FOXO3 expression in pancreatic cancer and adjacent tissues was retrieved from LinkedOmics database. Western blotting and real-time quantitative polymerase chain reaction were used to detect FOXO3 expression in pancreatic cancer cells and human pancreatic stellate cells. PANC-1 and MIAPaCa-2 pancreatic cancer cells with low FOXO3 expression were selected to transfect FOXO3 overexpression plasmid and negative control plasmid, respectively. The motility and proliferation ability of pancreatic cancer cells were detected by colony formation assay, cell scratch assay, Transwell assay and flow cytometry.Results:In the LinkedOmics database, the relative expression of FOXO3 protein in the cancer tissues of 64 patients with pancreatic cancer was significantly lower than that in the adjacent tissues ( t=8.36, P<0.001). The number of clones in PANC-1 cell line was (30.0±6.6) after overexpressed FOXO3, which was lower than that in negative control cells (92.7±6.7), and the difference was statistically significant ( t=11.54, P<0.001). After overexpressed FOXO3 in PANC-1 and MIAPaCa-2 cell lines, the scratch repair rate was significantly decreased compared with the control group. In Transwell experiment, the number of cells in FOXO3 overexpressed group in PANC-1 cell lines was (21.0±6.6), which was lower than that of negative control groups (55.7±8.5), and the difference was statistically significant ( t=5.59, P=0.005). The results of MIAPaCa-2 cell line were consistent with that of PANC-1 cell line. After overexpressing of FOXO3 in PANC-1 and MIAPaCa-2 cell lines, the proportion of cells in the G0/G1 phase decreased, while the proportion in the S phase increased. Conclusion:The expression of FOXO3 was decreased in pancreatic cancer. Overexpression of FOXO3 could significantly inhibit the proliferation, migration and invasion of pancreatic cancer cells and induce cell cycle arrest, which is a potential target for the treatment of pancreatic cancer.

Objective:To analyze the efficacy and feasibility of performing a new surgical procedure, tunnel esophagogastrostomy, to perform proximal gastrectomy.Methods:The study cohort comprised 10 consecutive patients who had undergone esophagogastrostomy by the tunnel technique in Jiangsu Cancer Hospital between October 2019 and July 2022. All patients were male. Their average age was (64.2±8.1) years and body mass index (25.5±3.2) kg/m2. Nine had upper gastric body adenocarcinoma, the remaining one having signet ring cell carcinoma. TNM staging of the tumors showed that seven were Stage IA, one Stage IB, one Stage IIA, and one Stage IIIA. Briefly, tunnel esophagogastrostomy is performed as follows: After performing a proximal gastrectomy, a rectangular seromuscular flap (3.0 cm × 3.5 cm) is created. The posterior esophageal wall is sutured to the gastric wall at the orad end of the seromuscular flap 5 cm from the stump with three to four stitches. Next, the stump of the esophagus is opened, the posterior esophageal wall is sutured to the gastric mucosa and submucosa, and the anterior esophageal wall is sutured to the full layer of the stomach. Finally, the caudad end of the seromuscular flap is closed. Data on surgical safety, postoperative morbidity, and postoperative reflux esophagitis were analyzed. All enrolled patients completed endoscopic follow-up 1 year and 2 years after surgery.Results:All procedures were completed. They comprised four cases of laparoscopic assisted surgery, four of DaVinci robotic surgery, and two of open surgery. The mean operation time was 212.7±33.2 mins, mean anastomosis time (51.6±5.3) minutes, mean tunnel preparation time (20.0±3.5) minutes, and mean operative blood loss (90.0±51.6) mL. The time to first postoperative passage of flatus was (64.8±11.5) hours. The mean hospital stay after surgery was (9.2±1.7) days. There were no postoperative complications above Clavien-Dindo Grade II. The mean preoperative Reflux Disease Questionnaire score was (3.3± 0.4) before the surgery, (3.8±1.0) 1 month postoperatively, and (3.3±0.4) 12 months postoperatively. All patients underwent endoscopic follow-up; no anastomotic stenoses were found. However, one patient had Grade A reflux esophagitis 1 year after surgery and another Grade B reflux esophagitis 2 years after surgery.Conclusion:Esophagogastrostomy by the tunnel technique is a safe and feasible means of performing proximal gastrectomy.

Objective:To analyze the efficacy and feasibility of performing a new surgical procedure, tunnel esophagogastrostomy, to perform proximal gastrectomy.Methods:The study cohort comprised 10 consecutive patients who had undergone esophagogastrostomy by the tunnel technique in Jiangsu Cancer Hospital between October 2019 and July 2022. All patients were male. Their average age was (64.2±8.1) years and body mass index (25.5±3.2) kg/m2. Nine had upper gastric body adenocarcinoma, the remaining one having signet ring cell carcinoma. TNM staging of the tumors showed that seven were Stage IA, one Stage IB, one Stage IIA, and one Stage IIIA. Briefly, tunnel esophagogastrostomy is performed as follows: After performing a proximal gastrectomy, a rectangular seromuscular flap (3.0 cm × 3.5 cm) is created. The posterior esophageal wall is sutured to the gastric wall at the orad end of the seromuscular flap 5 cm from the stump with three to four stitches. Next, the stump of the esophagus is opened, the posterior esophageal wall is sutured to the gastric mucosa and submucosa, and the anterior esophageal wall is sutured to the full layer of the stomach. Finally, the caudad end of the seromuscular flap is closed. Data on surgical safety, postoperative morbidity, and postoperative reflux esophagitis were analyzed. All enrolled patients completed endoscopic follow-up 1 year and 2 years after surgery.Results:All procedures were completed. They comprised four cases of laparoscopic assisted surgery, four of DaVinci robotic surgery, and two of open surgery. The mean operation time was 212.7±33.2 mins, mean anastomosis time (51.6±5.3) minutes, mean tunnel preparation time (20.0±3.5) minutes, and mean operative blood loss (90.0±51.6) mL. The time to first postoperative passage of flatus was (64.8±11.5) hours. The mean hospital stay after surgery was (9.2±1.7) days. There were no postoperative complications above Clavien-Dindo Grade II. The mean preoperative Reflux Disease Questionnaire score was (3.3± 0.4) before the surgery, (3.8±1.0) 1 month postoperatively, and (3.3±0.4) 12 months postoperatively. All patients underwent endoscopic follow-up; no anastomotic stenoses were found. However, one patient had Grade A reflux esophagitis 1 year after surgery and another Grade B reflux esophagitis 2 years after surgery.Conclusion:Esophagogastrostomy by the tunnel technique is a safe and feasible means of performing proximal gastrectomy.