Objective:To explore the postprandial plasma low-density lipoprotein cholesterol (LDL-C) changes by various detection methods.Methods:A total of 85 subjects admitted to the Second Xiangya Hospital of Central South University from November 2017 to May 2019 were included. Serum samples were collected from fasting and the 2 nd hour and the 4 th hour after breakfast. Serum lipid levels were measured with enzymatic assays and nuclear magnetic resonance spectroscopy (NMRS), and proprotein invertase subtilisin/kexin type 9 (PCSK9) levels were measured with enzyme-linked immunosorbent assays. The differences of blood lipid components at different time points were compared by Friedman two-way rank analysis of variance and Wilcoxon signed rank test, and the correlation between PCSK9 level and lipoprotein particles was analyzed by Spearman correlation. Results:Measured by enzymatic assays, compared with the fasting state, LDL-C decreased at the 2 nd hour and the 4 th hour after the meal (2.58[2.09, 3.12], 2.47[1.92, 3.02], 2.37[1.82, 2.80] mmol/L, P<0.001). Measured by NMRS, the concentration of LDL particles (1 086[830, 1 239], 1 083[848, 1 213], 1 061[814, 1 213] nmol/L, P=0.417) did not change significantly, and cholesterol in LDL particles were 2.13 (1.56, 2.54), 2.16 (1.68, 2.50), 2.06 (1.58, 2.50) mmol/L, respectively ( P=0.047)，and postprandial cholesterol in LDL particles in the 2 nd hour and in the 4 th hour did not change significantly compared with fasting ( P>0.05). while the concentration of large LDL particles (185.2[150.6,221.6], 173.0[144.8,220.3], 178.1[144.0,233.6] nmol/L, P=0.001), and the cholesterol level in large LDL particles (0.49[0.39, 0.57], 0.47[0.38, 0.57], 0.46[0.37, 0.58]mmol/L, P<0.001) decreased after the meal. The PCSK9 level also decreased significantly after the meal (299[233, 397], 257[208, 342], 251[215, 340] ng/ml, P<0.001). There was an independent positive correlation between the decrease of PCSK9 levels and the increase of remnant cholesterol detected by MNRS after the meal ( r=0.232, P=0.035). Conclusions:The postprandial LDL-C level measured by NMRS and enzymatic assays is not consistent. The decrease of LDL-C measured by enzymatic assays is not caused by the clearance of LDL particles, but by the redistribution of cholesterol in each LDL subfraction.

Objective:To detect the methylation status of sine oculis homeobox homolog 1 (Six1) in breast cancer and study its value in disease condition and prognosis evaluation.Methods:Methylation specific polymerase chain reaction (PCR) was used to detect the Six1 gene methylation in 80 patient with breast cancer (breast cancer group) and 50 patients with benign breast disease(benign breast disease group) in Binzhu Center Hospital from January 2015 to January 2017. The Six1 gene methylation rates in different clinicopathological factors were compared. Comparison of unmethylated and methylated Six1 gene in quality of life were made in breast cancer patients.Results:The unmethylation rate and mRNA expression of Six1 gene in breast cancer group were significantly higher than those in benign group ( P<0.05). Six1 genes in HCC1937, MCF-7, Hs 578T and Bcap-37 breast cancer cells were unmethylated. The unmethylated rate of Six1 gene were significantly higher in patients with Karnofsky score <70 scores, poorly differentiation, tumor maximum diameter ≥ 5 cm, number of lymph node metastases ≥ 9, with distant metastasis and TNM stage Ⅲ+Ⅳ class, compared with those in patients with Karnofsky score ≥ 70 scores, high and medium differentiation, maximum tumor diameter <5 cm, number of lymph node metastases<9, no distant metastases, and TNM stage Ⅰ+Ⅱ class. The patients with Six1 gene unmethylated had significantly lower quality of life compared with patients with Six1 gene methylated ( P<0.05). Conclusions:Six1 gene is hypomethylated in breast cancer and plays an important role in the evaluation of breast cancer disease condition and prognosis.

Background: The occurrence of gastrointestinal symptoms in cirrhotic patients with gastroesophageal varices (GOV) after endoscopic treatment is obvious, and the role of gastric myoelectrical activity (GMA) and autonomic nerve function imbalance in the development of gastrointestinal symptoms has not been clarified. Aims: To investigate the changes of GMA and autonomic nerve function in cirrhotic patients with GOV after endoscopic treatment. Methods: Twenty-five cirrhotic patients with GOV from May 2019 to October 2019 at the First Affiliated Hospital of Nanjing Medical University were enrolled, and 10 patients with gastric polyp were served as controls. Electrogastrogram (EGG) and heart rate variability (HRV) were detected before the operation, 1 day after the operation and 5 days after the operation in GOV group. For the gastric polyp group, EGG and HRV were detected before the operation and 1 day after the operation. Changes of GMA and autonomic nerve function were compared between the two groups. Results: No significant differences in GMA and autonomic nerve function were found between GOV group and gastric polyp group before and 1 day after the operation (P>0.05). LF, LF/HF were significantly increased 1 day after the operation in GOV group (P<0.05), while HF was significantly decreased (P<0.01), and the percentage of bradygastria was significantly increased (P<0.01). There were no significant differences in GMA and autonomic nerve function between pre-operation and 5 days after the operation in GOV group (P>0.05). There were no significant differences in GMA and autonomic nerve function 1 day after the operation compared with pre-operation in gastric polyp group (P>0.05). Compared with Child-Pugh A group, Child-Pugh B group had more obvious GMA abnormalities, and the difference was statistically significant (P<0.05). Conclusions: In cirrhotic patients with GOV, the percentage of bradygastria and the sympathetic activity increased, and the vagal activity decreased 1 day after the operation. These results suggest that GMA and autonomic nerve dysfunction may be related to the gastrointestinal symptoms after endoscopic treatment.

Objective To observe the effects of apolipoprotein AⅠ (apoAⅠ) on autophagy,lipid retention,and apoptosis in foam cells, and to explore the anti-atherosclerotic mechanism of apoAⅠ. Methods Macrophages derived from THP-1 cells were randomly divided into the control group,the 3-MA+apoAⅠ group,and the apoAⅠ group. Each group was administered oxidized low-density lipoprotein for 36 hours,then lipid droplets and autophagosomes were observed and cellular cholesterol content was quantified. LC3 and Beclin-1 expression was examined by western blot and the apoptotic ratio determined using flow cytometry. Results Compared with the results of the control group,apoAⅠ treatment inhibited lipid retention and apoptosis in foam cells,decreased cellular cholesterol content,and up-regulated the expression of LC3 and Beclin-1 (P < 0.01). Administration of 3-MA abrogated the effects of apoAⅠ (P < 0.05). Conclusion apoAⅠ inhibits lipid retention and apoptosis in foam cells by inducing autophagy.

Objective To study the effect of epigallocatechin-3 gallate (EGCG) on cholesterol efflux in foam cells and its mechanism.Methods THP-1 cells were induced to differentiate into macrophages which were then transformed to foam cells.Foam cells were divided into 0 μmol/L EGCG group,10 μmol/L EGCG group,30 μmol/L EGCG group,and 100 μmol/L EGCG group (1.5 × 106 in each group).Their cholesterol content was measured with a cholesterol test kit,apoA-I-mediated cholesterol efflux was assayed with a liquid scintillation counter,expression of ATP-binding cassette A1 (ABCA1) was detected by RT-PCR and Western blot respectively.Results The ABCA1 mRNA and protein expression levels and cholesterol efflux were significantly higher while the cholesterol content was significantly lower in 10 μmol/L EGCG group,30 μmol/L EGCG group,and 100 μmol/L EGCG group than in 0 μmol/L EGCG group (7.04％ ±0.21％,7.75％±0.17％ and 8.53％±0.18％ vs 3.37％±0.16％,P＜0.01;419.33±19.75 mg/g,352.58± 14.23 mg/g and 312.62±17.45 mg/g vs 520.51 ±20.62 mg/g,P＜0.01),and in 30 μmol/L EGCG group,100μmol/L EGCG group than in 10μmol/L EGCG group (P＜0.05).Conclusion EGCG increases cholesterol efflux and decreases cholesterol content in foam cells by upregulating the transcription and expression of ABCA1.

OBJECTIVE To explore the effect of aqueous extract of Zheng Chaihu Yin(ZCH)on paracetamol(acetaminophen,APAP)-induced hepatotoxicity. METHODS Male ICR mice were divided into three scenarios randomly:the single treatment dose of ZCH,multiple treatment or pretreatment dose of ZCH. Each scenario had a up control group and an APAP model group,while single treatment dose of ZCH group had a ZCH group at the same time. The dose of APAP and ZCH was 500 mg·kg-1 and 36 g · kg- 1,respectively. 24 h after the last administration,plasma and liver samples were prepared. Ultra- performance liquid chromatography/quadrupole- time- of- flight mass spectrometry (UPLC-Q-TOF-MS)based metabolomics profiling was used to examine changes in plasma after expo?sure to ZCH,APAP or co-exposure to ZCH and APAP. Glutamic pyruvic transaminase (GPT) and glutamic oxaloacetic transaminas (GOT) values were determined by a biochemical auto analyzer in plasma. Histopathologic changes in the liver were observed and the area was calculated after HE staining. The data were analyzed with SPSS16.0 statistical software and the results were compared with the test between the two groups to find biomarkers. Also,SIMCA software was used for partial least squares-discriminant analysis (PLS-DA) pattern recognition. RESULTS Compared to control group, APAP dosing alone caused an increase in plasma transaminases and alterations in multiple metabolic pathways. Compared to APAP group,decrease in plasma transaminases was noted when ZCH was administered after or prior to APAP. Histopathologic results showed that in the single treatment group, multiple treatment group and pretreatment group,ZCH could alleviate the liver damage induced by APAP from (32.3 ± 12.0)% to (14.2 ± 9.9)%,(8.6 ± 7.9)% to (5.2 ± 1.7)% and (32.5 ± 10.0)% to (5.2 ± 6.4)%(P<0.05). Similarly,the PLS-DA of the LC-MS data showed that the groups dosed with APAP alone were the most distinct from controls,while animals dosed with ZCH prior to or after APAP treatment were located near control group. Metabolic spectrum results showed that ZCH could restore the changes in endogenous substances including lipid metabolism,amino acid metabolism,sugar metabolism and energy metabolism induced by APAP to normal. CONCLUSION ZCH water-extraction plays major roles in the regulation of metabolism on APAP-induced liver injury. These studies demonstrate that UPLC-Q-TOF-MS-based metabolomic analysis can be sensitively and accurately predict the initiation and progres?sion of liver injury and greatly contribute to a better understanding of the hepatoprotective effects of ZCH in a clinical environment.

Objective To explore effects of apoAI on MCP?1 levels in the plasma and the Ly6Chi monocyte proportion in the blood and spleen of atherosclerotic mice,as well as on CCR2 expression in vitro. Methods Sixteen male apoE?/?mice were fed with high cholesterol diet for 12 weeks. Mice were randomly divided into control and apoAI groups and were administered with PBS or apoAI(40 mg/kg),respectively,via tail vein on the 1st and 3rd day before sacrifice. Mice in both groups were administered LPS(25μg/mouse)via intraperitoneal injection 12 h before sacrifice. Plas?ma levels of MCP?1 were determined using ELISA,and the Ly6Chi monocyte proportion was analyzed using flow cytometry. In addition,human monocytic THP?1 cells were randomly divided into control and apoAI(10 mg/L)?treated groups,pretreated with corresponding intervention,and incubated with LPS(10μg/L). CCR2 expression levels were measured by Western blotting. Results Compared with the control treatment, apoAI treatment remarkably reduced MCP?1 levels in plasma and Ly6Chi monocyte proportion in the blood and spleen(P<0.01). Furthermore, apoAI treatment inhibited CCR2 expression in monocytes in vitro(P<0.05). Conclusion apoAI can reduce MCP?1 levels in plasma and the Ly6Chi monocyte proportion in the blood and spleen and can inhibit CCR2 expression in monocytes in vitro.

Objective To evaluate the efficacy and safety of the unilateral and bilateral drainage in hilar malignant biliary obstruction with a meta?analysis of relevant studies. Methods A systematic electronic search with keywords “ biliary stent”, “hilar tumor” and “malignant biliary obstruction” was independently performed by two reviewers in major electronic databases of Pubmed, EMBASE, Cochrane Library and Web of Science. A meta?analysis was conducted using Revman 5?? 1 software. Results Six studies were included with a total number of 558 patients, of whom 307 patients underwent unilateral biliary drainage and 251 pa?tients bilateral drainage. There was no significant difference in early complications ( OR = 1?? 03,95% CI:0?? 58?1?? 81,P = 0?? 93), later complications (OR = 0?? 98,95%CI:0?? 46?2?? 07,P = 0?? 95), operation success rate (OR= 1?? 42,95%CI:0?? 76?2?? 66,P = 0?? 28),drainage efficacy or median survival time between the two groups. Compared with unilateral biliary drainage, bilateral biliary drainage had a longer time of stent patency (MD = - 29?? 12,95% CI:- 38?? 55?- 19?? 70,P< 0?? 001). Conclusion Both unilateral and bilateral biliary drainage are safe and effective for hilar malignant biliary obstruction, but more high quality clinical researches are needed.

Objective To investigate clinical efficacy and safety of endoscopic multiband mucosec-tomy(EMBM)for esophageal submucosal tumors(SMTs).Methods Data of 51 patients with SMTs diag-nosed between Jan 2012 and Aug 2014 were retrospectively studied.Of the 51 patients,33 patients(34 le-sions)received EMBMand 18 patients received endoscopic submucosal resection(ESMR).The operation success rates,complete resection rates,procedure time,complications and the follow-up of group EMBMand group ESMR were compared.Results All of 51 cases had successful endoscopic treatment with no perfora-tion,infection or obvious bleeding.Follow-up showed no recurrence after operation.Compared with group ESMR,group EMBM had higher complete resection rate [97.1% (33 /34)VS 61.1% (11 /18 ),P =0.010],shorter operation time[(6.3 ±1.8)min VS (21.4 ±3.8)min,P =0.001]and lower complication rate[6.1%(2 /33)VS 27.8%(5 /18),P =0.024].Conclusion EMBM is simple,safe and effective for treating SMTs originating from muscularis mucosa or submucosa which are less than 2.0 cm in diameter.

Objective To evaluate the clinical efficacy of neoadjuvant chemo radiotherapy combined with surgical treatment for advanced rectal cancer.Methods Fifty-one patients with advanced rectal cancer were randomly divided into treatment group and control group by random number table.In treatment group,26 cases received three-dimensional conformal radiotherapy synchronization XELOX chemotherapy for 2 cycles,then they received radical resection after 4-6 weeks.Twenty-five cases in control group received neoadjuvant chemotherapy with XELOX for 2 cycles,then received radical resection.Results The objective response rate in treatment group was 84.6％ (22/26),and in control group was 60.0％(15/25),there was significant difference between two groups (P =0.049).Radical resection in treatment group was 96.2％ (25/26),significantly higher than that in control group 76.0％ (19/25)(P =0.037).The sphincter preservation rate in treatment group was 61.5％ (16/26),and in control group was 20.0％ (5/25),there was significant difference between two groups (P =0.003).The pathologic complete response rate in treatment group was 26.9％ (7/26),significantly higher than that in control group 4.0％ (1/25)(P =0.024).The 1,2 and 3 year survival rate in treatment group were 88.0％(22/25),60.0％(15/25),32.0％(8/25),which were significantly higher than those in control group 62.5％ (15/24),29.2％ (7/24),8.3％ (2/24) (P =0.038,0.030,0.040).The 1,2,and 3 year recurrence rate in treatment group were 8.0％(2/25),20.0％(5/25),36.0％ (9/25),which were significantly lower than those in control group 33.3％ (8/24),44.8％(12/24),66.7％ (16/24) (P=0.028,0.027,0.032).Conclusion Neoadjuvant chemoradiotherapy can improve the rate of surgical resection,sphincter preservation and prolong survival of rectal cancer,it can be used as a kind of effective treatment for rectal cancer.