Objective To evaluate the efficacy and safety of trimebutine combined with mosapride on functional dyspepsia. Methods Patients with functional dyspepsia were randomly divided into three clinical groups. Group A (n=116) received 0.2 g trimebutine after meal,group the drug combination B (n=116) received 5 mg mosapride before meal,and the drug combination group (n=115) received 0. 2 g trimebutine after meal plus 5 mg mosapride before meal. All medications were taken orally three times daily for 4 weeks. Improvement in clinical symptoms and adverse reactions in each group were evaluated at the end of study. Results A total of 339 patients among 347 enrollees completed the treatment and follow-up. The clinical efficacy on postprandial fullness, early satiation, epigastric pain, epigastric burning, upper abdominal bloating and nausea were 88. 4%,76. 9%,72. 9%,61. 8%,86. 7% and 81. 7%,respectively in the drug combination group after 4-week treatment,which were superior to those in group A or B (P<0. 05) except for epigastric burning. The total effective rate of the drug combination group was 78. 8%,significantly higher than the other two groups (P<0. 05). The total incidence of side effects in the drug combination group was 1. 8%,similar to that of group A and B (1. 8% and 0. 9%,respectively, P =0. 776). Conclusion Trimebutine combined with mosapride is safe and effective for improving symptoms in functional dyspepsia.

Objective To investigate the protective effect of glutamine(Gln) pretreatment on intestinal ischemia-reperfusion (I/R) injury and endothelial nitric oxide synthase (eNOS)/nitric oxide (NO) signaling pathway in rat model. Methods Thirty male Wistar rats were randomly divided into three groups(n=10 for each group):sham group, I/R group and Gln group. Animals were pretreated with 1 g/(kg·d)Gln by orogastric route for 7 days in Gln group, and normal saline was given to the other two groups in the same dose. Intestinal I/R was induced by 30 min occlusion of the superior mesenteric artery followed by 24 h of reperfusion. After the operation, the intestinal histopathological changes, the plasma endotoxin level, serum D-lactic acid, eNOS, inducible NOS(iNOS)activity and NO levels were detected by ultraviolet spectrophotometer. The mRNA expressions of myocardial eNOS and iNOS were detected by real-time fluorescence quantitative PCR (RT-PCR). Results After reperfusion, in IR group, extensive epithelial sloughing and mucosal ulceration of villous tips were observed, whereas these findings did not occur in Gln group and sham group. Compared with IR group, the serum NO, eNOS levels and eNOS mRNA expression of intestinal tissue were elevated in Gln group (P<0.01), but the plasma endotoxin level, serum D-lactic acid, serum iNOS and intestinal iNOS mRNA expression decreased in IR group(P<0.05). Conclusion Glutamine pretreatment has protective effects on intestinal ischemia-reperfusion injury in vivo. The mechanism may be related to the inhibition of iNOS expression and the increased expression of eNOS, thereby increasing NO activity.

Background and purpose:MicroRNA-486-5p (miR-486-5p) has been demonstrated to play an important role in many kinds of tumor, however, there are few reports about the relationship between miRNA-486-5p in gastric carcinoma. This study was aimed to explore the effect of miR-486-5p on the proliferation, apoptosis and migration abilities of the human gastric cancer cell line SGC7901.Methods:Quantitative real-time PCR (qRT-PCR) analysis was performed to detect the expression of miR-486-5p in the SGC7901 and GES-1 cells, miR-486-5p over-expressing plasmid was constructed and transfected into the human gastric carcinoma cell line SGC7901 using LipofectamineTM2000. The expression of miR-486-5p of the transfected cells was measured by qRT-PCR, the proliferation level of SGC7901 cells was detected by MTT method, the apoptosis rate of the cells was measured by lfow cytometry and the in vitro migration abilities of SGC7901 cells by transwell test. Results:The miR-486-5p expression in SGC7901 cells was down-regulated compared with GES-1 cells. The expression of miR-486-5p in SGC7901 cells that was transfected miR-486-5p over-expressing plasmid was obviously up-regulated. The proliferation and migration abilities of SGC7901 cells were inhibited signiifcantly, and the apoptosis rate of the cells increased. Conclusion:miR-486-5p can effectively suppress the proliferation and in vitro migration abilities of SGC7901 cells, indicating that miR-486-5p might be used as a target for molecular therapy of gastric cancer.

Objective To investigate the effects of isoliquiritigenin on the invasive ability of human gastric carcinoma SGC7901 cells, and its molecular mechanisms thereof. Methods The logarithmic phase human gastric carcinoma SGC7901 cells were divided into control group (normal cell culture fluid) and isoliquiritigenin group (isoliquiritigenin solu?ble in cell culture fluid, the concentrations were 10, 25, 50 and 100 μmol/L respectively). Each group had four repeated holes. The proliferation of SGC7901 cells were detected with MTT assay after 24 h, 48 h and 72 h of culture. The experimen?tal drug concentration and action time were researched for the subsequent experiments. The in vitro invasion abilities of SGC7901 cells were assessed with Transwell test. The expression levels of MMP9, Akt and P-Akt were detected by Western blot assay. Results The proliferation of SGC7901 cells were inhibited by 10μmol/L isoliquiritigenin, which can be signifi?cantly inhibited by 25, 50 and 100μmol/L isoliquiritigenin in a concentration-dependent and time-dependent manner. The half inhibitory concentrations (IC50) of 24, 48 and 72 h were 52.48, 44.49 and 32.50μmol/L, respectively. Therefore, the 25, 50 and 100μmol/L isoliquiritigenin were selected as the subsequent experimental drug concentration, and 24 h was used as the action time. Compared with the control group (209.75±9.29), the membrane cell number of 25μmol/L (138.50±10.15), 50μmol/L (89.50 ± 16.56) and 100μmol/L (45.00 ± 8.08) decreased gradually (F=267.948,P<0.05). There was no signifi?cant difference in the expression level of Akt protein between four groups (F=1.492). The expression levels of P-Akt and MMP9 were gradually decreased with the increase of the isoliquirigenin concentration (F=359.219 and 431.324,P<0.05). Conclusion Isoliquiritigenin can obviously inhibit invasion ability of SGC7901 cells, which may be related to the down reg?ulation of the signal transduction pathway protein PI3K/Akt and the down steam protein MMP9.

Objective　To compare the effects of mild hypothe rmic cardiopulmonary bypass (CPB) and moderate hypothermic cardiopulmonary bypas s in pediatric cardiac surgery. Methods　A total of 118 cas es of less than 3 years of age that had undergone open heart surgery were review ed, in which 46 patients received moderate hypothermic CPB(group 1) and 72 patie nts received mild hypothermic CPB(group 2). The CPB duration, incidence of low c ardiac output and postoperative concentration of CK-MK, etc, were compared with each other betwee n the two groups. Results　Duration of bypass and postoperative mechanical respiratory assistance of group 2 was shorter than that of group 1 ( P<0.05). Transfusion requirements, incidence of low cardiac output syndrome, concentration of CK-ME and percentage of metabolic acidosis were lower in grou p 2 than in group 1 (P<0.05), while the index of oxygenation was higher in g roup 2(P<0.05). Conclusion　The mild hypothermic CPB is saf er and more effective and therefore is superior to moderate hypothermic CPB in p ediatric cardiac surgery.

Objective To evaluate the clinical efficacy of the over-the-scope-clip (OTSC) for endoscopic closure of acute refractory non-variceal upper gastrointestinal bleeding. Methods This retrospective study selected 16 refractory patients, including 2 cases with Mallory-Weiss syndrome, 7 cases with gastric ulcer, 1 case with gastric carcinoma and 6 cases with duodenal ulcer, underwent OTSC treatment of acute non-variceal upper gastrointestinal bleeding from January 2015 to June 2016 as study subjects. Results All of the 16 patients with bleeding lesions were successfully controlled. The successful rate is 100.0%. The mean procedure of OTSC for endoscopic bleeding closure was between 5.0 and 6.0 min. Conclusion The Over-the-Scope-Clip system is safe and effective for closure of acute non-variceal upper gastrointestinal bleeding in refractory patients, and deserves further clinical applications.

Objective　To improve intracardiac operation skil ls on bea-ting-heart with mild hypothermic cardiopulmonary bypass (On pump beating-heart technique), and to review the clinical experience in 1 032 c ases. Methods　A total of 1 032 cases of intracardiac operatio ns on pump beating-heart from November 1997 to September 2000 were reviewed. Of them, 714 cases were congenital heart diseases (CHD), and 318 cases were valvul ar heart diseases (VHD). The technique was improved by establishing simultaneous left atrium and ventricle suction and integrating sequential de-airing procedu re. Results　The operative mortality was 2.33% (24/1 032), the m ortality was 2.7% (19/714) in cases with CHD, and 1.6% (5/318) in those with VHD. There was no pati ent complicated with systemic air embolism or permanent atrioventricular conduct ion block. Conclusion　Results suggested that intracardiac procedures on pump beating-heart with mild hypothermic cardiopnlmonary bypass is safe and available in patients with CHD or VHD. It might extenuate the heart and lung injury by hypothermia and ischemia-reperfusion during cardiopulmonary bypass. Cardiac conducting block might be prevented during operation.

OBJECTIVETo observe the impact of the JNK inhibitor XG-102 in a diet-induced rat model of non-alcoholic steatohepatitis.

METHODSForty-eight Sprague-Dawley male rats were subjected to a percutaneous superior mesenteric vein retention catheter operation and fed with a standard diet for 10 days, after which the rats were randomly divided into the following three groups: normal control (NC) group; high-fat (HF) model group; XG-102 treatment group. The HF group was fed an HF diet and treated with 0.9% sodium chloride for 16 weeks. The XG-102 group was fed an HF diet for 16 weeks and simultaneously treated with XG-102 (1 mg/kg) once per day for 4 weeks. The levels of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), triglyceride (TG), homeostasis model of assessment insulin resistance (HOMA-IR) and tumor necrosis factor-alpha (TNFa) were measured. Liver histological changes were observed. The protein expressions of phospho-c-Jun and cleaved caspase-3 were detected by western blotting.

RESULTSCompared with the NC group, the HF group showed significantly higher levels of serum ALT, AST, TC, TG, HOMA-IR and TNFa (P<0.05). Compared with the HF group, the XG-102 group showed significantly lower levels of serum ALT, AST, TC, TG, HOMA-IR and TNFa (P<0.05). The HF group also showed significantly higher protein expression of phospho-c-Jun and cleaved caspase-3 than the NC group (P<0.05) and the XG-102 group (P<0.05).

CONCLUSIONThe JNK inhibitor XG-102 may ameliorate lipid metabolism, reduce insulin resistance, decrease liver injury and inhibit hepatocytes apoptosis.

Alanine Transaminase ; Animal Feed ; Animals ; Aspartate Aminotransferases ; Caspase 3 ; Cholesterol ; Insulin Resistance ; Lipid Metabolism ; Male ; Non-alcoholic Fatty Liver Disease ; Peptides ; Protein Kinase Inhibitors ; Rats ; Rats, Sprague-Dawley ; Triglycerides ; Tumor Necrosis Factor-alpha

Objective To investigate the application value of secondary splenic pedicle separation technology through superior posterior approach of the pancreatic tail in laparoscopic partial splenectomy.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 13 patients who underwent laparoscopic partial splenectomy in the Ningbo First Hospital from March 2016 to October 2017 were collected.After preoperative assessment using computed tomography(CT) angiography,13 patients underwent laparoscopic partial splenectomy using secondary splenic pedicle separation technology through superior posterior approach of the pancrcatic tail.Observation indicators:(1) intra-and post-operative recovery situations;(2) follow-up situations.Follow-up using outpatient examination was performed to detect postoperative changes of peripheral blood platelet (PLT),thrombosis of splenic vein,lesions residual or recurrence up to November 2017.Measurement data were represented as average (range).Results (1) Intra-and post-operative recovery situations:13 patients underwent successful laparoscopic partial splenectomy using secondary splenic pedicle separation technology through superior posterior approach of the pancreatic tail,without conversion to open surgery,including 6 with laparoscopic partial splenectomy of inferior pole of the spleen and 7 with laparoscopic partial splenectomy of upper pole of the spleen.Operation time was 42-93 minutes,with an average of 61 minutes;volume of intraoperative blood loss was 30-260 mL,with an average of 92 mL;postoperative gastrointestinal function recovery time was 22-47 hours,with an average of 34 hours;postoperative drainage tube removal time was 3.0-6.0 days,with an average of 4.2 days.The postoperative pathological examination of 13 patients:7,2,2,1 and 1 patients were respectively confirmed with splenic cysts,splenic hemangiomas,vascular hemangiomas,splenic hamartoma and splenic lymphangioma.Of 13 patients,1 was complicated with splenic recess effusion and fever,and was improved with B ultrasound-guided percutaneous catheter drainage.Duration of hospital stay of 13 patients was 7.0-16.0 days,with an average of 9.6 days.(2) Follow-up situations:13 patients were followed up for 1.0-19.5 months,with a median time of 8.5 months.During the follow-up,PLT level of 13 patients was normal.Color Doppler ultrasound examination showed no venous embolism,and CT angiography showed good vascular perfusion.There was no recurrence of splenic cysts in 7 patients and no tumor residual or recurrence in 6 patients.Conclusion Laparoscopic partial splenectomy using secondary splenic pedicle separation technology through superior posterior approach of the pancreatic tail is safe and effective,and it can precisely dissect splenic hilum,preserve blood supply and function of the remnant spleen,and reduce surgical injury.

Objective To compare the rates and pathological features of diabetic keratopathy in mice induced by single high dose or multiple low dose streptozotocin (STZ) injections.Methods Eighty male C57BL/6 mice (6-8 weeks old) were randomly divided into 4 groups with each group contain 20 mice:normal control group,multiple low dose 1 month group and multiple low dose 3 months group (injected with 60 mg/kg STZ for 5 consecutive times),single high dose 1 month group (injected with 150 mg/kg STZ).The survival rate,model success rate,body weight,glycosylated hemoglobin (HbA1c) content were compared among different modeling group.The percentages of residual epithelial defect area were examined by fluorescein sodium staining after removal of central corneal epithelium.The expression of p-Akt,Sirt1 and Ki67 were evaluated by immunofluorescent staining.The corneal sensitivity were compared among different groups before corneal epithelial curettage,3,7,10 and 14 days after corneal epithelial curettage.The corneal subbasal nerve density at 14 days after corneal epithelial curettage were compared among different groups.This study complied with the declaration of ARVO Results The success rate of diabetic modeling in multiple low dose 1 month group,multiple low dose 3 months group and single high dose 1 month group was 90％,80％ and 70％,respectively.The HbA1c levels in the diabetic modeling groups were significantly higher than that in the normal control group (all at P＜0.05).The percentage of residual epithelial defect area 24 and 48 hours after corneal epithelial curettage in the multiple low dose 3 months group and single high dosc 1 month group were significantly higher than those in the normal control group (all at P＜0.05).The fluorescence intensity of p-Akt,Sirt1 and Ki67 in the multiple low dose 3 months group and single high dose 1 month group were stronger than those in the normal control group.There were no significant differences on corneal sensitivity and corneal nerve density between normal control and multiple low dose 3 months group before and 14 days after the corneal epithelial removal (all at P＞0.05).However,the corneal sensitivity and corneal nerve density were dramatically decreased in the multiple low dose 3 months group and single high dose 1 month group before and 14 days after the corneal epithelial removal,and there were significant differences compared with normal control group (all at P＜0.05).Conclusions The injection of 60 mg/kg STZ can not induce the features of diabetic keratopathy in mice within 1 month.However,the mice of both 1 month after 150 mg/kg STZ injection and 3 months after 60 mg/kg STZ injection appear the typical epithelial and nerve features of diabetic keratopathy,therefore can be the ideal animal models for research.