Objective To investigate the clinical results and prognosis between proximal and total gastrectomy in proximal advanced gastric cancer.Methods The clinicopathological data of 221 patients with proximal advanced gastric cancer who undcrwent radical gastrectomy were retrospectively analyzed.82 patients and 139 patients underwent proximal and total gastrectomy respectively.The number of dessected lymph nodes,postoperative complications and mortality were compared.Kaplan-Meier survival rate curves and Log-rank test were drawn and compared.Results A total of 1 411 (11-34) and 3 345 (14-35) lymph nodes were harvested from the surgical specimens of 82 and 139 patients with proximal and total gastrectomy respectively,the average number of harvested lymph nodes was 17 ± 11 and 24 ± 10 (t =2.586,P ＜0.05).The overall complications in proximal gastrectomy were higher than total gastrectomy (73.2％ vs.30.2％,x2 =38.291,P ＜0.01).The ratio of functional delayed gastric emptying,anastomotic leakage and stenosis,reflux esophagitis in proximal gastrectomy patients was higher than total gastrectomy.The survival rate in proximal gastrectomy were lower than total gastrectomy in proximal advanced gastric cancer (P ＜0.01).Conclusion Total gastrectomy is recommended for proximal advanced gastric cancer.

Objective To explore the role and possible mechanism of transforming growth factor (TGF)-β autocrine in CDH17 regulating invasion of gastric cancer cells.Methods Construction and transfection of siRNA-CDH17 into MKN-45 gastric cancer cell line to silence the expression of CDH17.Expression of TGF-β and concentrations of TGF-β in supernatants were detected before and after CDH17 silence by immunofluorescence,immunoblotting and ELISA.The autocrine situation of TGF-β was observed.Meanwhile,the activation of TGF-β/Smad3 signaling pathway was also detected by immunoblot.After giving signaling pathway inhibitor,the changes of invasion ability of MKN-45 cells were observed by Transwell invasion experiment.The role of TGF-β autocrine and related signaling pathway activation in CDH17-regulated invasion of gastric cancer cells was evaluated.Results After transfecting siRNA-CDH17 for silencing CDH17 expression in MKN-45 cells,the expression of TGF-β was significantly decreased compared with non-transfection group,its concentration in supernatants was also significantly reduced[(510 ±55)pg/mL vs.(115±20) pg/mL,P<0.01].The immunoblots revealed that phosphorylation level of Smad3 after CDH17 silence was also significantly diminished.However,giving the TGF-β/Smad3 signaling inhibitor SIS3 (10 μmol/L) could also suppress the phosphorylation level of Smad3 when CDH17 was highly expressed,meanwhile silencing CDH17 and inhibiting Smad3 phosphorylation could significantly decrease the invasion of MKN-45 gastric cancer cells (P<0.05).Conclusion CDH17 could participate in the invasion of gastric cancer cells by promoting TGF-β autocrine to activate TGF-β/Smad3 signaling pathway.

Objective To explore a method for establishing stable auditory deprived animal model of mouse.Methods Forty two-month old BALB/c mice with normal auditory brainstem response(ABR) thresholds were divided into two groups randomly.The experimental group underwent an incision inferior to the pinna,and the cochleas were destoried with a drill through the bulla bilaterally.The control group underwent only an incision without cochlea ablation.Mice were tested for ABR thresholds 4 month later to assess hearing sensitivity by comparing the ABR before and after operation.Results In the experimental group,auricle reflection disappeared after operation and ABR waves couldn't be detect.In the control group,the result of hearing test was normal.Conclusion Mouse cochlea ablation is a reliable method for establishing a stable auditory deprived animal model of mouse by the pinna inferior approach.It can be used to the research of auditory centre plasticity induced by auditory deprived.

Objective To investigate the expression and the significance of a group of metastasis-associated proteins in invasive ductal breast carcinoma(IDC).Methods Tissue microarray containing 247 IDC specimens was constructed.The expressions of ?-B crystallin,CD44v6,MMP-2 and TIMP-2 were detected by immunohistochemistry,and the relation between the expression of these proteins and the clinicopathologic character was analyzed.Results(1) The expression rates of ?-B crystallin,CD44v6,MMP-2 and TIMP-2 in IDC were 70.0%,61.5%,57.5% and 57.1% respectively,and significantly higher than those of normal breast tissues(P

Objective To improve the knowledge of the diagnosis and treatment of functional insulinoma. Methods The clinical data of 12 cases of functional insulinoma in China-Japan Union Hospital of Jilin University from 2000 to 2009 were analyzed retrospectively. Results For the 12 cases of functional insulinoma, preoperative fasting blood glucose and the positive rate of insulin were 92% and 89% respectively. The positive rate of IRI/G and C-Peptide reached 100%. The accuracy of the niveau diagnosis of preoperative abdomen ultrasound, CT and of MRI were 75%, 36% and 0% respectively; whereas the accuracy of localization of intraoperative palpation combined with ultrasonography reached 100%. The result of glucose increased by one time within one hour after excision and the rest excision. In the 7 follow-up cases, the symptom of hypoglycemia was not found. There were 3 cases of pancreatic fistula after operation. Conclusions For the suspected cases of functional insulinoma, the measurement of IRI/G and C-Peptide are needed besides measuring blood glucose and insulin. Intraoperative palpation and ultrasonography are effective methods of the localization of functional insulinoma. The complete resection of the insulinoma can be assessed by monitoring the change of the blood glucose after excision as well as the rapid intraoperative pathological examination.

Objective To study the asymmetric dimethylarginine(ADMA) concentrations in plasma of acute coronary syndrome (ACS) and its various subgroups ,and analyze the relationship between ADMA and traditional risk factors of ACS .Methods 101 ACS patients were enrolled in the study ,which were divided into several subgroups according to clinical diagnosis ,ECG and coro‐nary angiography .ACS group were divided into unstable angina(UA) group(n=70) and acute myocardial infarction(AMI) group (n=31) ,then AMI group was divided into non‐ST segment elevation myocardial infarction(NSTEMI) group(n=19) and ST seg‐ment elevation myocardial infarction (STEMI) group(n=12) .The control group(n= 40) were recruited in the study during the same period ,who showed normal coronary arteries in coronary angiography .All the patients received coronary attery angiography . The plasma ADMA concentration was measured by using enzyme‐linked immunosorbent assay (ELISA) ,and serum contents of lip‐id(TC ,TG ,HDL‐C ,LDL‐C) ,C‐reactive protein(CRP) ,troponin were detected by automatic biochemic analysis apparatus .Results Compared with the control group ,plasma ADMA concentration of ACS group increased ,the difference was statistically significant (P<0 .05) .The concentrations of ADMA in AMI group and UA group were higher than those in control group ,and the difference was statistically significant(P< 0 .05) .The concentrations of ADMA in AMI group were significantly higher than those in UA group(P<0 .05) .Plasma ADMA negatively correlated with HDL‐C concentrations(r= -0 .222 ,P<0 .05) ,positively correlated with LDL‐C concentration(r=0 .357 ,P<0 .05) ,and positively correlated with CRP(r=0 .619 ,P<0 .05) .Conclusion The occur‐rence of ACS and some of its related risk factors are correlated with plasma ADMA concentration .

Objective To investigate the value of intravoxel incoherent motion MR imaging (IVIM-MRI)on monitoring impairment of renal function in hydronephrosis.Methods Left hydronephrosis model of Healthy New-Zealand rabbits made by ureteral incomplete obstruction were scanned by IVIM-MRI at 4, 8, 12, and 16 weeks.The change of IVIM-MRI quantitative parameters (ADC values, D values, D* values, and f values) in left hydronephrosis kidney were observed.The correlation between these parameters and glomerular filtration rate (GFR) were evaluated.Results ADC values, D values, D* values and f values at cortex and medulla in left hydronephrosis model of rabbits decreased gradually in the progression of renal damage after 4, 8, 12, and 16 weeks.For D value, f value and ADC values, there was statistical significant difference among the group of 12 weeks, the group of 16 weeks, the control group, and the group of 4 weeks;statistical significant difference was also observed between the group of 8 weeks and the group of 16 weeks by LSD contrast.ADC values, D values, D* values, and f values were positively correlated to GFR at 4, 8, 12, and 16 weeks for left hydronephrosis model of rabbits.Conclusion IVIM-MRI could monitor impairment of renal function in hydronephrosis dynamically.

Objective To compare the prevalence of patent foramen ovale (PFO) in young and middle-aged patients with cryptogenic ischemic stroke (CS) and in normal population.Methods The casecontrol study included consecutive 318 young and middle-aged patients with CS and 336 normal control subjects with matched age and sex for group comparisons.Stroke risk factors including hypertension,diabetes mellitus,hyperlipidemia,ischemic heart disease,atrial fibrillation,carotid atherosclerosis plagues and smoking,etc.were studied.Transesophageal echocardiography (TEE) were performed to detect the presence of PFO.The prevalence of PFO and difference of risk factor levels between the groups was compared.Then the odds ratios (OR) of a PFO was estimated in CS patients versus control subjects.Results The prevalence of PFO was significant higher in patients with CS than in control subjects (145/318,45.6 ％ versus 46/336,13.7％,P ＜0.001).The odds ratio(OR) for PFO in CS for patients versus control subjects was 5.3 (confidence interval,3.6 to 7.8).The mean size of PFO was larger in stroke group than that in control group (P ＜ 0.001).There were no significant differences in levels of other stroke risk factors between two groups.Conclusions PFO may play an important role in etiology of CS in young and middleaged adults.Larger and longer PFOs may be more concomitant with ischemic attacks.More efforts should be employed in patients with CS to detect PFO for further treatment.

Objective The objective of this study was to investigate the effect of lycopene( LP) on the proliferation and apoptosis of human osteosarcoma MG-63 cells and to explore its mechanism. Methods MG-63 cells in the logarithmic growth phase were treated with LP(5,10 and 20μg/mL) or Cisplatin(40μg/mL) for 48 h. No LP or Ciplatin treatment was as the control group. The cell growth status was observed and the cell prolif-eration was measured by MTT colorimetric assay. Flow cytometry( FCM) was used to detect the cell cycle and ap-optosis of MG-63 cells and the apoptotic rate was calculated in this study. Reverse transcription-polymerase chain reaction(RT-PCR)was used to measure mRNA levels of Bax and bcl-2,and calculate the ratio of Bax/bcl-2 in MG-63 cells. Western blot also was used to examine the expression of caspase-3 protein in MG-63 cells. Results MG-63 cells were adherent and proliferated rapidly in the control group. The cells in LP treated groups showed that the cell proliferation was inhibited and the number of cells was significantly decreased,with retraction and detaching. The inhibitory rate of MG -63 cells in LP treated group were significantly increased when compared to the control group. LP significantly prolonged the cell cycle at the G0/G1 phase and shortened the cell cycle at the S and G2/M phase. LP also significantly increased the apoptosis rate,up-regulated the mR-NA level of Bax,down-regulated the mRNA level of bcl-2,increased the ratio of Bax/bcl-2 and the expres-sion of caspase-3 protein in MG-63 cells(P<0. 05 or P<0. 01). Conclusion LP may effectively inhibit the proliferation of MG-63 cells and promote the apoptosis. The mechanism may be related to the cell cycle and the regulation of apoptosis and gene expression.

Objective To observe the effects of iguratimod ( IT) combined with methotrexate ( MTX) in patients with refractory rheumatoid arthritis ( rRA) . Methods Sixty patients with rRA were randomly divided into 2 groups ( n=30 each group) . The cases in treatment group received 50 mg.d-1 of iguratimod and 10 mg of MTX for 16 weeks. The cases in control group were treated by 10-15 mg of MTX. DAS28 was analyzed. Levels of VEGF and endostatin ( ES) were quantified. Results In the treatment group,after 16-week treatment,DAS28,levels of VEGF and ES were (3.0±1.2),(818.9±178.8) pg.mL-1, (337.8±132.6) ng.mL-1,and those in the control group were (5.7±1.9),(1000.2±245.9) pg.mL-1,(253.8±77.8) ng.mL-1,respectively. In the treatment group,DAS28 and VEGF after the treatment were significantly decreased as compared with those before the treatment ( P<0.01) . The decrement was more significant in the treatment group than in the control group ( P<0.01) . At the 16th week of treatment,ES was significantly increased as compared with that before the treatment ( P<0.01) , and there was a significant difference between the treatment group and the control group (P<0.01). Conclusion Iguratimod combined with MTX have a prominent effect on rRA with high safety. The efficacy of IT on RA might be related with decreasing VEGF release,increasing ES production and alleviating synovium angiogenesis.