AIM:To analyze the correlation of age, axial length(AL)and spherical equivalent(SE)with the morphology of optic nerve head(ONH)in high myopia(HM)patients.METHODS:In this retrospective study, the medical records of HM patients were reviewed, and were classified based on age, AL, and SE. Participants were stratified into three age subgroups: Age1(<20 y), Age2(20-29 y), and Age3(≥30 y). For SE, participants were classified into three subgroups: SE1(-9 D≤SE<-6 D), SE2(-12 D≤SE<-9 D), and SE3(SE<-12 D). AL was further divided into four groups: AL1(<26 mm), AL2(26≤AL<27 mm), AL3(27≤AL<28 mm), and AL4(AL≥28 mm). The effects of different ages, AL, and SE on optic disc morphological parameters and their correlations were investigated.RESULTS:Totally 188 right eyes from 188 HM patients(65 males and 123 females)with mean age of 25.00±6.44 y were analyzed. No significant difference was observed in morphological data of ONH among the age groups(all P>0.05). The ONH tilt index and ONH rotation angle had no correlation with the age, AL, and SE. However, the optic disc-fovea distance(DFD), angle α, largest diameter(LD), short diameter(SD), and ONH area were significantly correlated with AL and SE(DFD: r=0.195, 0.221; angle α: r=-0.242, -0.266; LD: r=0.319, 0.295; SD: r=0.274, 0.225; ONH area: 0.310, 0.265; all P<0.01)but not with age(P>0.05). In HM, as the AL grew larger than 28 mm, the angle α was smaller and the DFD was larger significantly. CONCLUSION:The DFD and angle α can be used as evaluation indicators for the changes of ONH morphology in HM patients. The main cause of morphology change may be related to AL and SE increase rather than age.

Objective:To evaluate the techniques and short-term outcomes of pericardial autologous angioplasty for the reconstruction of mediastinal large vessels in the treatment of locally advanced malignant thymoma.Methods:We retrospectively analyzed the clinical data of 6 patients with locally advanced malignant thymoma who received autologous pericardial transplantation for mediastinal great vascular reconstruction in the same treatment group of Department of Thoracic Surgery, the Affiliated Hospital of Qingdao University from April 2017 to October 2018.Results:The operative time of malignant thymoma patients receiving autologous pericardial vascular reconstruction was(192.3±32.5)min, intraoperative blood loss was(105.0±27.5)ml, thoracic drainage time was(4.5±1.5)days, and postoperative hospital stay was(5.3±2.5)days. The postoperative quality of life of the patients was satisfactory. Angiography showed that the reconstructed vessels of the left inus vein were occluded in 1 patient 10 months after the operation, and the reconstructed vessels were unobstructed in the other patients. The average follow-up time of the patients was 34.3 months after surgery. One patient developed chest wall metastasis 23 months after surgery, and his condition was stable after receiving local radiotherapy. The other 5 patients did not occur local recurrence or distant metastasis.Conclusion:The application of autologous pericardium for the reconstruction of mediastinal great vessels in the treatment of malignant thymoma is a safe and effective method, and its clinical application prospect is worth expecting.

Objective Renal cell carcinoma ( RCC) is a common renal malignancy, which is resistant to nearly all chemo-therapeutics and radiotherapy.Wnt signaling plays an important role in the tumorigenesis and cell proliferation and apoptosis of RCC. This study was to explore the inhibiting effect of 15-oxospiramilactone NC043, a new Wnt molecule inhibiter, on the xenograft growth of human renal carcinoma (ACHN) cells in nude mice. Methods ACHN cells (1 ×107) were suspended in 100μL PBS and injec-ted subcutaneously into the right side of the posterior flank of female BALB/c athymic nude mice to establish a xenograft model.The nude mice bearing ACHN cells were randomly divided into three groups, negative control, low-dose medication, and high-dose medica-tion, treated by daily intraperitoneal injection of 3%DMSO, NC043 at 45μg/kg, and NC043 at 90μg/kg, respectively, for 15 days. At 16 days, all the mice were killed, the body weight and tumor volume obtained, and the expressions of ki67, TCF4 and β-catenin determined by immunohistochemistry. Results NC043 significantly inhibited the growth of the xenograft tumor, with an inhibition rate of 36.4%in the 45 ug/kg group and 56.4% in 90 μg/kg group.The expressions of ki67, TCF4, andβ-catenin were markedly down-regu-lated in a dose-dependent manner ( P <0.01 ) . Conclusion NC043 can effectively suppress the growth of ACHN cells in the xeno-graft tumor and reduce the expression of Wnt-related proteins, andtherefore is a potential compound for the treatment of renal cell carcinoma.

Objective The occurrence and progression of renal cell carcinoma ( RCC) is complicated process associated with DNA abnormal methylation , histone modification , and Wnt signaling pathway .This study aimed to investigate the expression of histone methylase SET8 in RCC, its relationship with the Wnt signaling pathway , its action mechanism in RCC , and its clinical significance . Methods We selected 50 cases of RCC treated by radical nephrectomy , detected the expression of SET 8 in the RCC and adjacent noncancerous kidney tissues by immunohistochemical EliVision two-step staining with β-catenin.We compared the expression levels of SET8 and β-catenin in the two types of tissue and analyzed their relationship with the patients′clinical information and the pathologic stage and grade of tumor as well as the correlation between the SET 8 andβ-catenin expressions . Results SET8 was mainly express in the cytoplasm of the RCC and noncancerous kidney tissues , partially in the cell membrane and nucleus , while theβ-catenin protein chiefly in the cell membrane of renal tubular epithelial cells in the normal kidney tissue .The expression levels of SET 8 and β-catenin in the RCC tissue were closely related to the TNM stage and tumor grade (P<0.05).The positive expression of SET8 in the RCC tissue (76%[38/50]) showed no significant difference from that in the ad-jacent noncancerous kidney tissue (66% [33/50]) (P>0.05), but that of β-catenin was remarkably higher in the former (68%[34/50]) than in the latter (4%[2/50]) (P<0.01).There was a positive correlation between the positive expression of SET 8 and the abnormal expression of β-catenin (r=0.219, P<0.05). Conclusion SET8-activated H4K20me-1 controls the activation and abnormal activities of the Wnt signaling pathway , affects the gene transcription and cell activity , and participates in the occurrence , progression, and distant metastasis of RCC .

Objective Studies on the application of fast track surgery ( FTS) are comparatively limited in urologic proce-dures.This randomized controlled study was to evaluate the impact of FTS on recovery after retroperitoneal laparoscopic adrenalectomy . Methods Eighty patients undergoing retroperitoneal laparoscopic adrenalectomy were randomly assigned to an FTS and a control group of equal number to receive an FTS recovery program and conventional perioperative care , respectively .Comparisons were made between the two groups in the time of the first flatus , first oral nutrition , and first mobilization , the incidence of gastrointestinal tract complica-tions, the time of drainage and transurethral catheterization , the length of postoperative hospital stay , hospitalization expenses , visual analogue scale (VAS) pain scores, and general state of the patients . Results The FTS group, in comparison with the control, showed significantly earlier time of first flatus ([20.6 ±8.3] vs [39.8 ±18.3]h, P<0.05), first oral nutrition ([21.1 ±9.9] vs [51.8 ±16.9]h, P<0.05), and first mobilization ([23.6 ±9.0] vs [55.6 ±18.5]h, P<0.05), markedly shorter time of drain-age ([20.9 ±7.9] vs [70.6 ±18.9]h, P<0.05), transurethral catheterization ([20.2 ±8.3] vs[62.5 ±27.1]h, P<0.05), and postoperative hospital stay ([2.43 ±0.94] vs [5.46 ±1.60] d, P<0.05), remarkably less expenses of hospitalization ([21.7 ± 3.2] vs [28.6 ±6.5] ￥1000, P<0.05), and lower postoperative pain scores at 12 h (0.93 ±0.89 vs 1.80 ±1.38), at 24 h while coughing (1.27 ±0.99 vs 4.65 ±1.33), and at 24 h at rest (0.70 ±0.61 vs 1.40 ±0.84) (P<0.05).The general state score was dramatically higher in the FTS patients than in the control on postoperative day (POD) 1 (6.85 ±1.00 vs 4.28 ±1.11) and POD 2 (8.30 ±0.94 vs 5.53 ±1.24) (P<0.01).No significant differ-ences were observed in the general state of the patients between POD 2 and the baseline (P>0.05), nor in the incidence of gastrointesti-nal tract complications between the FTS and control groups ( P >0.05). Conclusion By improving the general state and accelera-ting the recovery of the patients , FTS can be applied safely and effectively in retroperitoneal laparoscopic adrenalectomy .

Objective Wnt signaling plays an important role in the development and progression of renal cell carcinoma (RCC).This study aimed to evaluate the effects of the Wnt signaling inhibitor 15-oxospiramilactone on the proliferation , migration, cell apoptosis, and cycles of the human RCC cell line 786-0, and to investigate the possible mechanisms of this small molecule acting on RCC in ivtro. Methods We treated 786-0 cells with DMSO ( blank control group ) and 15-oxospiramilactone at the concentrations of1.25μmol/L (low 15 -OSL), 2.5μmol/L (medium 15-OSL), and 5μmol/L (high 15-OSL), respectively, for 72 hours.Then we observed the changes in the proliferation and migration of the 786-0 cells by MTT and scratch-wound assay and determined their apopto-sis and cycles by Annexin V-FITC/PI assay and flow cytometry . Results 15-oxospiramilactone significantly inhibited the growth of the 7860-cells, with the IC 50of 1.088 μmol/L at 72 hours, and decreased their migration distance (P<0.05).After 36 hours of treatment, the apoptosis rates of the 786-0 cells in the low, medium, and high 15-OSL groups were (12.17 ±0.56), (18.54 ± 1.07), and (50.74 ±1.28) %, respectively, significantly increased as compared with (7.85 ±0.42) %in the blank control group (P<0.05), and in an obviously concentration-dependent manner.15-oxospiramilactone remarkably reduced the number of cells in the G0/G1 phase and increased that in the G 2/M phase (P<0.05). Conclusion 15-oxospiramilactone can significantly inhibit the pro -liferation and migration and induce the apoptosis of 786-0cells in vitro.It may be a potential anti-RCC agent.

The quality control of traditional Chinese medicine (TCM) preparations is a key issue related to their curative effect, safety and stability. The application of modern analytical means and the development of new disciplines improve the quality control of TCM preparations to some extent. For a long time, however, the quality control level of TCM preparations remains low and the quality standards exist in name only unable to effectively control drug quality and ensure therapeutic effect and safety. The essay makes a systematic analysis on possible factors impacting TCM preparations and current situation of quality control and discusses possible approaches and new methods for improving quality control of TCM preparations, in order to give an impetus to the quality control standards and the mode evolvement of TCM preparations and ensure safety, efficiency and quality controllability of TCM preparations.
Drugs, Chinese Herbal ; Medicine, Chinese Traditional ; methods ; Quality Control

Objective To investigate the effects of inhibiting epithelial mesenchymal transition (EMT) on metastastic potential of hepatocellular carcinoma (HCC) enhanced by hepatic arterial occlusion in mice. Methods Using a metastatic human HCC orthotopic nude mice model (MHCC97),the effects of hepatic artery ligation (HAL) alone,combination of HAL and phosphatidylinositol 3-kinase (PI3K)inhibitor LY294002,or combination of HAL and interferon-α (IFN-α) on the growth of planted human HCC cells and pulmonary metastasis were evaluated,respectively.The cells and tumor tissues specimens were analyzed through expression of Akt,p-Akt,E-cadhein,N-cadherin and Twist. Results HAL inhibits tumor growth (2002.97 ± 331.28 ) mm3 vs.( 3921.23 ± 786.21 ) mm3,t =4.052,P ＜ 0.01 ),while promoting pulmonary metastatsis ( 10/12 vs.4/12,P ＜ 0.05).HAL combined with LY294002 represses significantly enhanced pulmonary metastasis rate by HAL alone (0/6 vs.6/6,P ＜ 0.01 ).Moderate-dose IFN-α (7.5 × 106 U/kg) combined with HAL failed to further reduce tumor volume compared with that of HAL alone,but inhibited markedly pulmonary metastasis (2/6 vs.6/6,P ＜ 0.05 ).The augmented level of N-cadherin and Twist in tumor tissues due to HAL reduced by LY294002 or 7.5 × 106 U/kg IFN-α.The arrest of EMT by LY294002 or IFN-α in HAL-treated xenografts was further demonstrated by the in vitro response of hypoxic cells to both agents. Conclusions Inhibition of EMT in HCC cells could repress enhanced metastastic potential due to hepatic arterial occlusion.

Objective To investigate the effects of hypoxia on malignant phenotype of a hepatocellular carcinoma(HCC)cell line and its molecular basis.Methods Human HCC cell line with highly metastatic potential(MHCC97H)was grown under hypoxia(induced by 100 μmol/L CoCl_2)and normoxic conditions respectively.To observe the effects of hypoxia on MHCC97H cells was observed,the tumorigenicity was carried out by soft agar cloning method in vitro and inoculation in nude mice in vivo;Invasive and metastatic potential were measured.Experiments with and/or without Matrigel in vitro and a metastatic human HCC orthotopic nude mice model by HAL in vivo.To clarify the molecular background,the proliferation of cells were analyzed by MTT assay and the cell cycle was detected by flow cytometry;The expression of embryonic stem cell(ES)-like genes(Oct4,Nanog and Sox2)were detected by real-time RT-PCR;CD90~+ and CD133~+ subpopulation from MHCC97H cells were isolated by flow cytometry and the expressions of CD90 and CD133 of MHCC97H cells were analyzed by immunofluorescence.Results Hypoxia increased tumor migration(t=2.792,P=0.023),invasiveness(t=7.624,P＜0.0001)and clone forming ability(t=3.292,P=0.011)of MHCC97H cells in vitro,and promoted tumorigenesis(x~2=8.571,P=0.015)and pulmonary metastasis(x~2=5.507,P=0.031)in vivo.The proliferation of MHCC97H cells arrest under hypoxic conditions accompanied with increased proportion of cells in G1 phase,the expressions of Oct4,Nanog,Sox2 significantly increased in response to hypoxia,but the fluorescence intensity and number of CD90~+ and CD133~+ MHCC97H cells decreased or unchanged.Conclusion Hypoxia increases aggressiveness of MHCC97H cells,which was correlated with the acquisition of embryonic stem cell-like characteristics.