Hepatopulmonary syndrome is the triad of arterial hypoxemia due to pulmonary vascular dilatation induced by liver diseases.The pathogenis' s is complicated.This article reviews the advances of pathogenisis of the disease.

Hepatopulmonary syndrome is a pulmonary syndrome that is characterized by the clinical triad of chronic liver disease,arteriovenous shunts due to intrapulmonary vasodilatation,and arterial hypoxemia.Dwing to its complicated pathogenisis,unconspicuous behavior and lack of clinic features,it is very hard for early diagnosis,so while diagnosed,most of HPS patients are in a hard way.The clinical treatment is limited with unsatisfactory effectiveness,so does the prognosis.This article reviews the current diagnosis and therapies of hepatopulmonary syndrome.

Objective To explore the independent risk factors of lymph-node metastasis (LNM) in patients with early gastric cancer (EGC),and establish a risk-prediction model based on LNM.Method 962 early gastric cancer patients undergoing curative radical gastrectomy in the First Hospital of Anhui Medical University from July 2011 to April 2016 were enrolled in this study.The relationships between different clinicopathologic characteristics and LNM were analyzed by Chi-square test or Fisher exact probability,and the independent risk factors were determined using Logistic regression analysis.Moreover,LNM risk was stratified and a risk-predicting model was established on the basis of the identified independent risk factors for LNM.Further,the risk-predicting model was validated using 962 EGC cases.The discriminatory accuracy of risk-predicting model was measured by area under ROC curve (ROC-AUC).Results Mucosal differentiated cancer ≤2 cm,irrespective of the existence of an ulcer,had low LNM rates (LNMR ＜ 3.0％).Univariate and multivariate analysis revealed that female EGC patients with submucosal,undifferentiated,vessel invasion and tumor size ＞ 2 cm were independent risk factors of LNM for EGC patients,and relative risks were 1.893,3.173,1.956,1.922 and 9.027 respectively (P ＜ 0.05).ROCAUC of risk-predicting model was 0.768 (P ＜ 0.01),which showed high diagnostic accuracy and sensitivity.Conclusion Female EGC patients with submucosal undifferentiated carcinomas measuring ＞ 2 cm with vessel invasion have higher risk of LNM.

In this study histochemical method was used. It has been found that on the seventh day after epidural administration of capsaicin substance p like immuno- reactivity (SPAR) in laminae Ⅰ-Ⅱ of dorsal horn of spinal cord decreased obv- iously as compared with that of vehicle treated animals, meanwhile, the activity of fluoride resistant acid phosphatase (FRAP) in both laminae Ⅱ of dorsal horn of spinal cord and the B-type cells of spinal ganglion disappeared. On the cont- rary the Leu-enkephalin immunoreactivity (ENK-IR) in laminae Ⅰ-Ⅲ of dorsal horn of spinal cord apparently increased as compared with that in vehicle group. the evidence from functional measurement showed that capsaicin can raise pain threshold, however, vehicle didnot have obvious influence on pain threshold. The foregoing results suggest that epidural administration of capsaicin in adult rat can effect the level of neurontransmitters, the activity of enzymes and block the con- duction of the primary afferent C fibers; the capsaicin-sensitive C fibers may have relationship with the ENK-containing interneurons in dorsal horn of spinal cord.

Objective To investigate the changes of hematoma and perihematomal edema in spontaneous hypertensive rats (SHRs),as well as the correlation between blood pressures and perihematomal edemaMethods A total of 24 6-month-old male SHRs were included.They were randomly divided into intracerebral hemorrhage 1-,3-,5-,and 7-day groups (n =6 in each group).Blood pressure was determined by tail-cuff sphygmomanometry.Collagenase Ⅳ was injected into caudate nucleus in order to induce a model of intracerebral hemorrhage.Magnetic resonance T2 weighted imaging was used to observe hematoma and perihematomal edema.Results On day 1 after modeling,the blood pressure was decreased significantly compared to that before modeling,and it was elevated gradually on day 3.Parallel profile test showed that the overall profile was parallel between the change rate of blood pressure and the change rate of perihematomal edema volume (F =2.820,P =0.063).The coincident profile test showed that both the overall profiles did not coincide (F =10.961,P =0.000).The change rate of systolic blood pressure was significantly positively correlated with the change rate of perihematomal edema volume (r =0.527,P =0.024) and the change rate of perihematomal edema volume (r =0.755,P =0.000) showed a significant positive correlation.Conclusions Brain edema appeared and expanded rapidly on the day of intracerebral hemorrhage in SHRs.It reached the peak on day 3,and then dissipated gradually.The blood pressure decreased significantly on day 1 after intracerebral hemorrhage,and it began to increase from day 3 till day 7.The changing trends of the blood pressure and perihematomal edema volume were parallel to each other,and the change rate of systolic blood pressure and the change rate of perihematomal edema volume showed a positive correlation.

Abstract Bisphenols (BPs), which are mainly used in the production of polycarbonates and epoxy resins, are common endocrine disruptors (EDCs) in natural environments. Human mainly exposes to BPs via ingestion and skin. Previous studies have deteted BPs in human urine, serum, and milk samples, and children and pregnant women have a high level of exposure to to BPs. Based on international and national publications pertaining to BPs since 2009, this review describes the exposure to BPs in human urine, serum, and milk and summarizes neuroendocrine dysfunctions, oxidative stress injury and epigenetics changes caused by BPs, so as to provide insights into reducing the exposure to and health risk of BPs.

Objective:Glutamine is the main oxidative fuel of the enterocyte which enters the enterocyte primarily via amino acid transporters.The aim of the test was to study the distributions and functions of glutamine transporters in IEC-6 cell line.Methods:The rat intestinal epithelial cell line(IEC-6) was incubated in vitro.The mRNA expression of different glutamine transporters,protein expression of system ASCT2,and the [3H]-L-glutamine uptake were measured.Results:The mRNA of system ASCT2,SN1,ATA1,LAT1,LAT2 was expressed and the protein expression of ASCT2 was also validated in IEC-6.In Na+-containing buffer,the velocity of Na+-dependent glutamine uptake was(164.07?37.94) fmol/(mg protein?10min).In Na+-free buffer,the velocity of glutamine uptake was(58.71?10.51)fmol/(mg protein?10min).With the saturate dosage of MeAIB,the velocity of glutamine uptake was(81.02 ?19.59) fmol/(mg protein?10min).Conclusion:There may be five kinds of glutamine transporters(ASCT2,SN1,ATA1,LAT1,and LAT2) in IEC-6 cell.The Na+-dependent transporter was the major contributor(64.22%) to glutamine total uptake in IEC-6.The contributions of system A and the remainder were 50.62% and 13.60%,respectively.The Na+-independent transporter was the lesser contributor(35.78%).

Objective To investigate the effect of leptin on endoplasmic reticulum stress related protein after focal cerebral ischemia in rats. Methods Ischemia was induced by occluding the middle cerebral artery in rats brain using the filament occlusion method. Forty SD rats were randomly divided into sham operation group, cerebral is-chemia group and leptin-preconditioning group. Leptin was injected subcutaneously before occlusion of blood vessel. Longa 5 score neurological function scale, body weight and brain edema changes were measured 6 hours after MCAO, and the brain was removed to detect the endoplasmic reticulum marker protein: glucose-regulated protein 78 (GRP78) and C/EBP-homologous protein (CHOP) by immunohistochemical method. Results There was no difference in the body weight changes between leptin-preconditioning group and ischemic group. In the leptin-preconditioning group, the neurological function score (1.90±0.31 vs. 2.50±0.52, P<0.05) and the degree of brain edema (3.60±0.52 vs. 7.70±0.94, P<0.001) were significantly lower than those in the cerebral ischemia group. Moreover, the expression of GRP78 in leptin-preconditioning group was significantly higher than that in ischemia group (48.69 ±5.06 vs. 35.78± 4.35, P<0.01), and the expression of CHOP was significantly lower than that of ischemia group (60.24 ±4.11 vs. 38.81±5.34, P<0.01). Conclusion Leptin can reduce the neurological deficit and may be associated with the up-reg-ulation of GRP78 protein, and down regulation of CHOP protein to weaken the endoplasmic reticulum stress caused by cerebral ischemia

Objective: This study was designed to investigate the variations of endotoxin,glutamine and TNF-? concentration in septic rats. Methods: A total of 90 adult male SD rats were divided as follows: control group(normal),experimental group(CLP).They were killed on hour 6,12,24,48,72 after surgery.Plasma,liver,small intestine and skeletal muscle were collected to measure the concentrations of glutamine in plasma and tissues,the levels of endotoxin and TNF-? in plasma. Results: In septic rats,plasma concentrations of endotoxin and TNF-? increased on hour 6,significantly increased on hour 12,attained the peak on hour 24,and decreased evidently on hour 48 and 72.Glutamine concentration in plasma elevated on hour 6 and 12,elevated significantly on hour 24 and 48,and decreased on hour 72.Glutamine concentration in liver increased on hour 6～12,increased significantly on hour 24,and decreased significantly on hour 48 and 72.Glutamine concentration in small intestine and skeletal muscle decreased on hour 6 and 12,and decreased significantly after 24 hour. Conclusion: During the early stage of sepsis,the plasma levels of endotoxin and TNF-? are increased significantly,the glutamine concentration in plasma and liver is also increased significantly,however,it was decreased evidently in skeletal muscle and small intestine.

Objective To evaluate the predictive value of neutrophil-to-lymphocyte ratio (NLR) and hemoglobinto-white blood cell ratio (HWR) prior to treatment in prognosis of non-operative esophageal squamous cell carcinoma (ESCC) patients.Methods From October 2009 to November 2014,a total of 362 non-operative ESCC patients were enrolled in this prospective study.x2 test was used to analyze the relationship between NLR,HWR and general clinical features;Univariate and multivariate Cox regression analysis was performed to evaluate the association between variables and prognosis of non-operative ESCC patients.Results The optimal cutoff level of 1.23 for NLR and 24.92 for HWR were identified by X-title software.x2 test indicated NLR was significantly associated with gender,tumor length,T stage,TNM stage and fasting blood glucose level.Moreover,univariate and multivariate analyses showed that high NLR and high HWR were all associated with a poor prognosis in non-operative ESCC.However,when patients were specifically stratified by treatment modus,subset analysis showed that NLR was only predictive of prognosis in the concurrent chemoradiotherapy group (HR =4.080,95％ CI:1.074-15.497,P =0.039),whereas the influence of HWR on prognosis was just existed in the sequential chemoradiotherapy group (HR =2.625,95％ CI:1.311-5.254,P =0.006).Conclusions In this investigation,we found that high NLR and high HWR were associated with poor prognosis in non-operative ESCC.