Objective To study the effect and mechanism of high glucose on mesothelial-mesenchymal transition(MMT)of peritoneal mesothelial cells(HMrSV5),and the protective effect of pharmacological blocking of signal transducer and activator of transcription 3(STAT3)on rat peritoneal fibrosis(PF)model.Methods The animals were divided into three groups:the sham group,the model group,and the STAT3 inhibitor group.A miniature per-itoneal dialysis catheter was implanted under the dorsal skin of rat and the rat peritoneal fibrosis model was induced by daily injection of high glucose dialysate.After 10 weeks,HE staining was used to evaluate the histology of the peritoneum,and the level of transforming growth factor-β1(TGF-β1)in the peritoneum was measured by immuno-histochemistry.HMrSV5 was cultured in high glucose and the optimal stimulation concentration of high glucose was determined by Western blot.High glucose was used to stimulate HMrSV5 after successful transfection with si-STAT3 and Western blot was used to measure the protein level of STAT3,p-STAT3,and the key enzymes of glycol-ysis 6-phosphofructo-2-kinase/fructose-2,6-biphosphatase 3(PFKFB3)and lactate dehydrogenase A(LDHA).Results HE staining showed that administration of STAT3 inhibitor(BP-1-102)could inhibit the thickening of subperitoneal tissue and the proliferation of vessels in HG dialysis rats.The expression of TGF-β1 in the rats perito-neum of the model group was significantly higher than that in the sham group,and the level of TGF-β1 was marked-ly lower in the STAT3 inhibitor group compared to the model group(P<0.05).Compared to the control group,high glucose induced the up-regulation of α-smooth muscle actin(α-SMA),the down-regulation of E-cadherin and STAT3 activation in HMrSV5(P<0.05).Mesothelial cells treated with high glucose also exhibited high expres-sion of the key enzymes of glycolysis(PFKFB3,LDHA)(P<0.05),and si-STAT3 can effectively inhibit the overexpression of PFKFB3 and LDHA induced by high glucose(P<0.05).Conclusion STAT3 is involved in high glucose-induced HMrSV5 hyperglycolysis and MMT,and targeting STAT3 alleviates peritoneal fibrosis and an-giogenesis during peritoneal dialysis treatment in rats.

Anti-N-methyl-D-aspartate receptor encephalitis is severe diffuse encephalitis caused by cerebrospinal fluid(CSF)antibodies against the GluN1 subunit of the NMDAR.Pediatric NMDAR encephalitis is mainly characterized by neurological symptoms such as dyskinesia, ataxia and epilepsy.Auxiliary examinations of the patients show positive CSF IgG antibodies, EEG slow waves and metabolic changes in FDG-PET/CT.But there is lacking of clinical biomarkers for early diagnosis of children with atypical symptoms and negative antibody.Immunotherapy is effective for most children and early treatment can improve prognosis remarkably.At the same time, antipsychotic drugs and antiepileptic drugs can treat children with psycho behavioral symptoms and seizures.However, some patients are refractory to conventional therapies and have neurological sequela even after the application of multiple immunosuppressants.Therefore, more further studies are needed to clarify the pathogenesis and find biomarkers for early diagnosis of pediatric patients.This article reviews the pathogenesis, clinical characteristics, diagnosis and treatments of the disease.

Irreversible electroporation (IRE) is an emerging tissue ablation technique. Compared with thermal ablation technique such as radiofrequency, IRE can achieve focal ablation in a shorter time without heat sink effect while sparing the tissue scaffold. IRE has been demonstrated to be a feasible therapeutic modality for the liver, pancreatic, and prostatic cancer. In recent years, several studies regarding of catheter-directed IRE for digestive tract, bronchus, urinary tract, and myocardium have been performed, which preliminarily demonstrated the safety and efficacy of IRE for tissue ablation under endoscopic or interventional technique. This study summarized the research progress of catheter-directed IRE for tissue ablation. The critical technique and future direction of catheter-based IRE are prosp.
Catheter Ablation ; Catheters ; Electroporation ; Endoscopy ; Humans

Objective: To investigate the inhibitory effect of macrophage foaming by Yinlan Tianzhi formula (YLTZ) and to explain its effects on lipid-induced inflammation and LXRα-ABCA1 signal pathway. Methods: The model of macrophage foaming was induced by incubating the RAW264.7 cells or BMMs with ox-LDL (50 mg·L-1). The serum containing YLTZ was prepared. The cells were divided into blank group, model group, and drug group. After drug intervention, MTT method was used to detect cell proliferation. The lipid accumulation in cells was observed by oil red O staining, and GPO-PAP method was used to determine the total cholesterol content in cells. Protein and mRNA levels were determined by Western blot and RT- qPCR. Results: Compared with control group, after YLTZ treatment, the lipid level was significantly decreased, and the level of mRNA and protein of LXRα and ABCA1 were significant increased. The expression of inflammatory factor COX2 and iNOS was significantly decreased. Conclusion: YLTZ inhibits macrophage foaming through enhancing LXRα-ABCA1 pathway and suppressing of inflammatory response.

OBJECTIVETo compare the effects between acupuncture with regulating mind and spleen and wes-tern medication for diarrhea irritable bowel syndrome (IBS-D).

METHODSEighty-one patients were randomly at the ratio of 2 to 1 assigned into an acupuncture group (54 cases) and a western medication group (27 cases). Acupuncture with regulating mind and spleen was applied in the acupuncture group for 6 weeks at Baihui (GV 20), Yintang (GV 29), Tianshu (ST 25), Zusanli (ST 36), Shangjuxu (ST 37), Sanyinjiao (SP 6), and Taichong (LR 3), once every other day, 3 times a week. Pinaverium bromide tablet was used orally in the western medication group for 6 weeks, 50 mg a time, 3 times a day. IBS symptom severity score (IBS-SSS) were observed before and after 1-week, 6-week treatment. Pittsburgh sleep quality index (PSQI) was applied before and after 6-week treatment. Also, clinical efficacy was evaluated in the two groups.

RESULTSThree patients dropped out in the acupuncture group, and 1 in the western medication group. Except abdominal distension score after 1-week treatment in the western medication group, single scores and total scores of IBS-SSS apparently reduced in the two groups after 1-week and 6-week treatment (<0.01,<0.05). After 1-week treatment, the abdominal pain score of the acupuncture group was obviously lower than that of the western medication group (<0.05). After 6-week treatment, with abdominal pain relief advantage, other results including the number of pain days, defecation satisfaction,life disturbance degree and total score of the acupuncture group were obviously lower than those of the wes-tern medication group (<0.01,<0.05). After 6-week treatment, the PSQI score and its change before and after treatment in the acupuncture group were superior to those in the western medication group (both<0.05). The relief rate and relief plus obvious effective rate in the acupuncture group were higher than those in the western medication group[51.0% (26/51) vs 19.2% (5/26),<0.01; 64.7% (33/51) vs 34.6% (9/26),<0.05].

CONCLUSIONSAcupuncture with regulating mind and spleen for diarrhea irritable bowel syndrome can more effectively relieve abdominal pain than pinaverium bromide tablet at the early stage. Its total effect and single effects are better at the later stage on abdominal pain, seizure frequency, defecation satisfaction, life disturbance, and sleep quality.

Objective: To investigate the combined impact of lifestyle factors on stomach cancer risk. Methods: We analyzed the data from the Shanghai Men's Health Study (SMHS) (2002-2013). The SMHS was conducted in eight neighborhood communities of urban Shanghai. From 2002 through June 2006, 61 480 residents aged 40 to 74 years old with no history of cancer were recruited. Failure time was the date of stomach cancer incidence, death or date of the last follow-up (December 31, 2013). The first two in-person follow-up surveys were conducted in 2004-2008, and 2008-2011, respectively. Using data on lifestyle, the healthy lifestyle index (HLI) was developed. The following lifestyle factors were included: smoking, alcohol consumption, diet habit, overweighted and physical activity. Cox proportional hazard models were used to evaluate the association of stomach cancer risk with lifestyle factors and HLI. Results: Over 9.28 years' follow-up, 477 incident cases of stomach cancer were identified from 59 503 study participants. Participants with zero, one, two, three, four, and five favorable lifestyle behaviors accounted for 3.44% (n=2 045), 18.14% (n=10 793), 33.68% (n=20 041), 29.43% (n=17 511), 12.82% (n=7 627), and 2.50% (n=1 486), respectively. Among all the five lifestyle factors, smoking and alcohol use were significantly related to stomach cancer risk. The relative risk of stomach cancer was 0.71 (95%CI: 0.57-0.87) for those who never smoked or quitted smoking for no less than 10 years and 0.70 (95%CI: 0.55-0.90) for those who consumed alcohol no more than 14 drinks per week. For each increment of healthy lifestyle index, the relative risk of stomach cancer was 0.86 (95%CI: 0.79-0.95). Compared to men with none or one healthy lifestyle factor, the relative risk for those with four or five was 0.62 (95%CI: 0.46-0.83). When we rebuilt HLI using more categories of each lifestyle factors, the HLI ranged from 0 to 11. For each point increase, the relative risk of stomach cancer was 0.93 (95%CI: 0.89-0.97). Compared those with 0 to 3 points, the relative risk of those with 8 to 11 points was 0.64 (95%CI: 0.47-0.87). Conclusion In the SMHS, only a small proportion of men adhered to all the five healthy lifestyle factors. Compared to those with none or one healthy lifestyle behaviors, those with five may prevent about 1/3 stomach cancer incidence and the HLI was inversely associated with stomach cancer risk.

Objective To investigate influence on dose distribution due to cavity and inhomogeneous structures using thermoluminescence dosimeters (TLD) and Chengdu phantoms.Methods A cavity 4 cm × 4 cm × 3 cm was made by a head and neck phantom and a lung phantom was cut into slices which were got a CT scanning and setup in a digital simulator.The TLD were pasted on edge and in the center of cavity structure and inhomogeneous structures.Treatment plans of different radiotherapy technologies were made generated and delivered on a linear accelerator.Then the TLD were read and analyzed.Results There were remarkable cavity effects of conventional single field,opposite fields and IMRT plans with 7 fields for head and neck phantom.There is similar effect in lung phantom.The more complexity the radiotherapy technology was the less cavity effect.Conclusions It is necessary to consider using more advanced radiotherapy technology or applying more fields to make treatment plans in order to decrease the cavity effect or similar effect when there are inhomogeneous structures.

Objective To identify clinical predictive factors in intractable childhood epilepsy,to provide some evidence for its early diagnosis.Methods Six hundred and twenty-four children with newly diagnosed epilepsy were retrospectively identified in Xinhua Hospital Affiliated to Shanghai Jiaotong University Medical School(1993-2009).The epileptic children were divided into a drug-responsive epilepsy group (n =584) and an intractable epilepsy group (n =40).Clinical data of patients were retrospectively analyzed,including the gender,age,pathogen,inducement,number of pre-treatment seizures,seizure type,seizure type change,seizure duration,family history,previous history,physical examination,brain CT and initial electroencephalogram(EEG) findings.Single factor analysis and Logistic regression analysis were made in 2 groups.Results Strong univariate associations suggested that some factors could increase the risks of intractable epilepsy:symptomatic or cryptogenic epilepsy,mental retardation,type of infantile spasm,positive neurological examination and large absolute number of pre-treatment seizures,and changes in seizure types in the course of the disease.With multiple Logistic regression,independent predictors of intractability were symptomatic or cryptogenic etiology(OR =3.61),large absolute number of pre-treatment seizures and changes in seizure types in the course of the disease(OR =4.76).Conclusions It's necessary to be wary of intractable epilepsy and to adjust therapy accordingly when seizures were uncontrollable and accompanied by one or more conditions such as symptomatic or cryptogenic epilepsy,large absolute number of pre-treatment seizures,changes in seizure types in the course of the disease.

ObjectiveTo compare the calculation precision of the collapsed cone convolution (CCC) algorithm and pencil beam convolution (PBC) algorithm in TPS in heterogeneous tissue.Methods We made two virtual lung phantoms,one is single field phantom,In this case the photon beam incident into the phantom,the other is the two fields phantom and a cubic'tumor' was placed in the centre of the phantom.two opposite photon beams incident into the phantom.We calculated the dose of the'tumor' and the lung with the CCC and PBC algorithm.We compared the results in both case with if obtained from Monte Carlo (MC) method.ResultsIn the single field phantom,the photon beam incident from the high-density tissue to the low-density lung equivalent tissue,compared with the result of MC algorithm PBC algorithm overestimated the lung equivalent tissue dose (t =3.90,P =0.012) and the result of CCC algorithm is close to it ( t =2.25,P =0.087 ).In the two fields phantom,tumor boundary dose calculated by CCC algorithm and the MC algorithm are lower than that of the PBC algorithm (t =2.43,3.18,P =0.038,0.011 ),and the difference increase when the field size decrease, the beam energy increase and the density of the inhomogeneity decrease.ConclusionsWe had better use the CCC algorithm when calculating the dose of the tumor surrounded by low-density tissue or the tumor behind the low-density tissue,such as the lung cancer,esophageal cancer etc.