A pre-column derivatization and ultra-high performance liquid chromatography quadrupole time-of-flight mass spectrometry (UHPLC-QTOF-MS/MS) method was developed for qualitative and quantitative determination of medium- and short-chain fatty acids in mice feces, and was further applied to evaluate variations in the feces of mice before and after antibiotic treatment. This animal experiment had been approved by Animal Experimental Ethics Committee of Jiangsu Province Academy of Traditional Chinese Medicine. By optimizing the derivatization conditions and UHPLC-QTOF-MS/MS parameters a new UHPLC-QTOF-MS/MS method with 3-nitrophenylhydrazine as the derivatization reagent was developed for simultaneous determination of 16 medium- and short-chain fatty acids. Validation studies showed that the linearity of the calibration curves was good (R²>0.99), the RSD of intra-day and inter-day precision was less than 10%, the repeatability RSD was less than 6%, the recovery rate was between 80% - 120% at three spiked levels, and the stability RSD was less than 7% within 36 h. The types and amounts of the detected medium- and short-chain fatty acids in feces significantly changed after the mice were treated with antibiotics. The content of formic acid, acetic acid, propionic acid, butyric acid, isobutyric acid, valeric acid, and lactic acid decreased, whereas that of heptanoic acid and succinic acid increased significantly. All these results suggest that the newly established method is accurate and reliable, and can be used for determination of medium- and short-chain fatty acids in feces.

To study the mechanism of Huangqin decoction (HQT) in the treatment of ulcerative colitis (UC) by using network pharmacology, chemical components and targets related to the four herbs of Chinese meteria medical in HQT were searched through the traditional Chinese medicine systems pharmacology database and analysis platform (TCMSP) to construct the interaction network diagram of the target point of the compounds. The UC-related targets were screened through OMIM, TTD, and GeneCard databases. The compound-target network was constructed using Cytoseape_v3.7.1 software; based on the STRING database, a target interaction network for HQT for UC was constructed, and the core target of HQT for UC was selected based on topological parameters. GO (gene ontology) biological process enrichment analysis and KEGG (KEGG pathway analysis) pathway annotation analysis were performed on the disease and drug intersection targets using the R package clusterprofile version 3.12.0 in Bioconductor. The HQT compound-UC target network contains 128 compounds and corresponding targets 141. The core targets are AKTI, IL6, PTGS2, IL10, IL1β and so on. GO functional enrichment analysis yielded 151 GO terms, and KEGG pathway enrichment screening resulted in 33 associations with UC, mainly involving PI3K-AKT signaling pathway, NF-kappa B signaling pathway, TNF signaling pathway, Toll-like receptor signaling pathway and so on. The synergetic effect of HQT with multi-components and multi-pathway was confirmed by network pharmacology, and the main possible mechanism of HQT in treating UC was predicted, which lay a foundation for the identification of effective components, the mechanism of action, and clinical application.

To investigate the application of Acute Gastrointestinal Injury(AGI) grading in evaluating gastrointestinal failure in patients with acute pancreatitis(AP). In this retrospective observational study,patients presented with moderate severe AP and severe AP in our hospital from October 2013 to October 2016 were consecutively enrolled.Logistic regression analysis and receiver operating characteristic curve were used to explore and evaluate potential predictors of gastrointestinal failure. A total of 202 patients were included in this study,with 90 cases(44.6%) identified as gastrointestinal failure.Survival curve showed significantly increased risk of death in patients with gastrointestinal failure( < 0.05).Logistic regression analysis showed age(=1.06,95%:1.03-1.09,<0.001),complaint of stopping flatus and defecation(=7.02,95%:2.08-23.66,=0.002),increased counts of white blood cells in peripheral blood(=1.09,95%:1.02-1.17,=0.015),decreased level of serum albumin(=0.93,95%:0.86-1.00,=0.048),and increased level of serum creatinine at admission(=1.02,95%:1.01-1.04,=0.001) were the independent risk factors of gastrointestinal failure.The area under curves of Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) and Beside Index for Severity in Acute Pancreatitis (BISAP) scores in diagnosing gastrointestinal failure were 0.999 and 0.782,respectively. Gastrointestinal failure can remarkably increase the risk of death in patients with AP.Both APACHE Ⅱ and BISAP scores at admission are useful in diagnosing gastrointestinal failure in patients with AP.

PURPOSE: Extranodal natural killer/T-cell lymphoma, nasal type (ENKTL) is a rare subtype of non-Hodgkin lymphoma, and asparaginase-based regimens are the best first-line treatments. Data on the role of specific circulating lymphocyte subsets in the progression of ENKTL are limited. The aim of this study was to investigate the clinical correlation and distribution of circulating absolute CD4+ T-cell counts (ACD4Cs) in ENKTL. MATERIALS AND METHODS: We retrospectively searched medical records for 70 newly diagnosed ENKTL patients treated with pegaspargase-based regimens. Comparison of ACD4Cs as a continuous parameter in different groups was calculated. Univariate and multivariate analyses were used to assess prognostic factors for overall survival (OS) and progression-free survival (PFS). RESULTS: Stage III/IV, B symptoms, elevated lactate dehydrogenase, monocytopenia, high-intermediate and high risk International Prognostic Index (IPI) and Korean Prognostic Index (KPI), high risk Prognostic Index of Natural Killer Lymphoma (PINK), and lower lymphocytes were significantly associated with low ACD4C at diagnosis. With a median follow-up time of 32 months, patients who had an ACD4C < 0.30×109/L had a worse OS. Median OS was 11 months and median PFS was 5 months in the low ACD4C cohort. There were significant differences in both OS and PFS between the two cohorts. Moreover, multivariate Cox analysis identified ACD4Cs as an independent predictor for OS and PFS. CONCLUSION: Low ACD4Cs were associated with poorer survival and could act as a negative predictor for ENKTL patients treated with asparaginase-based regimens.
Cell Count* ; Cohort Studies ; Diagnosis ; Disease-Free Survival ; Drug Therapy* ; Follow-Up Studies ; Humans ; L-Lactate Dehydrogenase ; Lymphocyte Subsets ; Lymphocytes ; Lymphoma* ; Lymphoma, Extranodal NK-T-Cell ; Lymphoma, Non-Hodgkin ; Medical Records ; Multivariate Analysis ; Prognosis* ; Retrospective Studies ; T-Lymphocytes

AIM:To investigate the stemness of mouse triple-negative breast cancer (TNBC) 4T1 cells induced by doxorubicin (DOX) and the underlying mechanism.METHODS:The 4T1 cells and MDA-MB-468 cells were treated with DOX at different concentrations (0, 0.05, 0.1 and 0.5μmol/L) for 24 h, and the shape and viability of the cells were observed.The concentration of DOX at 0.1μmol/L was chosen as the optimal concentration for the following experiments.The 4T1 cells and MDA-MB-468 cells resistant to DOX were established by continuous stimulation with DOX for 4 weeks, and named as 4T1-DOX and MDA-MB-468-DOX.Sphere formation assay was used to detect the stemness of 4T1cells and MDA-MB-468 cells.The expression of CD133 was observed by immunofluorescence staining.The expression of CD44 was analyzed by flow cytometry.The protein levels of Stat3, phosphorylated Stat3 (p-Stat3) and Oct-4 were determined by Western blot.RESULTS:The sphere formation ability of the 4T1-DOX cells was stronger than that of the 4T1control cells.The 4T1-DOX cells expressed high levels of the stemness markers CD133 and CD44 as compared with the 4 T1 cells (P<0.05).Furthermore, the 4T1-DOX cells exhibited enhanced activation of Stat3 (p-Stat3) and increased expression of Oct-4 (P<0.05) , while the expression of total Stat3 had no obvious variation.In addition, when activation of Stat3 was inhibited by WP1066, the protein levels of p-Stat3, Oct-4 and CD44 were down-regulated (P<0.05).Furthermore, inhibition of Stat3 phosphorylation reduced the sphere formation ability of the 4T1-DOX cells (P<0.05).CONCLUSION:DOX induces the stemness of mouse TNBC 4T1 cells through Stat3-Oct-4 signaling pathway.

Enhanced recovery after surgery is the path of perioperative multi-modal management.It is coordinated by anesthesiologists, surgeons, nursing staff, nutritionists and rehabilitation physician to reduce the perioperative stress response of patients.Maintenance of the body and organ functions before and after surgery to achieve early rehabilitation.Enhanced recovery after surgery integrates a series of interventions during the perioperative period to maintain physiological function and promote postoperative recovery.Its core goal is to reduce trauma and stress, to reduce pain and complications of patient, shorten hospital stay and reduce hospitalization costs.The ultimate goal is to accelerate patients recovery. so it is the direction of perioperative medical development. As an indispensable part of anesthesia management,the professionalism and ability of anesthesiologists will be critical to accelerating the success of rehabilitation surgery.

Objective To evaluate the efficacy of autologous cultured melanocyte transplantation in the treatment of genital vitiligo.Methods A retrospective analysis was carried out.From 2013 to 2016,6 patients with genital vitiligo were enrolled from Department of Dermatology,Hangzhou Third People's Hospital,who received the treatment with autologous cultured melanocyte transplantation.These patients aged 13-29 years,and the age of onset and disease duration ranged from 10 to 19 years and 2 to 10 years respectively.The area of white patches at the genital site ranged from 10 to 25 cm2.Before the transplantation,all the white patches of the 6 patients bad been stable for ＞ 12 months.Two weeks after the treatment,pimecrolimus was applied to the wounds twice a day after crust shedding.When the patient achieved ＞ 90％ repigmentation of the white patches,pimecrolimus was applied once per three days for maintenance treatment.After the treatment,these patients were followed up for at least 24 months,and the longest follow-up period was 60 months.Results Obvious pigmentation was observed in all the 6 patients 2 months after the transplantation.Meanwhile,3 patients achieved 80％ repigmentation,2 achieved 70％ repigmentation,and 1 achieved 50％ repigmentation.Six months after the treatment,3 patients achieved 95％ repigmentation,2 achieved 80％ repigmentation,and 1 still maintained 50％ repigmentation.Twelve months after the treatment,95％ repigmentation was still maintained in the 3 patients,90％ repigmentation was achieved in 2 patients,and 1 patient maintained 50％ repigmentation,and these outcomes lasted until the end of follow-up.During the follow-up,no adverse reactions were observed.Conclusion Autologous cultured melanocyte transplantation is effective for the treatment of stable genital vitiligo.

Objective :To compare short-term and midterm therapeutic effect between sirolimus-eluting stent implan-tation (SES-PCI) and coronary artery bypass graft (CABG) in aged patients with coronary heart disease (CHD) and multi-vessel coronary disease (MVD).Methods : Aged MVD patients undergoing selective revascularization were en-rolled and divided into CABG group (n＝301) and SES-PCI group (n＝289).Major adverse cardio-and cerebrovas-cular events (MACCE) were followed up for 30d ,one ,two and five years .Logistic multi-factor regression was used to analyze independent risk factors for different therapeutic methods .Results : Compared with CABG group after 30d follow-up ,there was significant reduction in all-cause mortality (6-3% vs.2-8%) and significant rise in a sec-ond revascularization rate (RVR ,1-3% vs.8-3%) in SES-PCI group , P＜0-05 or ＜0-01 ;compared with CABG group during one ,two and five-year follow up ,there were significant reductions in all-cause mortality [one year :(11-6% vs.4-8%) ,five years :(23-3% vs.12-1%)] and incidence rate of cerebrovascular accidents [one year :(8-6% vs .3-5%) ,five years :(18-3% vs.6-9%)] ,and significant rise in incidence rate of non-fatal myocardial infarction [one year :(6-6% vs.11-8%) ,five years :(12-0% vs.24-9%)] and a second RVR [one year :(3-0%vs.16-3%) ,five years :(9-3% vs.24-6%)] in SES-PCI group , P＜0-05 or ＜0-01- Logistic multi-factor regres-sion analysis indicated that DM and EH were independent risk factors for SES-PCI (OR＝ 45-772 ,13-218 , P＝0-001 both) ,while peripheral vascular disease was independent protective factor for SES-PCI (OR＝ 0-007 , P＝0-001).Conclusion : Compared with CABG ,there are significant reductions in short-term and midterm all-cause mortality ,and significant rise in a second RVR in MVD patients undergoing PCI .

To compare short‐and mid‐term therapeutic effect on aged patients with multi‐vessel coronary disease between minimally invasive coronary artery bypass grafting (MIDCAB) and coronary artery bypass grafting (CABG).Methods : A total of 72 patients with multi‐vessel disease , who were suitable for MIDCAB from 2016 to 2018 , were regarded as MIDCAB group .Another 96 patients with multi‐vessel disease , who were not suitable for MIDCAB , were enrolled as CABG group (received selective on‐pump CABG).Clinical data and incidence of major adverse cardio‐ and cerebrovascular events (MACCE ) within two‐year follow‐up were compared between two groups.Results : Men percentage of MIDCAB group was significantly higher than that of CABG group (83. 3% vs. 67. 7%, P＝0.022) ; compared with CABG group , there were significant reductions in percentages of left anterior descending proximal lesions (61.5% vs.34.7%) and chronic total occlusion disease (57.3% vs.34. 7%) in MID‐CAB group ( P＜0. 01 both) , there were no significant difference in other indexes between two groups , P＞ 0. 05 all.All subjects were followed up for two years , follow‐up rate was 90. 5% .There were no significant difference in incidence rates of all‐cause death and MACCE between two groups , P＞0.05 all.Conclusion : There is no signifi‐cant difference in incidence rate of short‐and mid‐term events between CABG and MIDCAB in patients with multi‐vessel coronary disease .MIDCAB is recommended for proper patients in clinic .

Objective To investigate the relationship between adipose tissue insulin resistance and subclinical atherosclerosis in patients with newly diagnosed type 2 diabetes mellitus. Methods The clinical data of 102 patients with newly diagnosed type 2 diabetes mellitus from March 2012 to March 2013 in Beijing Friendship Hospital, Capital Medical University were retrospectively analyzed. According to the carotid artery intima media thickness (cIMT) by ultrasonography, the patients were divided into cIMT thickening group (cIMT ≥0.9 mm, 44 cases) and cIMT normal group (cIMT＜0.9 mm, 58 cases). The fasting insulin (FINS), free fatty acids (FFA), fasting blood glucose (FBG) and blood lipids were measured, and the adipose tissue insulin resistance index (Adipo-IR) and homeostatic model assessment insulin resistance index (HOMA-IR) were calculated. Results The cIMT of 102 patients with newly diagnosed type 2 diabetic mellitus was (0.85 ± 0.15) mm. The age, triglyceride, FFA, HOMA-IR and Adipo-IR in cIMT thickening group were significantly higher than those in cIMT normal group:(50.82 ± 12.45) years vs. (41.41 ± 10.61) years, (2.43 ± 0.78) mmol/L vs. (2.14 ± 0.70) mmol/L, (0.58 ± 0.09) mmol/L vs. (0.48 ± 0.10) mmol/L, 5.57 ± 2.88 vs. 4.11 ± 1.93 and 8.39 ± 3.72 vs. 5.69 ± 3.05, and there were statistical differences (P＜0.01 or＜0.05). Logistic regression analysis result showed that cIMT thickening was independently associated with age and Adipo-IR in patients with newly diagnosed type 2 diabetes mellitus ( OR=1.119 and 1.473, P=0.002 and 0.003, 95% CI 1.041 to 1.201 and 1.144 to 1.895). Conclusions Adipose tissue insulin resistance is an independent risk factor for subclinical atherosclerosis in patients with newly diagnosed type 2 diabetic mellitus.