ABSTRACT:Objective To a rare case of double primary cancer (hepatocellular carcinoma with gallbladder)to guide clinical application.Methods and Results We reported one case of primary hepatocellular carcinoma and gallbladder.A male patient,54 years old,had main complaints of intermittent right upper quadrant pain for 4 days. The abdominal CT of the local county hospital showed gallstones,gallbladder with liver infiltration.And then he went to the First Affiliated Hospital of Xi’an Jiaotong University for further treatment.Laboratory examination revealed:HBsAg(+),HBcAb(+),alpha-fetoprotein (AFP)> 60 500 ng/mL,carcinoembryonic antigen (CEA) 5.25 ng/mL.Abdominal CT showed hilar slightly stronger light echo groups:liver cancer or gallbladder cancer? Hepatic artery and portal vein CT imaging (CTA+CTV)examination showed the malignant tumor shadow in the inside of the left hepatic lobe huge,uneven thickening of the gallbladder wall,suspected liver disease with gallbladder infringement or gallbladder disease with liver infringement. With the preoperative preliminary consideration of primary liver cancer with infiltration of the gallbladder,we chose the operation as the resection of segment Ⅳ b and Ⅴ of the liver,cholecystectomy and T tube drainage.Pathological examination postoperative showed the bulky liver carcinoma grade Ⅲ and the poorly differentiated adenocarcinoma of gallbladder.A month later,abdominal CT showed the tumor spread intrahepatic,prompting the poor prognosis.Conclusion The two which are not continuous,which is the standard of double primary cancer,are not suitable for all double primary cancers.This case provides useful experience for future similar diagnosis and treatment of disease,and also helps us with timely and accurate identification of “metastatic”or “primary”,which is the key point for clinicians to give patients an effective treatment.

Objective To investigate the changes of calcium /calmodulin - dependent protein kinase Ⅱ (CAMKⅡD) gene expression in 3T3 - L1 preadipocyte diffe-rentiation and TNF - ? regulation of CAMKⅡD gene expression on matured adipocytes. Methods 3T3 - L1 preadipocytes were cultured and differentiated into adipocytes. The levels of CAMKⅡD gene mRNA expression at various times were evaluated by RT-PCR. Matured adipocytes were interfered with 0.1,1.0,10.0 ?g/L TNF - ? and the levels of CAMKⅡD gene mRNA expression were evaluated. Results The levels of CAMKⅡD gene mRNA expression in 3T3 - L1 adipocytes were significantly down- regulated at first day, compared with those at zero day (P0. 05). CAMKⅡD gene mRNA expression decreased significantly at 12 hours after treatment with 10.0 ?g/L TNF-?, treatment of matured adipocytes with TNF - ? did not have any regulation role on it. Conclusions CAMKⅡD gene is involved in the differentiation of adipocytes and related to the etiology of obesity. The changes in the level of CAMKⅡD gene mRNA expression during 3T3 - L1 preadipocyte differentiation may contribute to the differentiation and adipogenesis of adipocytes. It seems that TNF - ? does not have any regulation role on the expression of CAMKⅡD genes.

Objective To study the iodine nutritional status of population living in Tibetan pastoral areas,in order to provide a scientific basis for prevention and control of iodine deficiency disorders.Methods Drinking water samples were collected to test iodine content in agricultural town(Kajiaman) and pastoral area(Zuogaiduoma town) of Hezuo in Gannan Tibetan autonomous prefecture.Thirty of child-bearing age,pregnant and breastfeeding women were selected,respectively,and 90 male adults aged 20-50 from these families(1 from each family) and 90 children aged 8-10 (30 people in each age group) from local schools were randomly sampled at the same time,and urinary iodine (UI) was measured randomly.Edible salt and main food samples were collected to test iodine content from the 10 families of the three types of women,respectively,and they were asked to recall its family intake of food species in the past 24 h excluding spices.The water iodine was determined using arseniccerium redox method (GB/T 5750.1-2006) ; UI with ammonium persulfate digestion-arsenic cerium catalytic spectrophotometric method (WS/T 107-2006) ; salt iodine used direct determination method(GB/T 13025.7-1999); and food iodine with alkali the gray arsenic cerium contact colorimetry.All these work were done in May,2011.Results The average of water iodine was (1.63 ± 0.14)μg/L in agricultural areas and (2.08 ±1.90)μg/Lin pastoral areas of the 10 water samples tested,respectively.The median urinary iodine(MUI) among women of pregnant,lactating and child-bearing age,male adults and children was 141.99,126.65,253.33,258.07,191.0μg/L,respectively,in agricultural areas and 137.26,97.36,126.16,159.48,285.07 μg/L,respectively,in pastoral areas.The difference of MUI in lactating,male adults and children between pastoral and agricultural areas was statistically significant.The proportion of UI ＜ 50 μg/L was less than 20％,and ＜ 100 μg/L was less than 50％ among all population except lactating woman and pregnant women in pastoral areas.The iodized salt coverage rate was 100％(30/30) in agricultural areas and 90％(27/30) in pastoral areas,and the salt iodine was (32.1 ± 7.8)mg/kg in agricultural areas and (32.3 ± 6.0)mg/kg in pastoral areas,respectively.The food structure in agricultural areas was mainly potato,naked oat fruit,cabbage and so on,the average dietary iodine content was 285.7 μg/kg,and in pastoral areas was mainly chow mein,wheat flour,ghee,yogurt,barley and so on,the average dietary iodine content was 51.1 μg/kg.Conclusions There is no iodine deficiency in general in the population in Tibetan areas with low water iodine.However,iodine nutrition of pregnant women can not be guaranteed.It is recommended that classified guidance measures be taken to ensure the sustainable elimination of iodine deficiency disorders in the Tibetan minority areas.

To study the changes of pupil diameter and its effects during phacoemulsification. METHODS: Block design, prospective study. 60 cataract patients (60 eyes) were selected, which divided into two groups according to the age, young age group (group A, 20 eyes of 20 patients) and older age group (group B, 40 eyes of 40 patients). Two groups were all given compound tropicamide eye drops for fully mydriasis before operation, computer software to process images during operation, and according to the cornea amplification ratio measure pupil diameter during the operation phase: before the corneal tunnel incision ( t1 ) , after injection of sodium hyalurantae ( t2 ) , before artificial lens implantation (t3), at the end of the surgery ( t4 ). Statistical analysis of data using SPSS18. 0 software.RESULTS: The pupil diameter measurements of t1-t4 were followed respectively:group A were 8. 36 ± 0. 65, 8. 97±0. 50, 8. 67±0. 63, 8. 72±0. 96mm; group B were 7. 73± 0. 58, 8. 23 ± 0. 59, 7. 89 ± 0. 16, 7. 70 ± 0. 63mm. Overall comparisons between the two groups, the pupil diameter measurements had differences during the operation phase ( F = 26. 696, P< 0. 05 ). Comparisons between the two groups at different time points: the pupil diameter of t1-t4 in group A was larger than that in group B, with statistically differences (P<0. 05). The pupil diameter of each groups had a tendency to change in different operation phrases, with no statistically differences (F=2. 617,P>0. 05). Comparisons in a group at different time points: the pupil diameter of t2 was larger than that in t1, with statistically differences ( P>0. 05), the pupil diameter of t3 and t4 were decreased in group B, with statistically differences (P<0. 05).CONCLUSlON: Compound tropicamide eye drops are given for mydriasis before operation, young patients with cataract and senile patients with cataract can achieve the effect of surgery for mydriasis, the pupil stability of phacoemulsification in senile patients with cataract are lower than that in young patients with cataract.

An HPLC method to determine six alkaloids of the Coptidis for Chinese Pharmacopoeia of 2015 Edition was established through C18 column. The mobile phase was CH3CN-0.25 mol·L-1 NH4Ac (36:64) (containing 8 mmol·L-1 SDS and adjusting pH 9.3 with ammonia) at the flow rate of 1 mL·min-1, the detective wavelength was 270 nm and the column temperature was 35 oC. The linear ranges of jatrorrhizine hydrochloride, columbamine hydrochloride, epiberberine hydrochloride, coptisine hydrochloride, palmatine hydrochloride and berberine hydrochloride were 0.006 96-0.233, 0.004 75-0.152, 0.003 30-0.528, 0.006 31-1.010, 0.004 71-0.753, 0.017 8-2.884 μg·mL-1, respectively. The average recoveries were 99.65%, 98.59%, 98.49%, 98.66%, 98.64%, 98.63% and RSD were 0.03%、0.15%、0.21%、0.12%、0.28%、0.23%, respectively. The method is simple and accurate, and can be used to determine the contents of jatrorrhizine, columbamine, epiberberine, coptisine, palmatine and berberine in the Coptidis.

Objective To investigate the impact of a single sub-anesthetic dose of ketamine on postoperative emotional reactions of anxiety and depression during colorectal tumors surgery. Methods A total of 42 patients undergoing selective colorectal surgery,aged 18 to 65 years,were randomly divided into ketamine group (group K)and control group (group C).After induction of an-esthesia,a single intravenous injection of 0.3 mg/kg ketamine and saline were used in Group K and group C 5 minutes before the operation respectively.The intravenous analgesia program was identical between the two groups.The patients??emotional reactions (anxiety,depression)were assessed using the Hospital Anxiety and Depression Scale (HAD),the quality of recovery was assessed using the QoR-40 questionnaire on the day before operation and within postoperative 48 hours respectively.Pain was estimated by the visual analog scale (VAS)and sedation was assessed with Ramsay score 30 mi-nutes after extubation.The time of anesthetic end and extubation were recorded.The complications during anesthesia and recovery such as cough, agitation 30 minutes extubation were recorded. Results The HAD-A and HAD-D scores of group K were lower than group C (P <0.05)48 h post-operatively.There was no difference on the QoR-40 score postoperative 48 h between the two groups. The patients??emotional state QoR-40 score of group K were higher than group C (P <0.05 ).The VAS scores 30 minutes after extubation of group K were lower than group C (P <0.05).There was no significant difference on sedation score 30 minutes postoperatively between the two groups.There was no significant difference in extubation time,cough,agitation and delirium between the two groups.There was no dizziness, nausea, vomiting or diplopia 30 minutes after extubation. Conclusion A single subanesthetic dose of ketamine can significantly reduce the scores of postopera-tive anxiety and depression,improve the quality of recovery,and no postoperative adverse reactions increased.

ObjectiveTo investigate the effective method of preventing blood return when using nitroglycerin for patients with heart failure. Methods Using physiological saline solution or 5% glucose with nitroglycerin pumped into the same vein for patients at the same time, and then observed the condition of blood returning, recorded the critical drop-speed which can effective prevented blood return. Observed the influence of added solution on heart function of patients with heart failure. Results Pumped physiological saline solution or 5% glucose with nitroglycerin in the same time with the speed of 5ml/h can effective prevent the blood return, and the added solution can not influence the heart function for patients with heart failure significantly. Conclusion Pumped physiological saline solution or 5% glucose with nitroglycerin into the same vein at the same time can effective preventing the blood return, and the added solution can not influence the heart function for patients with heart failure significantly.

OBJECTIVETo observe the impacts on the muscle strength in the patients of stroke-induced acroparalysis treated with Xunjingcuiqi needling technique.

METHODSOne hundred patients were randomized into a Xunjingcuiqi group and a routine acupuncture group, 50 cases in each group. In the routine acupuncture group, the routine acupuncture technique was adopted at the main acupoints, such as Shangxing (GV 23), Baihui (GV 20), Dicang (ST 4), Quchi (LI 11), Huantiao (GB 30) and Zusanli (ST 36), etc. In Xunjingcuiqi group, on the basis of the routine acupuncture technique, Xunjingcuiqi needling technique (pricking technique was quickly applied with the filiform needle along the running course of meridian to promote the conduction of meridian qi) was added. For the patients being hard to feel the needling sensation and with the muscle strength of 0 to 1 degree, Dongzhencuiqi technique was supplemented at shu-stream points of yang meridians (after qi arrival, the needling manipulation with limb movement was given to promote the conduction of meridian qi). The treatment was given once every day in the two groups. Ten treatments made one session. Three sessions of treatment were required. At the end of each session treatment, the muscle strength and clinical efficacy were assessed.

RESULTSIn the 1st, 2nd and 3rd sessions of treatment, 20, 24 and 36 cases achieved the 3 to 5 degrees muscle strength in Xunjingcuiqi group, respectively; and 6, 10 and 15 cases achieved the 3 to 5 degrees muscle strength in the routine acupuncture group. The differences were significant statistically in comparison of the two groups (P < 0.01, P < 0.05). The markably effective rates were 60.0% (30/50), 64.0% (32/50) and 70.0% (35/50) after the 1st, 2nd and 3rd sessions of treatment in Xunjingcuiqi group, respectively; and those were 38.0% (19/50), 44.0% (22/50) and 46.0% (23/50) in the routine acupuncture group, respectively. The differences were significant in the 1st and 3rd sessions of treatment between the two groups (both P < 0.05).

CONCLUSIONXunjingcuiqi needling technique combined with routine acupuncture achieves the apparent superior efficacy on acroparalysis induced by ischemic stroke as compared with the simple routine acupuncture. Xunjingcuiqi needling technique obviously improves muscle strength and shortens the duration of sickness.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; methods ; Aged ; Female ; Humans ; Male ; Middle Aged ; Paralysis ; etiology ; therapy ; Qi ; Stroke ; complications ; Treatment Outcome

Background Eicosapentaenoic acid(EPA)function as the critical lipid mediators involved in several biological events in human body and play important role in suppressing the genesis of vascular endothelial growth factor (VEGF),migration and proliferation of vascular endothelial cells.Many ocular diseases were proved to be associated with neovascularization.Objecfive The purpose of this study was to investigate the inhibitory effect of EPA on the proliferation of human umbilical vein endothelial cells (HUVEC) indueed by VEGF. Methods HUVEC strain was cultured and passaged,and difierent concentrations of EPA were added to the medium with and without VEGF.The cultured cells were identified by antiofactor Ⅷ polyclonal antibody.The suppressing role of different concentrations of EPA on the proliferation of VEGF-induced or-uninduced HUVEC was assessed by MTT method.The influence of difierent concentrations of EPA on the cellular cycle of VEGF-induced HUVEC was assayed using flow eytometry.The expression of Flk-1,a receptor of VEGF,in the HUVEC Was detected by immunohistochemistry. Results Cultured HUVEC showed the ftlsiform in shape and presented with the cobblestone-like arrangement with the positive response for Ⅷ factor-related antigen.Various concentrations of EPA showed obviously inhibitory effect on VEGF-induced or-unindueed HUVEC at a dose-dependent manner (F=23.072.P=0.000).The inhibitory ability of EPA on VEGF-induced HUVEC was stronger than VEGF-uninduced HUVEC(F=41.417,P=0.000).In 24,48 and 72 hours,the action of EPA on the proliferation of HUVEC was gradually enhanced with the prolong of time(F=1.495,P=0.236).Cell cycle analysis indicated that EPA arrested VEGF-induced HUVEC in G0/G1 phase.The ratio of HUVEC in G0/G1 phase in EPA group was(75.83±1.56)%,and that in control groups was(68.62±1.44)%,showing a significant difference between them(t=-5.88,P=0.00),and no apoptosis of HUVEC was found in both groups.Flk-1 was strongly expressed in the cellular nucleus and cytoplasm in control group.However,the positive expressing intensity of Flk-1 in the HUVEC weakened,and the positive cell number was evidently less in EPA group. Conclusion EPA can inhibit the proliferation of VEGF induced HUVEC through arresting the synthesis of DNA of HUVEC and downregulate the expression of Flk-1 in HUVEC.These results suggest that EPA might exert an antiangiogenic effect.

Objective The role of long non-coding RNA Linc00467 in human lung adenocarcinoma is not yet clear.This study was to investigate the expression of long non-coding RNA Linc00467 in human lung adenocarcinoma, its clinical significance, and the effects of Linc00467 on the functions of the tumor and endothelial cells in vitro.Methods Lung adenocarcinoma tissue and normal tissue surrounding the malignance were obtained from 60 patients with pathologically proved stage I-Ⅲa lung adenocarcinoma.Human umbilical vein endothelial cells (HUVECs) were transfected with the over-expressed plasmid pccl-Linc00467 (HUVEC experimental group) or the empty vector pccl (HUVEC control group), A549 cells with Linc00467-siRNA (A549 experimental group) or negative siRNA (A549 control group), and H1299 cells, too, with Linc00467-siRNA (H1299 experimental group) or negative siRNA (H1299 control group).The expression level of Linc00467 in the lung adenocarcinoma tissue was detected by qRT-PCR with an analysis of its correlation with the clinicopathological characteristics of the patients;the influence of Linc00467 on the proliferation of the A549, H1299 and HUVEC cells was assayed with CCK-8;and the role of Linc00467 in the angiogenesis of the HUVECs was assessed by fibrin bead sprouting assay.Results The expression of Linc00467 in the lung adenocarcinoma tissue was 2.72±1.31 times as high as that in the normal lung tissue (P<0.01), and those in the A549 and H1299 cells were 3.45±0.25 and 3.22±0.33 times as high as those in the human bronchial epithelial (HBE) cells (P<0.01).The expression level of Linc00467 was significantly correlated with the tumor size and vascular invasion (P<0.05).After transfection of Linc00467-siRNA, the expressions of Linc00467 in the A549 and H1299 experimental groups were down-regulated by 72% and 68% as compared with those in the A549 and H1299 control groups (P<0.01).The number of living cells was remarkably decreased in the A549 experimental group in comparison with the A549 control at 48 h (1.29±0.07 vs 1.51±0.09), 72 h (1.53±0.15 vs 2.13±0.11), and 96 h after culturing (1.98±0.18 vs 3.02±0.12), and so was it in the H1299 experimental versus the H1299 control group, but markedly increased in the HUVEC experimental versus the HUVEC control group (P<0.05).At 5 days, HUVEC experimental group, as compared with the HUVEC control, showed a significantly increased number of newly formed vascular branches (7.36 vs 4.25/superbead, P<0.01) and relative length of the blood vessels (3.12 vs 1, P<0.01).Conclusion Linc00467 promotes tumor cell proliferation and angiogenesis and is highly expressed in the lung adenocarcinoma tissue, which is correlated with the tumor size and vascular invasion and suggests that Linc00467 could be a potential biomarker and therapeutic target.