OBJECTIVE: To investigate the expression of peroxisome proliferator-activated receptor γ (PPAR-γ) in the sinus mucosa of chronic rhinosinusitis without nasal polyps (CRSsNP) and chronic rhinosinusitis with nasal polyps (CRSwNP). METHOD: Using immunohistochemistry and RT-PCR, testing the content of PPAR-γ in sinus mucosa and nasal polyps of patients with chronic sinusitis without nasal polyps and normal inferior turbinate, and analyzing the differences. RESULT: The PPAR-γ was found both in sinus mucosa of CRSsNP, nasal polyps of CRSwNP and in normal inferior turbinate; (2) The expression of PPAR-γ in sinus mucosa of CRSsNP and nasal polyps of CRSwNP was lower than that in normal inferior turbinate tissue, and the differences was prominent in statistics; (3) No differences in the expression of PPAR-γ were obtained in sinus mucosa of CRSsNP and nasal polyps of CRSwNP. CONCLUSION The PPAR-γ expressed in human nasal mucosa, meanwhile it was descending in sinus mucosa of CRSsNP and nasal polyps of CRSwNP. The long-term inflammations resulted from CRSsNP and nasal polyps of CRSwNP might relate to PPAR-γ, it suggested that PPAR-γ agonists may offer a new therapy for the treatment of Chronic Rhinosinusitis.
Chronic Disease ; Humans ; Immunohistochemistry ; Inflammation ; Nasal Mucosa ; Nasal Polyps ; metabolism ; PPAR gamma ; biosynthesis ; Rhinitis ; metabolism ; Sinusitis ; metabolism ; Turbinates

Objective To investigate the relationship between Epstein-Barr virus (EBV) DNA and EBV serology markers and evaluate the clinical application values in different diseases.Methods Plasma samples from 397 diagnosed EBV infection-associated patients and 120 health donors from May 2014 to November 2015 in Wuhan Tongji Hospital were collected.Real-time fluorescent quantitative PCR was performed to detect the levels of EBV-DNA in peripheral blood mononuclear cell and plasma.ELISA was used to detect VCA IgA,VCA IgM,VCA IgG,EA(D) IgG and EBNA IgG antibodies in plasma.The positive rate of EBV-DNA and EBV antibodies were counted in each group according to the detection threshold.Kappa statistic and Spearman sank correlation test were used to analysis the correlation and uniformity between EBV-DNA and EBV serology indicators.Results The positive rate of VCA IgG in patient and health control was 94.2% (374/397) and 93.3% (112/120) respectively (χ2=0.125,P=0.67);The positive rate of EBNA IgG in patient and health control was 95.4% (379/397) and 95.0% (114/120) respectively (χ2=0.045,P=0.807);but the positive rate of VCA IgM was 5.5% (22/397) and 0% (0/120) respectively (χ2=6.9,P<0.01);The positive rate of VCA IgA was 43.3% (172/397) and 9.2% (10/120) respectively (χ2=49.5,P<0.01);The positive rate of EA(D) IgG was 42.0% (167/397) and 7.5% (9/120) respectively (χ2=49,P<0.01).The positive rate of EBV-DNA was 65.5% (260/397) and 16.7% (20/120) respectively (χ2=88.5,P<0.01);The positive rate of EBV-DNA in plasma was 45.8% (182/397) and 5.0% (6/120) respectively (χ2=66.4,P<0.01).Furthermore,the uniformity and Spearman correlation analysis showed that there was no significant correlation between EBV-DNA and EBV serology indicators.The correlation analysis between PBMC EBV-DNA and VCA IgM,VCA IgA,EA(D) IgG showed the Kappa was 0.073,0.147,0.073,respectively;the correlation analysis between plasma EBV-DNA and VCA IgM,VCA IgA,EA(D) IgG showed the Kappa was 0.144,0.369,0.288,respectively.Thus,the patients were divided into different groups according to the discharge diagnosis,it was observed that the positive rates of EBV-DNA is more than 90% in extra-nodal NK/T cells lymphoma,EBV-associated hemophagocytic lymphoid tissue hyperplasia,chronic active EBV infection and infectious mononucleosis.In nasopharyngeal carcinoma patients,the positive rate of EBV antibodies (VCA IgA and EA(D) IgG) were higher than the detection of EBV-DNA.Conclusions There was no significant correlation between EBV-DNA and EBV serology markers for the same sample.The clinical application values of EBV DNA and EBV serology markers were not identical in nasopharyngeal carcinoma,extra-nodal NK/T cells lymphoma,infectious mononucleosis and EBV-associated hemophagocytic lymphoid tissue hyperplasia.

Objective To assess the effect of preoperative carbohydrate preconditioning on postoperative insulin resistance and inflammatory response in patients after gastroenteric tumor resection.Methods Sixty patients with elective gastroenteric tumor resection were divided into preoperative carbohydrate preconditioning group and control group by random digits table with 30 cases each.Preoperative carbohydrate preconditioning group was given oral containing 50 g glucose carbohydrate 300 ml 2 h before surgery,and control group was given traditional method,fasting 12 h before surgery and water deprivation 6 h before surgery.The blood samples were collected to measure the level of fasting blood glucose (FBG),fasting insulin (FINS),interleukin (IL)-6 and C-reactive protein (CRP),3 h before surgery and 1,3,7 d after surgery respectively.Homeostasis model assessment insulin resistance index (HOMA-IR) was computed.Results There were no statistical differences in FBG,FINS,IL-6,CRP and HOMA-IR 3 h before surgery between the 2 groups (P ＞ 0.05).The FBG,FINS,IL-6,C RP and HOMA-IR in the 2 groups at 1,3 d after surgery were significantly higher than those 3 h before surgery,but those except for FBG in control group were significantly higher than those in preoperative carbohydrate preconditioning group [1 d after surgery:(39.67 ± 10.37) mU/L vs.(25.78 ± 12.43) mU/L,(98.67 ± 12.42) μg/L vs.(65.36 ± 16.72)μg/L,(121.74 ±11.32) mg/L vs.(82.18 ±4.36) mg/L,19.07 ±5.49 vs.11.67 ±6.32;3 d after surgery:(24.34 ±6.78) mU/L vs.(16.23 ±7.56) mU/L,(116.43 ± 18.57) μg/L vs.(78.53 ± 10.38) μg/L,(151.30 ± 10.46) mg/L vs.(129.29 ± 10.24) mg/L,8.56 ±2.87 vs.5.12 ±2.11],there were statistical differences (P ＜0.05).There were no statistical differences in FINS and HOMA-IR in preoperative carbohydrate preconditioning group between 7 d after surgery and 3 h before surgery (P ＞ 0.05),but there was statistical difference in control group (P＜ 0.05).There were no statistical differences in FBG,IL-6 and CRP in the 2 groups between 7 d after surgery and 3 h before surgery (P ＞ 0.05).There was no aspiration during anesthetic stage.Conclusion Preoperative carbohydrate preconditioning may shorten the insulin resistance time after gastroenteric tumor resection,reduce the intensity of insulin resistance,and improve inflammatory response,thus contributing to the rehabilitation of patients.

BACKGROUND:Studies have found that epithelial-mesenchymal transition is closely related with tumor invasion, metastasis, and drug resistance, but studies on the role of epithelial-mesenchymal transition in the transformation process of gastric cancer cels SGC7901 to gastric cancer stem-like cels are rarely reported.
OBJECTIVE: To explore the effect of epithelial-mesenchymal transition in the transformation process of gastric cancer cels SGC7901 to gastric cancer stem-like cels.
METHODS:Vincristine-induced SGC7901 cels were cultured and screened to prepare gastric cancer stem-like cels. CD44 phenotype, morphological changes, stem cel-related markers, and epithelial-mesenchymal transition related molecules were detected.
RESULTS AND CONCLUSION:After passage, vincristine-induced SGC7901 cels presented with morphological changes, and clonal cel spheres generated after serum-free suspension culture. Meanwhile, the proportion of SGC7901 cels positive for CD44 was decreased. Expression levels of SOX2, OCT4, Snail1 mRNA, Twist mRNA and Vimentin mRNA were significantly higher in the gastric cancer stem-like cels than SGC7901 cels, but the expression level of E-caderin was lower in the gastric cancer stem-like cels than SGC7901 cels. These findings indicate that gastric cancer cels SGC7901 can be successfuly transformed into gastric cancer stem-like cels, and the epithelial-mesenchymal transition is involved in this transforming progress.

Objective Non-contrast enhanced magnetic resonance angiography ( MRA) has become the focus of research at home and abroad .The aim of the article was to optimize the scan parameters of renal artery with inflow-sensitive inversion recovery ( IF-IR) MRA. Methods 30 cases of renal artery patients into two groups were collected from December 2013 to May 2014 in our hospi-tal.They were divided into stenosis group(n=12) and non-stenosis group(n=48).IFIR-MRA sequences were carried out on each patient by using various BSP-TI with 1200,1300 and 1400 ms, all other parameters were identical .The image signal to noise ratio, a renal artery branch and venous artifact were evaluated by two experienced radiologists , and the best BSP-TI was obtained from different groups. Results BSP-TI=1400 ms was optimal for renal artery stenosis group while 1200 ms was the most suitable for non-stenosis group. Conclusion IFIR-MRA of renal artery can achieve better image quality of renal artery and its branches and it is feasible in clinical routine practice , especially for those patients with renal insufficiency .

Objective Cervical radiculopathy treatment experts' consensus to establish radiculopathy type by using the modified Delphi method. Methods Use document retrieval method to review information and articles about the treatment guidelines and articles of cervical radiculopathy including domestic and international areas, established a protocol about clini?cal consensus of the treatments for cervical radiculopathy. This protocol included 23 questions (the effective proportion of non?operating therapy, neck immobilization, physiotherapy, pharmacologic treatment, surgical indications, contraindications, anteri?or surgical decompression, anterior surgical implants). We performed a modified Delphi survey in which current professional opinions from experienced experts, representing from almost all of the Chinese provinces, were gathered. And then we modi?fied the protocol according to those professional opinions. Three rounds were performed and finally we established consensus. Consensus was achieved with ≥70% agreement. Results The panel included 30 experienced experts. The recycling question?naire's quantity of three rounds were 30(100%), 24(80%) and 16(53.3%) respectively. After three expert assessments, there were 18 questions which achieved with≥70%agreement and these questions accounted for 64.3%(18/28) of all the questions. Consen?sus of the treatments for cervical radiculopathy was reached on 7 aspects, including:the effective proportion of non?operating thera?py (1 question), neck immobilization (1 question), physiotherapy (1 question), pharmacologic treatment (5 questions), surgical indi?cations (3 questions), contraindications (4 questions), surgery (3 questions). Conclusion This modified Delphi study had reached a consensus concerning several treatment issues on cervical radiculopathy which had strong representativeness of experts and good convergence of opinions. In the absence of high?level evidence, at present, these experts' opinion findings will guide health care providers to define appropriate treatment in their regions. Areas with no consensus provide excellent insight for future research.

Objective To observe the correlation between zinc-a2-glycoprotein (ZAG) in human plasma and the degree of coronary atherosclerosis lesion.Methods A total of 242 research subjects were included.The clinical indexes were perfected and plasma ZAG level was detected.The coronary angiography was performed.The subjects were divided into the coronary atherosclerosis group (CAD group) and control group according to the examination results.The Gensini score was used to assess the degree of coronary artery lesion,different degree subgroups were divided according to the assessment results.The correlation between the ZAG level with the clinical indexes was analyzed by Spearman analysis.The ROC curve was used to evaluate the efficiency of ZAG in the diagnosis of coronary atherosclerosis and its sensitivity and specificity were analyzed.Results The plasma ZAG level in the CAD group was significantly lower than that in control group,the difference was statistically significant [(45.12±5.02)μg/mL vs.(53.93±2.96)μg/mL,P＜0.01].With the increase of Gensini score,plasma ZAG level showed the decreasing trend,the difference among the groups were statistically significant (P＜0.05).The Spearman correlation analysis showed that body mass index (BMI),waist circumference and waist to hip ratio(WHR) were negatively correlated with ZAG (P＜0.05),and positively correlated with high density lipoprotein cholesterol(HDL-C,P＜0.05).The sensitivity of plasma ZAG for evaluating coronary atherosclerosis was 89.8％ and its specificity was 91.2％.Conclusion Plasma ZAG is negatively correlated with the severity of coronary atherosclerosis lesion,and its level detection has a certain value in the screening of coronary atherosclerosis.

Objective To discuss the clinical value of bile reinfusion via nasojejunal tube on liver function after biliary tract surgery. Methods Eighty patients with biliary tract surgery and bile outer drainage were divided into bile reinfusion group and control group by random digits table method with 40 cases each. The clinical data concerning the liver function and volume of biliary drainage were collected. Results The patients were well tolerated for bile reinfusion, and abdominal distension, nausea and vomiting occurred in some patients. The symptoms improved significantly after symptomatic treatment. The alanine aminotransferase (ALT) and total bilirubin (TBIL) levels at the fifth day after operation in bile reinfusion group were significantly reduced than those in control group:(31 ± 18) U/L vs. (48 ± 32) U/L and (51 ± 32)μmol/L vs. (76 ± 38)μmol/L, the aspartate aminotransferase (AST) and ALT levels at the seventh day after operation in bile reinfusion group were significantly reduced than those in control group: (32 ± 19) U/L vs. (43 ± 26) U/L and (20 ± 19) U/L vs. (31 ± 22) U/L, and there were statistical differences (P<0.05). The volume of biliary drainage in the bile reinfusion group was significantly increased compared with that in control group at the third and fourth day after operation:(485 ± 52) ml vs. (428 ± 96) ml and (509 ± 62) ml vs. (458 ± 59) ml, and there was statistical difference (P<0.01). Conclusions Bile reinfusion via the nasojejunal tube may facilitate the recovery of liver function after biliary tract surgery.

Objective To investigate the change in body weight over time in rectal cancer patients receiving radiotherapy and the correlation between setup errors and weight loss,and to establish the image-guided radiotherapy regimens in different periods of treatment.Methods A total of 24 postoperative patients with rectal cancer admitted to our hospital in 2016 were selected.Before each fraction of radiotherapy,the body weight was recorded,and the patients underwent cone-beam computed tomography (CBCT) with different frequencies in every week.The planning CT was matched with CBCT to obtain setup errors.The paired t test was used for difference analysis;the Pearson method was used to analyze the correlation between setup errors and weight loss.Results Body weight was measured 456 times in the 24 patients,and these patients underwent CBCT scans and image registration 456 times.Two patients were excluded because of treatment discontinuance.In the first and second weeks,there was no significant change in body weight.In the third week,the mean weight loss was 1.53 kg.In the fourth week,the mean weight loss was 2.48 kg.In the fifth week,the mean weight loss was 3.24 kg.The setup errors obtained by CBCT image registration in the superior-inferior (SI),anterior-posterior (AP),and left-right (LR) directions were 0.19 cm,0.20 cm,and 0.18 cm,respectively,in the first week,0.18 cm,0.17 cm,and 0.15 cm,respectively,in the second week,0.20 cm,0.22 cm,and 0.21 cm,respectively,in the third week,0.19 cm,0.25 cm,0.24 cm,respectively,in the fourth week,and 0.34 cm,0.33 cm,and 0.31 cm,respectively,in the fifth week.The Pearson correlation analysis showed that weight loss increased the setup errors,with P values of 0.140,0.046,and 0.044 in the SI,AP,and LR directions,respectively.Conclusions For rectal cancer patients receiving radiotherapy,the body weight decreases significantly in the late period (especially in the fifth week),which influences the setup errors.Therefore,in the fourth and fifth weeks of radiotherapy for rectal cancer,the weight loss should be closely monitored,and the number of CBCT scans can be increased before the treatment fraction to ensure the accuracy and optimization of treatment.

Objective To identify multidrug resistance (MDR) associated cell surface antigen in hematologic neoplasia and to investigate the universality of membrane-relocated expression of this antigen in hematologic neoplasia.Methods The membrane antigen was isolated and precipitated by SDS-PAGE and co-immunoprecipitation (co-IP),then was identified by mass spectrum (MS).Specific siRNA was used to interfere with gene expression,laser confocal microsopy was used to validate the results involved in antigen information.FACS was performed to analyse relocated expression of the antigen in hematologic neoplasia.Results Co-IP and MS show that a nuclear factor PSF was the antigen of 5D12,a leukemia-MDR associated McAb,and this antigen could relocate on HL-60 cell membrane.A series of experiences further confirmed that PSF overexpressed on HL-60 cell membrane compared with HL-60/ADR.The binding percentages of 5D12 to many hematologic tumor cells were observed,HL-60 (78.56±0.76) ％,K562 (26.54±4.42) ％,Nomalwa (38.10±5.11) ％,U937 (64.03±7.96) ％,Jurkat (29.12±5.58) ％,Raji (74.92±3.41) ％,CEM (12.18±3.21) ％.Conclusion Nuclear protein,PSF relocalizes on cell surfaces in hematologic tumor cells and contributes to cell sensitivity.PSF is a potential target of MDR prediction in hematologic neoplasia.