Objective To confirm the safety and nutritional efficacy of high branched-chain amino acids through a pragmatic study allowing its use as an alternative to 15AA in patients with liver dysfunction. Methods The study was performed as a randomized, prospective trial. Eighty two patients with liver dysfunction undergoing operation were randomly assigned to receive high branchedchain amino acids or 15AA as part of their TPN regimens for 7 days. Daily parenteral intakes of energy nitrogen and lipid were equal in the two groups. Results Efficacy analysis showed that high branched-chain amino acids were as efficient as 15AA in avoiding protein catablosim. No serious adverse event was reported in the two groups. For hematology, renal, hepatic safety criteria and for the vital signs,no significant difference was observed between the 2 groups. No significant difference was observed concerning nitrogen balance and protein catablosim. For peripheral immunoglobulin and lymphocytes, a statistically significant difference was observed between the high branched-chain amino acids and the 15AA groups. Conclusion High branched-chain amino acids is new, safe and efficient amino acids for parenteral nutrition.

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Objective To investigate the cachexia morbidity among hospitalized patients with digestive system cancer and evaluate its impact on clinical outcomes.Method By analyzing the clinical data of 5 118 hospitalized patients with digestive system cancer in Zhongshan Hospital,Fudan University from January 2012 to December 2013,we investigated the cachexia morbidity and compared the clinical outcome between cachectic patients and noncachectic patients.Results The overall cachexia morbidity of hospitalized patients with digestive system cancer was 15.7％ (803/5 118).The highest cachexia morbidity was 34.0％ (89/173),found in patients with pancreatic cancer.In cachectic group and non-cachectic group,the overall completion rate of radical resection was 67.1％ (539/803) and 74.5％ (3 214/4 315),respectively (P =0.000).Compared to the non-cachectic group,the cachetic group had significantly longer postoperative hospital days [(11.5 ±6.2) d vs (9.4 ±4.9) d,P =0.003],slower postoperative recovery of bowel function [(3.4 ±0.9) d vs (3.2 ±0.8) d,P =0.013],longer postoperative time to intake semifluid [(4.4 ± 1.5) d vs (3.9 ± 1.3) d,P =0.002],and more postoperative complications in 28 days after surgery [8.9％ (48/539) vs 5.8％ (186/3 214),P=0.006].After surgery,131 patients in the cachectic group were transferred to the ICU,and 646 patients in non-cachectic group transferred to the ICU (24.3％ vs 20.0％,P=0.026).Compared to the non-cachecic group,the reoperation rate [3.2％ (17/539) vs 1.5％ (48/3214)],ventilator support rate [8.0％ (43/539) vs 5.7％ (184/3 214)],and mortality [2.4％ (13/539) vs 1.1％ (35/3 214)] of the cachectic group were all significantly higher (P =0.006,0.042,0.011).Conclusions Cachexia is common in hospitalized patients with digestive system cancer,especially in patients with pancreatic cancer.Cachexia has negative impact on the clinical outcomes.

Objective To investigate the clinical effect of total hip replacement in patients with hip fusion .Methods 31cases (43 hips) with hip fusion underwent total hip replacement from January 2006 to December 2012 ,To retro-spective analysis on clinical curative effect and operation related issues .Results The mean time of follow-up was 14 .2 months(12 to 72 months) in 26 cases (37 hips) .All patients had good relief postoperative on hip pain ,knee pain and low back pain ,and the gait was closed to normal ,and the activities of daily living improved in part of cases ,including 16 cases went back to work .The assessment of X-ray showed that had not found any complications ,such as dislocation ,Osteolysis and loosening ,the excellent rate was 89 .19% .Conclusion For pa-tients with hip fusion ,Total hip replacement can improve the function of the hip fusion and relieve pain .

Objective To investigate the expression of glycoprotein M6A(GPM6A)in glioma specimens and its prognostic signifi-cance.Methods Bioinformatics methods were used to analyze the expression of GPM6A in 325 cases obtained from the Chinese Glioma Genome Atlas(CGGA)database.The STRING online database was used to screen and analyze the possible protein PPI interaction net-work and GO functional annotation that interact with GPM6A to explore its potential mechanism.The relationships between GPM6A and glioma cell purity and the level of CD8+T cell were assessed using the TIMER2.0database.Results The online analysis of the CGGA database showed that GPM6A was expressed in histopathological grades(WHO:G2,G3,G4)and histopathological types,and there were significant differences in GPM6A expression levels between all grades and all types of gliomas(Grades:F=50.25,P＜0.001;Types:F=14.26,P＜0.001);the expression level of GPM6A was closely related to molecular IDH mutation status,combined deletion of 1p19q,and patient age(all P＜0.01),regardless of patient gender(t=1.45,P＞0.05).The expression level of GPM6A in primary glioma was higher than that in secondary glioma,and the difference was not statistically significant(t=1.82,P＞0.05).The survival time of patients with low GPM6A expression was significantly shortened(x2=69.79,P＜0.001),but in glioblastoma(GBM)patients,regard-less of the level of GPM6A expression,there was no difference in survival time(x2=0.63,P＞0.05).GO functional analysis showed that GPM6A was closely related to the functions of transmembrane protein transport,synapse formation and development,and information ex-change between cells in the nervous system.TIMER2.0database analysis showed that GPM6A was positively correlated with glioma tumor cell purity and the level of CD8+T cell.Conclusion The prognosis of glioma patients with low GPM6A expression is significantly worse than that of patients with high expression,and its expression level can be used as a predictor for evaluating the prognosis of glioma.

OBJECTIVETo investigate cachexia in hospitalized patients with digestive system cancer and evaluate its impact on clinical outcomes.

METHODSBy analyzing the clinical data of 5118 hospitalized patients with digestive system cancer in Zhongshan Hospital of Fudan University from January 2012 to December 2013, cachexia was investigated and clinical outcomes between cachexia patients and non-cachexia patients was compared.

RESULTSThe total cachexia rate of hospitalized patients with digestive system cancer was 15.7%(803/5118). The highest rate of cachexia was 34.0%(89/262) in patients with pancreatic cancer followed by gastric cancer 22.4%(261/1164), colon cancer 21.7%(146/672), and rectal cancer 20.1%(117/581). In cachexia group and non-cachexia group, the overall completion rate of radical resection was 67.1%(539/803) and 74.5%(3214/4315) respectively(P<0.05). Compared to the non-cachexia group, the cachexia group was associated with longer postoperative hospital stay [(11.5±6.2) d vs. (9.4±4.9) d, P<0.05], slower postoperative recovery of bowel function [(3.4±0.9) d vs. (3.2±0.8) d, P<0.05], longer postoperative time to intake of semifluid [(4.4±1.5) d vs. (3.9±1.1) d, P<0.05], and more postoperative complications within 28 days after radical surgery [8.9%(48/539) vs. 5.8%(186/3214), P<0.05]. After radical surgery, the ICU admission rate of the cachexia group [24.3%(131/539)] was higher than that of the non-cachexia group [20.1%(646/3214)] with significant difference(P<0.05). Compared to non-cachexia group, the reoperation rate [3.2%(17/539) vs. 1.5%(48/3214), P<0.05], ventilator support rate [8.0%(43/539)vs. 5.7%(184/3214), P<0.05] and mortality [2.4%(13/539) vs. 1.1%(35/3214), P<0.05] in the cachexia group were all significantly higher(all P<0.05).

CONCLUSIONSCachexia is commen in patients with digestive system cancer. Cachexia has significant adverse effects on clinical outcomes in hospitalized patients with digestive system cancer.

Cachexia ; etiology ; Colonic Neoplasms ; complications ; Defecation ; Humans ; Postoperative Complications ; Rectal Neoplasms ; complications ; Reoperation ; Stomach Neoplasms ; complications

OBJECTIVETo evaluate the safety and short-term outcomes of laparoscopic-assisted surgery for rectal cancer by comparing the efficacy of laparoscopy and open surgery.

METHODSClinical data of patients with rectal cancer treated by laparoscopy or open surgery in Zhongshan Hospital from April 2011 to June 2012 were analyzed retrospectively, and the clinical outcomes between the two groups were compared.

RESULTSNinety-six rectal cancer patients undergoing laparoscopic surgery(LS) were enrolled. A total of 216 rectal cancer patients underwent open surgery(OS). There was no operative death in both groups. In LS and OS group, the overall completion rates of TME were 86.4%(83/96) vs. 89.3%(193/216)(P>0.05) respectively, and the overall anal reservation rates were 78.1%(75/96) vs. 75.0%(162/216)(P>0.05) respectively. The mean distance to proximal resection margin and distal resection margin respectively were (10.3±4.1) cm vs.(10.0±4.3) cm(P>0.05) and (3.4±0.9) cm vs. (3.6±1.4) cm(P>0.05) respectively. The mean number of harvested lymph nodes respectively were (12.8±5.2) vs.(13.7±6.4)(P>0.05). Compared to OS, LS presented less blood loss [(98.0±28.7) ml vs. (175.0±41.0) ml, P<0.05], shorter postoperative hospital stay [(9.4±4.9) d vs.(11.6±6.2) d, P<0.05], quicker postoperative recovery of bowel function[(2.7±0.9) d vs. (3.4±0.9) d, P<0.05], shorter postoperative time to intake semi-solid[(3.7±1.2) d vs. (4.4±1.5) d, P<0.05], less postoperative complications(15.6% vs. 25.9%, P<0.05), but longer operative time[(155.7±48.4) min vs. (120.0±26.7) min, P<0.05]. Postoperative follow-up was 6 to 24 months, and the local recurrence of LS and OS was 2.1% and 2.3%(P>0.05).

CONCLUSIONLaparoscopic surgery can obtain the same radical efficacy for rectal cancer as compared to open surgery.

Anal Canal ; Digestive System Surgical Procedures ; Humans ; Laparoscopy ; Lymph Nodes ; Neoplasm Recurrence, Local ; Operative Time ; Postoperative Complications ; Rectal Neoplasms ; surgery ; Retrospective Studies ; Treatment Outcome

Comparing 231 genes on chimpanzee chromosome 22 with their orthologous on human chromosome 21, we have found that 15 orthologs have indels within their coding sequences. It was rather surprising that significant number of genes have changed by indel, despite the shorter time since their divergence and led us hypothesize that indels and structural changes may represent one of the major mechanism of proteome evolution in the higher primates. Human T-complex protein 10 like (TCP10L) is a representative having indel within its coding sequence. Gene structure of human TCP10L compared with chimpanzee TCP10L gene showed 16 base pair difference in genomic DNA. As a result of the indel, frame shift mutation occurs in coding sequence (CDS) and human TCP10L express longer polypeptide of 21 amino acid residues than that of chimpanzee. Our prediction found that the indel may affect to dramatic change of secondary protein structure between human and chimpanzee TCP10L. Especially, the structural changes in the C-terminal region of TCP10L protein may affect on the interacting potential to other proteins rather than DNA binding function of the protein. Through these changes, TCP10L might influence gene expression profiles in liver and testis and subsequently influence the physiological changes required in primate evolution.
Base Pairing ; Chromosomes, Human ; Chromosomes, Human, Pair 22 ; Clinical Coding ; DNA ; Frameshift Mutation ; Genomics* ; Humans* ; Liver ; Pan troglodytes* ; Primates ; Protein Structure, Secondary ; Proteome ; Testis ; Transcriptome