OBJECTIVETo investigate the pathological diagnosis, surgical treatment and prognostic factors of gastrointestinal stromal tumors (GISTs).

METHODSThe clinicopathological data of operated 96 patients with GISTs were analyzed retrospectively. Expression of CD117, CD34, SMA and S-100 was determined by immunohistochemical methods.

RESULTSExpression of CD117, CD34, SMA and S-100 was 79.2% (76/96), 58.3% (56/96), 35.4% (34/96) and 9.4% (9/96). Benign tumor 23 and malignant 73. Of the malignant, the omentum was resected in 39 and the rest remained, of which the recurrent and metastatic rates were 5.1% and 26.5% (P < 0.05). The safety margin between the normal intestine and tumor was > 5 cm in 46 patients; while in the other 27 patients, it was < 5 cm. The recurrent and metastatic rates were 6.5% and 29.6% (P < 0.05), respectively. The 5-year survival rates of benign and malignant GISTs were 91.5% and 57.3% (P < 0.05).

CONCLUSIONThe application of immunohistochemical markers CD117 and CD34 are supplementary to pathological diagnosis. The adapting of rational primary treatment, including complete tumor resection and prophylactic omentectomy, is able to reduce the recurrence of GISTs.

Adolescent ; Adult ; Aged ; Antigens, CD34 ; metabolism ; Child ; Female ; Follow-Up Studies ; Gastrointestinal Stromal Tumors ; diagnosis ; metabolism ; pathology ; surgery ; Humans ; Liver Neoplasms ; secondary ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Omentum ; surgery ; Peritoneal Neoplasms ; secondary ; Proto-Oncogene Proteins c-kit ; metabolism ; Retrospective Studies ; Survival Rate

OBJECTIVETo evaluate the effect of early application of high-volume hemofiltration treatment (HVHF) on the levels of lactic acid, pro-inflammatory cytokines and C-reactive protein (CRP) in plasma, as well as APACHE II score in patients suffering from severe sepsis.

METHODSThirty patients meeting the diagnosis of severe sepsis were enrolled in the trial within 24 hours of insults. The level of lactic acid, interleukin-6 (IL-6) and CRP in plasma were measured before HVHF and at 24, 48 or 72 h following HVHF treatment.

RESULTThe plasma levels of lactic acid and IL-6 decreased significantly at 24 h, 48 h, 72 h after HVHF (P <0.05), while, IL-10 did not differ significantly following HVHF (P>0.05), when compared with that before HVHF.

CONCLUSIONThe early application of HVHF could clear the plasma lactic acid and pro-inflammatory cytokines, and improve the tissue oxygenation in severe sepsis.

APACHE ; Adult ; C-Reactive Protein ; analysis ; Female ; Hemofiltration ; methods ; Humans ; Interleukin-10 ; blood ; Interleukin-6 ; blood ; Lactic Acid ; blood ; Male ; Middle Aged ; Sepsis ; blood ; therapy ; Treatment Outcome ; Young Adult

AIM: To investigate the value of ultrasonography in diabetic retinopathy ( DR) .?METHODS: Totally 103 cases ( 103 eyes ) of type 2 diabetes mellitus were selected from May 2015 to May 2017 in our hospital, there were 32 patients 32 eyes with non diabetic retinopathy ( NDR) , 40 patients 40 eyes with non proliferative diabetic retinopathy ( NPDR ) , and 31 patients 31 eyes with proliferative diabetic retinopathy (PDR), 40 healthy volunteers (40 eyes) were selected as control group, the maximum systolic blood flow velocity ( PSV ) , end diastolic velocity ( EDV ) and resistance index (RI) of the central retinal artery (CRA), posterior ciliary artery ( PCA ) and ophthalmic artery ( OA ) were detected by color Doppler ultrasound.?RESULTS:The difference of PSV, EDV and RI of CRA, PCA and OA in each group was statistically significant (P<0. 05). The PSV of CRA, PCA and OA in NDR group were 12. 38 ± 2. 10cm/s, 13. 36 ± 2. 55cm/s and 32. 04 ± 6. 07cm/s, significantly higher than that of NPDR group (9.70±1.67cm/s, 12.20±2.01cm/s and 27.40±4.32cm/s) and PDR group ( 7. 13 ± 1. 40cm/s, 10. 31 ± 1. 82cm/s and 22.10±3.51cm/s) (P<0. 05). EDV were 4. 67±1. 20cm/s, 5. 61 ± 1. 25cm/s and 8. 40 ± 1. 51cm/s, significantly higher than that of NPDR group (3. 52±1. 19cm/s, 5. 01±1. 30cm/s and 6.61±1. 67cm/s) and PDR group (2. 48±1. 02cm/s, 4. 11±1.04cm/s and 4. 01±1. 52cm/s) (P<0. 05). And RI were 0. 63 ± 0. 07, 0. 60 ± 0. 04 and 0. 77 ± 0. 05, was significantly lower than that of NPDR group (0. 72±0. 06, 0. 67±0. 05 and 0. 81 ± 0. 03) and PDR group (0. 80 ± 0. 09, 0. 74±0. 06 and 0. 86±0. 04) (P<0. 05).?CONCLUSION: Color Doppler ultrasound monitoring the hemodynamic changes of ocular blood vessels in diabetes can provide evidence for early detection of diabetic retinopathy.

OBJECTIVETo investigate the characteristics of phase II metabolic enzymes in mouse embryonic stem (ES) cell-derived liver tissue.

METHODSMature hepatocytes were differentiated from embryonic stem cells in cultured mouse embryoid bodies (EB) at d18. Western blot was used to detect the expression of uridine 5'-diphosphate glucronosyl transferase (UGT1a1,UGT1a6) and microsomal glutathione S-transferases 1(mGST1) during the differentiation course.The derived liver tissue was incubated with UDPGA and 7-HFC,the formation of 7-HFC glucuronide was detected by HPLC to examine the total activities of UGT1a1 and UGT1a6. Furthermore, the microsomes were incubated with CDNB and GSH,and the mGST1 activity was measured by spectrometry.

RESULTSAn increase tendency of UGT1a1 expression was noticed during the differentiation course. UGT1a6 and mGST1 were not detected in the earlier stage until d18 of differentiation. The metabolic activity of mGST1 in the derived hepatocytes was 7.65 nmol/min/mg on d18.

CONCLUSIONThe ES cell-derived liver tissue possesses partial metabolic function of phase II enzymes on d18 of differentiation,which might be used as a model for in vitro research on hepatic pathophysiology and phase II drug metabolism.

Animals ; Cell Differentiation ; Embryoid Bodies ; cytology ; Embryonic Stem Cells ; cytology ; Glucuronosyltransferase ; physiology ; Glutathione Transferase ; physiology ; Hepatocytes ; cytology ; enzymology ; Mice

Objective To investigate the relationship between preoperative renal cortical thickness and glomerular filtration rate (GFR) before and after minimally invasive surgery in patients with unilateral upper urinary tract obstruction. Methods 63 patients with upper urinary tract obstruction from July 2015 to June 2016 were enrolled in the study, including 34 males and 29 females, age ranged from 22 to 73 years old (52.21 ± 11.56). Their operation methods included 24 cases of ureteroscopic lithotripsy and lithotomy, 21 cases with one-stage percutaneous nephrostomy + two-stage percutaneous nephrolithotomy (PCNL), 18 cases of PCNL. The abdominal enhanced CT and single photon emission computed tomography (SPECT) were measured to RCT and GFR. Then all cases were divided into group A (moderate renal impairment, 15.0 ml/min ≤ GFR < 30 ml/min), group B (severe renal damage, 7.5 ml/min ≤ GFR <15.0 ml/min) and group C (extremely severe renal injury, GFR < 7.5 ml/min) according to preoperative renal GFR, and changes of GFR before and after surgery were compared among three groups. Simple linear correlation analysis was used to analyze the correlation between preoperative RCT and other indexes in group A and B. Results 9 patients were not measured RCT because of serious hydronephrosis, 54 patients included 20 cases of RCT >10 mm, 23 cases of 5 ～ 7 mm and 11 cases of <5 mm, and the average value was (10.75 ± 4.91) mm. The preoperative RCT in group A was significantly higher than that in group B (P < 0.05). GFR at 1 and 9 months after operation in three groups were significantly higher than that before operation in the same group (P < 0.05). GFR at 1 and 9 months after operation in group A were significantly higher than that the other two groups, and GFR at 9 months after operation in group B was significantly higher than that in group C (P < 0.05), but there were no significant differences in GFR at 1 month after operation between group B and C (P > 0.05). GFR recovery value at 1 month after operation in group B was significantly lower than that in other two groups (P < 0.05), but there were no significant differences in GFR at 9 months after operation among three groups (P > 0.05). Preoperative RCT was positively correlated with preoperative GFR (r = 0.613), GFR at 1 month after operation (r = 0.697) and the recovery value (r = 0.552), GFR at 9 months after operation ((r = 0.589) and recovery values (r = 0.488), and the differences were statistically significant (P < 0.05). Conclusion Removal of upper urinary tract obstruction could recover the renal function to varying degrees, even for patients with extremely severe renal injury, who could retrieve their kidney. Preoperative RCT could be helpful in judging the renal function during operation, especially for the postoperative recovery of renal function.

OBJECTIVETo evaluate the osteogenic potential of bone morphogenetic protein (BMP)-2 gene transfected goat bone marrow-derived mesenchymal stem cells (MSCs).

METHODSGoat bone marrow-derived MSCs were transfected by Adv-human bone morphogenetic protein (hBMP)-2 gene (Group 1), Adv-beta gal transfected MSCs (Group 2) and uninfected MSCs (Group 3). Western blot analysis, alkaline phosphatase staining, Von Kossa staining and transmission electron microscopy were adopted to determine the phenotype of MSCs. Then the cells were injected into thigh muscles of the nude mice. Radiographical and histological evaluations were performed at different intervals.

RESULTSOnly Adv-hBMP-2 transfected MSCs produced hBMP-2. These cells were positive for alkaline phosphatase staining at the 12th day and were positive for Von Kossa staining at the 16th day after gene transfer. Electron microscopic observation showed that there were more rough endoplasmic reticulum, mitochondria and lysosomes in Adv-hBMP-2 transfected MSCs compared to MSCs of other two groups. At the 3rd and 6th weeks after cell injection, ectopic bones were observed in muscles of nude mice of Group 1. Only fibrous tissue or a little bone was found in other two groups.

CONCLUSIONSBMP-2 gene transfected MSCs can differentiate into osteoblasts in vitro and induce bone formation in vivo.

Animals ; Blotting, Western ; Bone Marrow Cells ; cytology ; metabolism ; Bone Morphogenetic Protein 2 ; Bone Morphogenetic Proteins ; genetics ; Cell Differentiation ; Genetic Therapy ; Goats ; Humans ; Mesenchymal Stromal Cells ; cytology ; metabolism ; Mice ; Mice, Nude ; Osteogenesis ; physiology ; Staining and Labeling ; Tissue Engineering ; Transfection ; Transforming Growth Factor beta ; genetics

Objective To analyze the infection of human parvovirus B19,human bocavirus(HBoV) and human parvovirus 4 (PARV4) in blood samples among patients with liver disease in Nanjing by molecular detection.Methods Nested PCR assays were designed and validated to detect B19,HBoV and PARV4,respectively.The assays were used to screen three parvoviruses in blood samples from 95 patients with different liver disease in Nanjing.The parvovirus infection was analyzed statistically.Results The detection limits were 10 copies of genomic DNA equivalents per reaction for each assays and the good specificity were observed.The frequency of B19 and HBoV were 2/95 (2.1％)and 9/95 (9.5％)in blood samples respectively.No PARV4 was detected.HBoV was detected in 3/5 patients with drug-induced hepatitis.Conclusion Both B19 and HBoV infection were detected in blood from patients with liver disease.

Objectives:To evaluate the role of pancreas multidisciplinary team(MDT) clinic in the diagnosis of pancreatic diseases,patient compliance with MDT advice,and the impact of MDT on the postoperative survival of patients with pancreatic cancer.Methods:The study included 927 patients(554 males,373 females,aged (58.1±13.3)years (range: 15 to 89 years)) that had visited the pancreas MDT clinic of Zhongshan Hospital from May 2015 to December 2021,and 677 patients(396 males, 281 females, aged (63.6±8.9)years(range: 32 to 95 years)) who underwent radical surgery and with pathologically confirmed pancreatic adenocarcinoma from January 2012 to December 2020,of whom 79 patients had attended the pancreas MDT. The clinical and pathological data were collected and analyzed retrospectively. Diseases were classified in accordance with 2010 WHO classification of tumors of the digestive system and usual clinical practices. The Kaplan-Meier method was used for drawing the survival curve and calculating the survival rate. The univariate analysis was done by Log-rank test and the multivariate analysis was done by COX proportional hazards model. Survival rates were compared using χ 2 test. Results:Among the 927 patients that had visited the MDT clinic,233 patients(25.1%) were referred due to undetermined diagnosis. A direct diagnosis was made in 109 cases (46.8%,109/233) by the MDT clinic, of which 98 were consistent with the final diagnosis,resulting in an accuracy of 89.9%(98/109). The direct diagnosis rate in the recent years(36.6%(41/112),from June 2019 to December 2021) decreased compared to that in the previous years(56.2%(68/121),from May 2015 to May 2019),yet the accuracy in the recent years(90.2%,37/41) was basically the same as before (89.7%,61/68). The rate of compliance of the entire cohort was 71.5%(663/927), with the compliance rate in the recent two and a half years(81.4%,338/415) remarkably higher than that in the previous four years(63.4%,325/512). Patients with pancreatic cancer that attended the MDT exhibited a trend toward longer median postoperative survival than patients that did not attend the MDT,but the difference was not statistically significant(35.2 months vs.30.2 months, P>0.05). The 1-year and 3-year survival rates of patients that attended the MDT were significanly higher than patients that did not attend the MDT(88.6% vs. 78.4%, P<0.05;32.9% vs. 21.9%, P<0.05,respectively),but the 5-year survival rate was not statistically different(7.6% vs. 4.8%, P>0.05). Conclusions:The pancreas MDT clinic is an accurate and convenient way to diagnose intractable pancreatic diseases,and in the recent years the patients′ compliance rate with MDT advice has increased. Pancreatic cancer patients that have attended the MDT have higher 1-year and 3-year postoperative survival rates,but the long-term survival benefits of MDT still needs to be proved by clinical studies on a larger scale.

Objectives:To evaluate the role of pancreas multidisciplinary team(MDT) clinic in the diagnosis of pancreatic diseases,patient compliance with MDT advice,and the impact of MDT on the postoperative survival of patients with pancreatic cancer.Methods:The study included 927 patients(554 males,373 females,aged (58.1±13.3)years (range: 15 to 89 years)) that had visited the pancreas MDT clinic of Zhongshan Hospital from May 2015 to December 2021,and 677 patients(396 males, 281 females, aged (63.6±8.9)years(range: 32 to 95 years)) who underwent radical surgery and with pathologically confirmed pancreatic adenocarcinoma from January 2012 to December 2020,of whom 79 patients had attended the pancreas MDT. The clinical and pathological data were collected and analyzed retrospectively. Diseases were classified in accordance with 2010 WHO classification of tumors of the digestive system and usual clinical practices. The Kaplan-Meier method was used for drawing the survival curve and calculating the survival rate. The univariate analysis was done by Log-rank test and the multivariate analysis was done by COX proportional hazards model. Survival rates were compared using χ 2 test. Results:Among the 927 patients that had visited the MDT clinic,233 patients(25.1%) were referred due to undetermined diagnosis. A direct diagnosis was made in 109 cases (46.8%,109/233) by the MDT clinic, of which 98 were consistent with the final diagnosis,resulting in an accuracy of 89.9%(98/109). The direct diagnosis rate in the recent years(36.6%(41/112),from June 2019 to December 2021) decreased compared to that in the previous years(56.2%(68/121),from May 2015 to May 2019),yet the accuracy in the recent years(90.2%,37/41) was basically the same as before (89.7%,61/68). The rate of compliance of the entire cohort was 71.5%(663/927), with the compliance rate in the recent two and a half years(81.4%,338/415) remarkably higher than that in the previous four years(63.4%,325/512). Patients with pancreatic cancer that attended the MDT exhibited a trend toward longer median postoperative survival than patients that did not attend the MDT,but the difference was not statistically significant(35.2 months vs.30.2 months, P>0.05). The 1-year and 3-year survival rates of patients that attended the MDT were significanly higher than patients that did not attend the MDT(88.6% vs. 78.4%, P<0.05;32.9% vs. 21.9%, P<0.05,respectively),but the 5-year survival rate was not statistically different(7.6% vs. 4.8%, P>0.05). Conclusions:The pancreas MDT clinic is an accurate and convenient way to diagnose intractable pancreatic diseases,and in the recent years the patients′ compliance rate with MDT advice has increased. Pancreatic cancer patients that have attended the MDT have higher 1-year and 3-year postoperative survival rates,but the long-term survival benefits of MDT still needs to be proved by clinical studies on a larger scale.

A method of ultra-high performance liquid chromatography coupled with quadrupole/electrostatic field Obitrap high-resolution mass spectrometry(UHPLC-Q-Exactive MS) was established to comprehensively identify the metabolites of carnosic acid in rats. After oral gavage of carnosic acid CMC-Na suspension in rats, urine, plasma and feces samples were collected and pretreated by solid phase extraction(SPE). Acquity UPLC BEH C_(18 )column(2.1 mm×100 mm, 1.7 μm) was used with 0.1% formic acid solution(A)-acetonitrile(B) as the mobile phase for the gradient elution. Biological samples were analyzed by quadrupole/electrostatic field Obitrap high-resolution mass spectrometry in positive and negative ion mode. Based on the accurate molecular mass, fragment ion information, and related literature reports, a total of 28 compounds(including carnosic acid) were finally identified in rat samples. As a result, the main metabolic pathways of carnosic acid in rats are oxidation, hydroxylation, methylation, glucuronide conjugation, sulfate conjugation, S-cysteine conjugation, glutathione conjugation, demethylation, decarbonylation and their composite reactions. The study showed that the metabolism of carnosic acid in rats could be efficiently and comprehensively clarified by using UHPLC-Q-Exactive MS, providing a reference for clarifying the material basis and metabolic mechanism of carnosic acid.
Abietanes ; Animals ; Chromatography, High Pressure Liquid ; Mass Spectrometry ; Rats ; Solid Phase Extraction