Objective To analyze the clinicopathological characteristics of patients with gastrointestinal malignant tumor in some parts of Hainan province and alien patients outside of Hainan province. Methods Three hundred and fifteen patients who were diagnosed by pathological confirmation were selected in Hainan Branch of PLA General Hospital from Jun 2012 to June 2016, clinicopathological parameters including age, gender, tumor location, cancer cell differentiation, body mass index (BMI), body surface area (BSA), value of preoperative tumor markers, TNM stages, microsatellite state, human epidermal growth factor receptor 2 (Her-2) staining, Ki-67 index and risk factors were collected and compared between local and alien patients. Results In contrast with patients outside of Hainan province, a significant lesser BMI [colorectal cancer: (23 ± 3) kg/m2 vs. (24 ± 4) kg/m2, t=-3.69, P< 0.05; gastric cancer: (21.50 ± 3.15) kg/m2 vs. (23.00 ± 3.61) kg/m2, t=-2.11, P=0.04] and BSA [colorectal cancer:[(1.73 ± 0.18) m2 vs. (1.82 ± 0.18) m2, t=-3.46, P<0.05;gastric cancer:(1.73 ± 0.16) m2 vs. (1.81 ± 0.18) m2, t=-2.09, P=0.04] were found in local patients. Local patients with colorectal cancer were much more younger [(57 ± 13) years old vs. (62 ± 13) years old, t=-2.30, P=0.02], with corresponding elevated positive rate of preoperative CEA (χ2=4.56, P= 0.03), T stages (χ2 = 8.31, P= 0.04) and TNM stages (χ2= 11.19, P= 0.01), however, no such difference was detected in gastric cancer patients (all P>0.05). Conclusions Patients with gastrointestinal cancer in some parts of Hainan province, in particular, colorectal cancer patients, present some exceptional clinicopathological features, which are marked by younger age at diagnosis, low level of BMI and BSA. In addition, preoperative level of CEA would be of important for these patients.

BACKGROUNDCapsule endoscopy is a novel non-invasive method for visualization of the entire small bowel. The diagnostic yield of capsule endoscopy depends on the quality of visualization of the small bowel mucosa and its complete passage through the small bowel. To date, there is no standardized protocol for bowel preparation before capsule endoscopy. The addition of simethicone in the bowel preparation for the purpose of reducing air bubbles in the intestinal lumen had only been studied by a few investigators.

METHODSSixty-four participants were randomly divided into two groups to receive a bowel preparation of polyethylene glycol (PEG) solution (Group 1) and both PEG solution and simethicone (Group 2). The PEG solution and simethicone were taken the night before and 20 min prior to capsule endoscopy, respectively. Frames taken in the small intestine were examined and scored for luminal bubbles by two professional capsule endoscopists. Gastric emptying time and small bowel transit time were also recorded.

RESULTSSimethicone significantly reduced luminal bubbles both in the proximal and distal small intestines. The mean time proportions with slight bubbles in the proximal and distal intestines in Group 2 were 97.1% and 99.0%, respectively, compared with 67.2% (P<0.001) and 68.8% (P<0.001) in Group 1. Simethicone had no effect on mean gastric emptying time, 32.08 min in Group 2 compared with 30.88 min in Group 1 (P=0.868), but it did increase mean small intestinal transit time from 227.28 to 281.84 min (P=0.003).

CONCLUSIONBowel preparation with both PEG and simethicone significantly reduced bubbles in the intestinal lumen and improved the visualization of the small bowel by capsule endoscopy without any side effects observed.

Adult ; Aged ; Capsule Endoscopes ; Female ; Humans ; Image Enhancement ; methods ; Intestine, Small ; cytology ; drug effects ; Male ; Middle Aged ; Premedication ; methods ; Simethicone ; administration & dosage ; Surface-Active Agents ; administration & dosage ; Young Adult

Objective To evaluate the effect of three diamension-digital subtraction angiography (3D-DSA) or computed tomography angiography (CTA) on the patients with ruptured multiple intmcranial aneurysm (MIA). Methods A retrospective study on 21 patients with MIA was performed.After scanning with 3D-DSA or 3D-CTA, three-dimensional reconstruction of MIA was carried out by 3D workstation,then the diagnosis was decided and the treatment plan (endovascular treatment or microsurgery) was selected according to stereoscopic image of MIA. Results (1) 3D-DSA or CTA was performed in 21 patients with subarachnoid hemorrhage (SAH),it was revealed these patients carried with 48 aneurysms,including 35 small aneurysms (25 mm).Not only miero-aneurysms and small aneurysms could be precisely showed,also the size of aneurysmal neck,the relationship of the aneurysm and the parent vessel and contiguous branches by stereoscopic image.(2) According to the standard of classification,9 patients with MIA for gradeⅠ(42.9%),10 for gradeⅡ(47.6%),2 for gradeⅢ(9.5%),0 for gradeⅣ.Endovascular treatment was selected prior to microsargery for those high grade patients.In this group,17 patients with 40 aneurysms underwent endovascular embolotherapy with GDC coils.Twenty four anemysms were completely occlusioned,12 beyond 90%,4 were left without treatment because of their small size.In microsurgery group,3 aneurysrus were totally clipped,1 could not be found during operation.No any treatment was accepted in 2 patients with 4 aneurysms. Conclusions 3D-DSA or CTA,which is very useful for the diagnosis and treatment of MIA,could improve the accuracy of diagnosis of MIA and clearly show the stereoscopic image of MIA,also the relation of sac and parent artery.For those patients with high grade MIA,endovascular treatment was selected prior to microsurgery,pro re nata,used to combine with mierosurgery.

This paper introduces a random measurement analysis of, lung function measurement values with two different apparatus. in 41 patients. It shows that the differences are not statistically significant (P>0.05) between two apparatus measurement values except DLCO, FEF25, FEF75 in the group of normal ventilation, FVC in the group of abnormal ventilation. The two groups are both correlated closely (r> 0.9) except MMF(r=0.7725, RV r=0.808) in the normal group of ventilation, and FEF75 (r=0.58) in the abnormal group of ventilation (p<0.001). The two apparatus with different measuring theories have a good correlation.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Respiratory Function Tests ; instrumentation ; methods

Objective To study the effect of quercetin on gene expression in glucose-oxygen deprived astrocytes using large-scale oligo microarray technology.Methods Astrocytes were primarily cultured in vitro and divided into ischemia and hypoxia group and ischemia and hypoxia plus quercetin treatment(50 μmol/L)group; ischemia and hypoxia cells from these 2 groups were induced by anaerobic culture for 4 h,and then,the nutrient solutions were added into each group,respectively.Twenty-four h after that,cDNA microarray was employed to select the differentially expressed genes in the 2 groups,and these genes were confirmed by quantitative RT-PCR.Results The cDNA microarray indicated that the expressions of 180 genes had significant changes at the mRNA level between ischernia and hypoxia group and ischemia and hypoxia plus quercetin treatment group,of which 49 genes were up-regulated and 131 were down-regulated.One hundred and forty-eight differentially expressed genes were confirmed by RT-PCR,including 34 up-regulated genes and 114 down-regulated genes,which showed that 82.2％(148/180)genes that matched with the results of cDNA microarray.Conclusion Gene expression profiling by large-scale oligo microarray provides good understanding of the molecular mechanism of quercetin in glucose-oxygen deprived astrocytes,and laids the foundation for investigating the influence of quercetin and astrocytes in hypoxic-ischemic brain damage.

BACKGROUNDAssessing the radiographic features of knee osteoarthritis (OA), especially joint space narrowing, is important for evaluating disease progression. The purpose of this study was to quantitatively analyze joint space narrowing by measuring 2 new variables: the average joint space width (aJSW) and the articulate angle (AA) on X-ray films, and to evaluate the relationship between the 2 variables, knee function and OA symptoms.

METHODSUsing the web-based radiology viewer (Cedara I-Reach™ 4.1.1), we measured the 2 variables in 50 knees of 41 patients with knee OA participating in the Shanghai OA Study. We also evaluated the Kellgren-Lawrence (K-L) grade, the Western Ontario and McMaster Universities OA Index (WOMAC), and additional questionnaire in OA knees. The study was approved by the ethics committee of Shanghai Ninth People's Hospital (No. 2009 - 28).

RESULTSThe aJSW correlated with the K-L grade (r = -0.57, P < 0.001), kneeling (r = -0.29, P = 0.04), sitting cross-legged on the floor (r = -0.31, P = 0.03), WOMAC pain (r = -0.31, P = 0.03), WOMAC disability (r = -0.35, P = 0.01), pain while squatting (r = -0.37, P = 0.01), and defecating in a squatting position (r = -0.39, P = 0.01). The AA correlated with defecating in a squatting position (r = 0.29, P = 0.05), WOMAC disability (r = 0.30, P = 0.04) and K-L grade (r = 0.44, P = 0.003). The K-L grade also correlated with pain while squatting (r = -0.40, P = 0.005) and defecating in a squatting position (r = -0.34, P = 0.02), WOMAC pain (r = 0.30, P = 0.04), and WOMAC disability (r = 0.30, P = 0.04).

CONCLUSIONSThe aJSW closely correlated with knee OA symptoms and function scores, and was more sensitive to knee OA related disabilities than K-L grade and the AA. The aJSW could be used as a new variable for knee OA evaluation.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Knee Joint ; diagnostic imaging ; physiopathology ; Male ; Middle Aged ; Osteoarthritis, Knee ; diagnostic imaging ; physiopathology ; Pain Measurement ; Radiography

OBJECTIVETo investigate the correlation between vascular remodeling index (RI) and serum adiponectin, plasma monocyte chemoattractant protein-1 (MCP-1), endothelial function and evaluate the mechanism of coronary in-stent restenosis.

METHODSRI 6 months after percutaneous coronary intervention (PCI), serum adiponectin, plasma MCP-1 and flow-mediated dilation (FMD) before and 3 days,6 months after PCI were measured in 30 patients with and 30 without coronary in-stent restenosis.

RESULTSCompared with patients without restenosis and those with restenosis before PCI, the patients with coronary in-stent restenosis showed significantly increased plasma MCP-1 3 days and 6 months after PCI (P<0.05) and reduced RI 6 months after PCI, serum adiponectin and FMD 3 days and 6 months after PCI (P<0.05). RI was positively correlated to serum adiponectin and FMD and inversely to MCP-1.

CONCLUSIONThe occurrence of coronary in-stent restenosis is the result of the interrelations between multiple factors.

Adiponectin ; blood ; Adult ; Aged ; Angioplasty, Balloon, Coronary ; Chemokine CCL2 ; blood ; Coronary Disease ; blood ; physiopathology ; therapy ; Coronary Restenosis ; blood ; etiology ; Endothelium, Vascular ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Stents ; adverse effects

OBJECTIVETo investigate the efficacy of interferon-alpha (IFN-alpha) therapy for HBeAg-negative chronic hepatitis B.

METHODSSixty-five Chinese HBeAg-negative chronic hepatitis B patients were treated with 5 MU recombinant rIFN-alpha 1b subcutaneously thrice weekly for 5 to 24 months, followed by 12 months of treatment-free follow-up; one hundred and eighty-eight Chinese HBeAg-positive patients served as controls. For each patient, serum alanine transaminase (ALT) was measured biochemically and serum HBV DNA level was detected with fluorescent-quantitative PCR, HBeAg with enzymoimmunoassay every 1 to 3 months during therapy and during the follow-up period. HBeAg loss (only for HBeAg-positive cases), HBV DNA undetectable, and ALT normalization: the three together were considered a combined response.

RESULTSRates of combined response were similar in HBeAg-negative patients (58.5%, 38/65) or HBeAg-positive ones at the end of treatment (weighted chi square test, chi2 = 1.878, P<0.05), but were higher at the end of the follow-up period in the HBeAg-negative cases (75.4%, 49/65) (weighted chi square test, chi2 = 4.796, P<0.05). Furthermore, relapse rates at the end of the follow-up period, were also similar in HBeAg-negative patients (15.8%, 6/38) or HBeAg positive (chi2 = 0.205, P>0.05). Combined response was achieved at a median of 6.0 months (2-16 months) of treatment course in HBeAg-negative patients while at a median of 6.0 months (1-22 months) in HBeAg-positive cases (Z = -0.186, P>0.05, by the Wilcoxon rank sum test). The only factor predictive of combined response, by binary logistic regression analysis, was inflammatory activity in the liver biopsy. Gender, age, baseline ALT level, baseline HBV DNA level, and anti-HBe were not predictive factors.

CONCLUSIONInterferon-alpha therapy induces a similar primary and sustained response in HBeAg-negative and in HBeAg-positive chronic hepatitis B patients.

Female ; Follow-Up Studies ; Hepatitis B e Antigens ; blood ; Hepatitis B, Chronic ; immunology ; therapy ; Humans ; Interferon-alpha ; therapeutic use ; Male ; Treatment Outcome

OBJECTIVETo investigate the role of allograft inflammatory factor-1 (AIF-1) in colorectal cancer (CRC) progression and explore the possible mechanism.

METHODSThe expression levels of AIF-1 in 70 CRC tissues and paired adjacent tissues were detected using immunohistochemistry and Western blotting, and the correlation of AIF-1 expression with the clinicopathological features of the patients was analyzed. In the CRC cell line SW480, the functional role of AIF-1 in regulating tumor progression was investigated by transfecting the cells with an AIF-1-overexpressing plasmid (AIF-1) and a negative control plasmid (NC). EdU proliferation assay and flow cytometry were used to assess the cell proliferation and cell cycle changes; Transwell migration assay and Annexin V-APC/7-AAD apoptosis assay kit were used to analyze the cell migration and apoptosis. The changes in the biological behaviors of the cells were observed after application of SB203580 to block the p38 MAPK pathway. The expression levels of CDK4, cyclin D1, P21, P27, MMP2, MMP9, Bax, Bcl2, Bcl-xl, p38 and p-p38 were detected using Western blotting.

RESULTSAIF-1 was down-regulated in CRC tissues compared with the adjacent normal tissues, and its expression level was positively correlated with lymph node metastasis (P=0.008), TNM stage (P=0.003) and tumor size (P=0.023). Overexpression of AIF-1 in SW480 cells significantly reduced EdU-positive cells and caused obvious cell cycle arrest in G1 phase (P<0.05). AIF-1 overexpression resulted in significantly lowered protein expressions of CDK4 and cyclin D1, enhanced expressions of P21 and P27, attenuated cell migration ability (P<0.001), and decreased protein levels of MMP2 and MMP9. AIF-1 overexpression also induced obvious apoptosis of SW480 cells (P<0.01), significantly increased the protein levels of Bax and p-p38, and decreased the protein levels of Bcl-2 and Bcl-xl; SB203580 significantly attenuated the apoptosis-inducing effect of AIF-1 overexpression.

CONCLUSIONAIF-1 plays the role of a tumor suppressor in CRC by inhibiting cell proliferation, suppressing cell migration and inducing cell apoptosis. AIF-1 overexpression promotes the apoptosis of CRC cells by activating the p38 MAPK pathway.

Objective To study the epidemiological characteristics of Keshan disease(KD) and its fiend so as to provide evidences for further research,prevention and treatment of the disease in Sichuan province.Methods Based on KD related data from 1990 to 2008,descriptive method was used to analyze the epidemiological characteristics of KD.Results 87 KD cases were identified during the 19 years.All cases were children from the countryside,with majority of them were Yi nationality.Age of the patients ranged from 5 months to 18 years,with majority at 2-6 year-olds.The annual incidence rates Were from 0/100 000 to 1.73/100 000 with 1999 the highest(1.73/100 000).A total number of 310 preclinical or chronic KD cases were identified and the total detection rates were between 0.28% and 2.8%.with 1992 the highest.As for levels of blood selenium during the 19 years:1995 appeared the lowest(0.1345 μg/g),followed by 1990-2000(0.1558 μg/g) but all of them fell in to the level in the KD epidemic areas.Conclusion There were 5 stages in the development trend of KD disease in Sichuan province,with 2 ascending and 3 descending.The differences between any of the two stages were statistically significant.The 3 descending stages all appeared right after the selenium supplement intervention was taken.Our data showed that the program of selenium supplement was closely related to the incidence of KD,suggesting that a long term mechanism of Selenium supplement in the epidemic areas should be taking into account.