OBJECTIVETo explore different frequency electroacupuncture in acupuncture-drug compound anesthesia on analgesic effect and immune function in the pulmonary resection patients in order to recommend the best electroacupuncture frequency in acupuncture-drug compound anesthesia.

METHODSOne hundred and sixty-three patients scheduled for pneumonectomy were randomly divided into group A (n = 31), B (n = 34), C (n = 32), D (n = 34) and E (n = 32). Houxi (SI 3), Zhigou (TE 6), Neiguan (PC 6) and Hegu (LI 4) were selected in the five groups. Group A was treated with sham acupuncture by pasting needles without needle bodies at acupoints and electroacupuncture at the needle handle, and group B with 2 Hz electroacupuncture, and group C with 2 Hz/ 100 Hz electroacupuncture, and group D with 100 Hz electroacupuncture, and group E with 2 Hz/100 Hz transcetaneous acupoints electrical stimulation, and general anesthesia was produced in all the groups followed by 30 min electrical stimulation and the stimulation was lasted till the end of operation. The dosages of the anesthetics and the changes of surface antigen of leukomonocyte (CD3+ , CD4+ , CD8+ and CD4+/CD8+) and natural killer (NK) cell were observed at 1 day before surgery, intraoperative and 1 day after surgery.

RESULTSIn comparison with group A, the dosages of Propofol in group B and D were decreased, Fentanyl in group B, D and E were decreased. CD3+ and CD4+ in 5 groups increased at first and then decreased over time (all P < 0.01), and group E and C could inhibit the decrease of CD3+ and CD4+ in postoperation in comparison with that in the other three groups (all P < 0.05). CD8+ in 5 groups has no change in different times (all P > 0.05), and group E and D could inhibit the decrease of CD8+ in postoperation in comparison with that in the other three groups (all P < 0.05). CD4+/CD8+ in 5 groups has no change in different times (all P > 0.05), and group E and C could inhibit the decrease of CD4+/CD8+ in postoperation in comparison with that in the other three groups (all P < 0.05). NK cells of 5 groups were increased gradually in different times (all P < 0.01), with the similar regulation of NK cells (all P > 0.05).

CONCLUSIONAcupuncture-drug compound anesthesia with 2 Hz and 100 Hz electroacupuncture together with 2 Hz/100 Hz transcetaneous acupoints electrical stimulation have the best analgesic effect, and 2 Hz/100 Hz transcetaneous acupoints electrical stimulation and 2 Hz/100 Hz electroacupuncture have the best regulation of immune function. Acupuncture-drug compound anesthesia with 2 Hz/100 Hz transcetaneous acupoints electrical stimulation is recommended for that it can not only decrease the dosages of the anesthetics, but also significantly improve the immunosuppression in patients undergoing pneumonectomy.

Acupuncture Analgesia ; Adult ; Aged ; Anesthesia, General ; Anesthetics ; Electroacupuncture ; Female ; Humans ; Immune System ; immunology ; Killer Cells, Natural ; immunology ; Lung Diseases ; immunology ; surgery ; Male ; Middle Aged ; Pneumonectomy ; Young Adult

AIM:To evaluate the effect of α2-macroglobulin(α2M) against X-ray induced obstacle on osteo-genic differentiation of human bone marrow mesenchymal stem cells(hBMMSCs). METHODS:hBMMSCs were cultured in vitro. The 4th generation of hBMMSCs was irradiated with 8 Gy X-ray,then induced osteogenic differentiation and trea-ted with different concentrations of α2M(0.5 and 1.0 g/L). The alkaline phosphatase(ALP) activity and the mRNA ex-pression of runt-related transcription factor-2 (RUNX2) were detected on day 7 after osteogenic induction. The protein ex-pression of osteoglycin (OGN) was evaluated by Western blot on day 14 after osteogenic induction. The formation of calci-um nodules was detected by alizarin red staining on day 21 after osteogenic induction. The activity of superoxide dismutase (SOD) and the protein expression of MnSOD of irradiated hBMMSCs with 8 Gy X-ray were determined at 24 h after α2M treatment. RESULTS:Compared with 8 Gy X-ray group,the activity of ALP,the mRNA expression of RUNX2,the pro-tein expression of OGN and MnSOD,as well as SOD activity were higher than those in the hBMMSCs treated with α2M at 0.5 and 1.0 g/L after 8 Gy X-ray irradiation,and the calcium nodules were also increased. CONCLUSION:α2M signifi-cantly improves the osteogenic differentiation ability,the SOD activity and MnSOD protein expression of hBMMSCs after ra-diation injury.

Objective To investigate the efficacy and safety of photoselective vaporization treatment on benign prostatic hyperplasia(BPH)in the elderly over 70 years old.Methods From August 2004 to December 2005,a total of 126 patients with lower urinary tract symptoms secondary to BPH underwent photoselective vaporization of the prostate(PVP)with an 80 W quasicontinuous KTP laser.The patients aged between 70 and 96 years,(median 78.0),with 46 cases above 80 years. Prostatic volume was 24～86 ml,in an average of 47.0 ml,with 46 cases above 60 ml.Results The mean operative time was 46.8 min(range from 30 to 100 min).After operation,the catheter was pulled out in 69 cases within 24 hours and the patients generally urinated well.At three-months follow-up,the mean I-PSS decreased significantly from(25.0?3.7)to(16.3?2.0)(P＜0.01), while the Qmax increased from(5.8?2.7)ml/s to(16.3?4.8)ml/s(P＜0.01).Complications consisted of 4 cases of hematuria,6 urinary infection and 1 acute epididymitis.Conclusions The study indicates that PVP,a minimal invasive surgical procedure,is a safe and effective procedure for the treatment of BPH in the elderly.

Objective To compare the diagnostic value of X-ray film and MRI in the posterior ankle impingement syndrome (PAIS).Methods X-ray film and MRI data of 72 cases with posterior ankle pain were analyzed retrospectively.Passive plantar flexion test and diagnostic blocking were used as the diagnostic criteria.72 patients with posterior ankle pain were divided into PAIS group and non PAIS group.X-ray film and MRI findings in the PAIS group and non PAIS group were compared,and features which had differential diagnostic value were selected for calculating and comparing the efficacy of X-ray film and MRI in diagnosing or excluding PAIS.Results There was no significant difference for X-ray film findings such as os trigonum osteosclerosis(χ2 =2.947,P =0.086),os trigonum cystic changes(χ2 = 3.031,P =0.082)and posterior ankle soft tissue swelling(χ2 = 1.610,P =0.205 )between the PAIS group and the non PAIS group.There was significant difference for MRI features such as os trigonum or posterior talus bone marrow edema(χ2 =38.868,P =0.000 ),edema around os trigonum(χ2 =39.919,P =0.000 )and tenosynovitis of the flexor hallucis longus (χ2 =8.854,P =0.003)between the PAIS group and the non PAIS group.There was no significant difference for MRI features such as posterior ankle synovitis(χ2 =2.534,P =0.119)and posterior ankle ligament thickening(χ2 =1.515,P =0.218)between the PAIS group and the non PAIS group.Conclusion Using passive plantar flexion test and diagnostic blocking as the gold standard,the diagnostic efficacy of MRI on PAIS is obviously higher than that of X-ray film.MRI can significantly improve the diagnostic accuracy of PAIS,and avoid unnecessary diagnostic blocking.

OBJECTIVETo compare the nutritional status between pancreaticojejunostomy(PJ) and pancreaticogastrostomy(PG) following pancreaticoduodenectomy.

METHODSA retrospective clinical analysis was performed on 37 patients undergoing pancreaticoduodenectomy(PD) for duodenal carcinoma and pancreatic non-epithelial tumor with PG(n=19) and PJ(n=18) in the First Hospital of Sun Yat-sen University from April 2006 to December 2010. All the patients had a needle catheter jejunostomy inserted at the conclusion of laparotomy. Postoperative early enteral nutrition and parenteral nutrition was performed for all the patients. Nutritional status of two groups was compared in body mass index (BMI), serum nutritional parameters such as albumin, transferrin and prealbumin before surgery and on 1, 3, and 6 months postoperatively.

RESULTSThere were no significant differences between PG and PJ groups in operative time, blood loss, pancreatic fistula, perioperative death, or postoperative length of hospital stay. One month after surgery, there were no significant differences in BMI [(17.1±7.0) vs. (19.0±4.8) kg/m(2), P>0.05], albumin [(30.1±0.5) vs. (32.1±1.3) g/L, P>0.05], transferrin [(1.89±0.57) vs. (2.01±0.61) g/L, P>0.05] and prealbumin[(0.18±0.05) vs. (0.18±0.09) g/L, P>0.05]. These parameters were decreased at 1 month after surgery, and gradually recovered to baseline or higher than the preoperative levels at 6 months after surgery. However, the differences were still not statistically significant between two groups.

CONCLUSIONSThe influence of PJ and PG on the postoperative nutritional status are comparable.

Adult ; Aged ; Female ; Gastrostomy ; Humans ; Male ; Middle Aged ; Nutritional Status ; Pancreas ; surgery ; Pancreaticoduodenectomy ; Pancreaticojejunostomy ; Postoperative Period ; Retrospective Studies

We studied a family with Gorlin-Goltz syndrome. The novel mutations of our cases were located on the 21st exon of the PTCH1 gene (c.3450C>G). The father, who received a strategic 56-day vismodegib treatment for disease control, was the first patient with Gorlin syndrome treated with the hedgehog inhibitor in Taiwan. The lesions regressed gradually, with scar formation, and were subsequently removed via a wide excision. Further details are provided below.
Basal Cell Nevus Syndrome* ; Cicatrix ; Exons ; Fathers ; Hedgehogs ; Humans ; Taiwan

OBJECTIVETo investigate the role of silencing PRL-3 expression by miRNA interference in gastric cancer growth.

METHODSRNA interference mediated by recombinant lentivirus expressing artificial PRL-3 miRNA was employed to knockdown PRL-3 expression in human SGC7901 gastric cancer cells. MTT assay and tumor implantation experiment were conducted to determine the role of PRL-3 in the proliferation of SGC7901 cells and the tumor growth.

RESULTSTransfection of recombinant lentivirus expressing artificial PRL-3 miRNA significantly suppressed the proliferation of SGC7901 cells in vitro. The implanted tumor size of the PRL-3 transfection group was (1.92 +/- 0.18) cm3, significantly smaller than those in control groups [(4.74 +/- 0.39) cm3] (P < 0.05).

CONCLUSIONSSilencing of PRL-3 significantly suppressed the proliferation of SGC7901 cells and tumor growth in vivo. PRL-3 could be a potential therapeutic target in gastric cancer.

Animals ; Cell Line, Tumor ; Cell Proliferation ; Genetic Vectors ; Humans ; Lentivirus ; genetics ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; MicroRNAs ; genetics ; Neoplasm Proteins ; genetics ; Protein Tyrosine Phosphatases ; genetics ; RNA Interference ; Stomach Neoplasms ; metabolism ; pathology ; therapy ; Transfection ; Xenograft Model Antitumor Assays

OBJECTIVESTo understand the role cellular immunology plays in the pathogenesis of chronic hepatitis B (CHB) through analysis of T cell receptor (TCR) beta chain variable region gene (BV) family dominant usage and beta chain complementarity determining region3 (CDR3) sequences of peripheral blood mononuclear cells of the patients.

METHODSTCR BV families were amplified by inverse polymerase chain reaction (RT-PCR), and the dominant usage of BV families and CDR3 repertoire were analyzed by immunoscope technology for 8 CHB patients during their acute exacerbations and for 4 healthy blood donors who served as controls. The clonality of the T cells suspected by immunoscope was further confirmed by CDR3 sequencing.

RESULTSThe TCR BV CDR3 repertoire of the 4 healthy blood donors showed a Gaussian distribution. In the 8 CHB patients, however, the clonal expansion of T cells showed different TCR BV families with each patient. The T cells of the clonal expansion shared different CDR3 sequences.

CONCLUSIONThe peripheral blood T cells of CHB patients during their acute exacerbation showed significantly a clonal expansion and their T cell clonal expansion may be stimulated by several HBV epitopes. These results indicate that cellular immunology is involved in the pathogenesis of the liver inflammation process of CHB.

Adult ; Amino Acid Sequence ; Base Sequence ; Cloning, Molecular ; Complementarity Determining Regions ; genetics ; Female ; Gene Rearrangement, beta-Chain T-Cell Antigen Receptor ; genetics ; Hepatitis B, Chronic ; genetics ; Humans ; Male ; Middle Aged ; Molecular Sequence Data ; Receptors, Antigen, T-Cell ; genetics

OBJECTIVETo evaluate the impact of different gastrectomy and reconstruction method on prognosis and quality of life in proximal gastric cancer.

METHODSThe 265 cases of proximal gastric cancer received radical resection, according to gastrectomy or reconstruction method, were divided into proximal gastrectomy/gastroesophagostomy group (PG) (n = 63) and total gastrectomy/esophagojejunostomy group (TG) (n = 202). The clinical pathologic features, prognosis, postoperative quality of life in 2 groups were compared.

RESULTSThere had no significant differences in age, gender, CEA value between two groups (all P > 0.05). In PG and TG group, tumor size (cm), ratio of organic invasion, lymph nodes metastasis, distal metastasis, TNM IV stage, Borrmann typing, poor or undifferentiated carcinoma was 2.9 ± 1.9 vs. 4.8 ± 2.8, 9.5% vs. 32.2%, 64.7% vs. 70.6%, 0 vs. 8.4%, 6.9% vs. 31.8%, 44.4% vs. 69.2%, 31.7% vs. 53.7%, respectively, all with significant difference (t = -6.260, χ(2) = 29.473, 14.559, 5.665, 32.483, 12.588, 10.954, all P < 0.05). In PG and TG group, the ratio of D3 and D3(+) resection, multi-visceral resection, complications was 0 vs. 13.8%, 9.5% vs. 38.6%, 7.9% vs. 1.5% respectively, showed increasing range of resection and decreasing complications significantly in TG group (all P < 0.05). The median survival time (months) was 62.5 vs. 78.9 in TG and PG group respectively, without significant difference (P > 0.05). In 2 groups, the evaluation index of post-operative quality of life without significant differences (P > 0.05).

CONCLUSIONSFor proximal gastric cancer, although the cases received TG with worse clinicopathological features, which prognosis was similar to that received PG. The postoperative quality of life without significant difference between the cases received gastroesophagostomy and esophagojejunostomy.

Adult ; Aged ; Aged, 80 and over ; Female ; Gastrectomy ; methods ; Gastroenterostomy ; methods ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Quality of Life ; Stomach Neoplasms ; mortality ; pathology ; surgery

OBJECTIVETo investigate the clinicopathological characteristics between mucinous gastric cancer (MGC) and poorly differentiated gastric cancer(PDGC) and factors associated with prognosis.

METHODSMedical records of 1016 consecutive patients with gastric cancer were retrospectively reviewed. Sixty-eight patients with MGC and 508 with PDGC were identified. Clinicopathologic characteristics and overall survival data were analyzed.

RESULTSAs compared to PDGC patients, patients with MGC were significantly older [(59.2±11.9) years vs. (54.1±13.2) years], had significantly more distant metastasis(36.8% vs. 23.8%), more peritoneal seeding(29.4% vs. 16.9%), and less radical resection(60.3% vs. 76.6%). There were no significant differences in 5-year survival rate between MGC and PDGC patients(29.4% vs. 35.5%). However, for tumors in the middle third of the stomach, the survival rate of MGC patients was lower than that of PDGC. Using a Cox proportional hazard ratio model, lymph node involvement and radical resection were independent prognostic factors for survival of MGC patients, while tumor invasion, lymph node involvement, and radical resection were associated with survival in patients with PDGC.

CONCLUSIONAlthough MGC and PDGC differ in age, frequencies of peritoneal seeding, distant metastasis, and rate of radical resection, overall survival is comparable.

Aged ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; classification ; pathology