Background and Objectives: The goal of this study was to investigate the mechanism of mesenchymal stem cell (MSC)-derived microRNA (miR)-150-5p-expressing exosomes in promoting skin wound healing through activating PI3K/AKT pathway by PTEN. Methods: and Results: Human umbilical cord (HUC)-MSCs were infected with miR-150-5p overexpression and its con-trol lentivirus, and HUC-MSCs-derived exosomes (MSCs-Exos) with stable expression of miR-150-5p were obtained. HaCaT cells were induced by H2O2 to establish a cellular model of skin injury, in which the expression of miR-150-5p and PTEN and the phosphorylation of PI3K and AKT were evaluated. HaCaT cells were transfected with pcDNA3.1-PTEN or pcDNA3.1 and then cultured with normal exosomes or exosomes stably expressing miR-150-5p. Cell proliferation was inspected by CCK-8. Cell migration was detected by scratch test and cell apoptosis by flow cytometry. The starBase tool was used to predict the binding site of miR-150-5p to PTEN. Dual-luciferase reporter assay and RIP assay were applied to assess the interaction between miR-150-5p and PTEN. In H2O2 -induced HaCaT cells, the miR-150-5p expression decreased, and PTEN expression increased in a concentration-dependent manner. MSCs-Exos promoted the growth and migration of H2O2 -induced HaCaT cells and inhibited their apoptosis. In addition, overexpression of exosomal miR-150-5p enhanced the protective effect of MSCs-Exos on H2O2 -induced HaCaT cells; PTEN overexpression in HaCaT cells partially restrained miR-150-5p-mediated inhibition on H2O2 -induced injury in HaCaT cells. PTEN was a target gene of miR-150-5p. MiR-150-5p regulated PI3K/AKT pathway through PTEN. Conclusions MSCs-derived miR-150-5p-expressing exosomes promote skin wound healing by activating PI3K/AKTpathway through PTEN.

Objective:To explore a method for detecting recombinant human Annexin A11 (ANXA11) in serum exosomes of pancreatic cancer patients, and then primarily evaluate the clinical value of ANXA11 in pancreatic cancer patients.Methods:A prospective study was conducted and serum specimens from 70 patients diagnosed with PC, 15 patients diagnosed with benign pancreatic mass and 70 patients diagnosed with pancreatitis from the Affiliated Hospital of Nantong University were collected from December 2016 to July 2019. 70 healthy subjects during the same period were selected as control group. The abundance of ANXA11 in serum and exosomes-free serum were detected through parallel reaction monitoring (PRM) basing on high-resolution, high-precision mass spectrometer. Dot immunoblotting created by ourselves for detecting ANXA11 in exosomes and then the methodological evaluation were carried out. Levels of ANXA11 in exosomes in all subjects were statistically analyzed. Moreover, the areas under the curve (AUC) of receiver operating characteristic (ROC) curves were adopted to evaluate the diagnostic efficacy of ANXA11, CA19-9, CEA on PC. The relationship between ANXA11 and clinicopathological parameters as well as prognosis of PC patients was analyzed in the next moment. For analysis, the Mann-Whitney U test was used for comparing between either two groups, and the kruskal-wallis test was used for comparison among four groups. Results:The detection of serum exosome ANXA11 has high sensitivity and repeatability by the method of self-established dot immunoblotting. ANXA11 increased most significantly in the PC group, and the difference was statistically significant ( Hc=58.079, P<0.01) compared with other three groups. ROC curve analysis showed that the diagnostic performance of ANXA11(area under the curve (AUC=0.836) was higher than CEA (AUC=0.656) and equal to CA19-9 (AUC=0.870). The combination of ANXA11 and CA19-9 could improve the sensitivity of diagnosing PC and maintain good specificity. The level of serum exosome ANXA11 before treatment in PC patients was not related to age, gender, tumor size, tumor growth site, lymph node metastasis, distant metastasis and TNM stage ( Z values are 0.052,-0.285,-0.402,0.324,0.888,0.658,1.734, P>0.05). Furthermore, during the 10th day after surgical treatment, the level of ANXA11 showed no statistical difference compared with that before surgery ( Z value is -1.569, P=0.12). The survival time of PC patients was related to the presence of lymph node metastasis, distant metastasis, TNM staging and treatment protocols (χ 2 values are 9.354,6.086,9.389,16.998, P<0.05), while had no correlation with levels of CEA, CA19-9 and ANXA11 (χ 2 values are 1.516, 0.011, 0.159, P>0.05). Conclusions:This study successfully established an original method for detecting ANXA11 levels in serum exosomes of human. Serum exosomes ANXA11 combined with CA19-9 could improve the diagnostic sensitivity of PC.

Objective To analyze the anatomic variation of the portal vein based on magnetic resonance angiography using THRIVE sequence in one-stop examination of the liver.Methods Reconstructed three-dimensional images of 648 cases of hepatic portal vein acquired by THRIVE sequence were analyzed.Anatomic variation of the hepatic portal vein was investigated and the diameters of main portal vein (MPV), splenic vein (SV), superior mesenteric vein (SMV) and inferior mesenteric vein (IMV) were measured.Results (1)Four types of different variations of intrahepatic portal vein were observed, with normal type accounting for 79.2% (514/648), type Ⅰ 8.3% (54/648), type Ⅱ 9.0% (58/648) and type Ⅲ 3.4% (22/648), respectively.(2)Four types of different variations of extrahepatic portal vein were also observed, with type Ⅰ accounting for 37.4% (167/447), type Ⅱ 20.4% (91/447), type Ⅲ 36.2% (162/447) and other 6.0% (27/447), respectively.(3)Diameter of MPV, SV, SMV and IMV were (14.03±2.44) mm, (9.51±2.40) mm, (11.14±1.99) mm and (6.01±0.78) mm, respectively.Conclusion It is feasible to analyze anatomic variation in the hepatic portal vein using reconstructed three-dimensional images acquired by THRIVE sequence in one-stop examination of the liver.

OBJECTIVETo compare the clinical efficacy with meta-analysis between robot-assisted gastrectomy(RAG) and laparoscopy-assisted gastrectomy (LAG) for gastric cancer.

METHODSA literature search was performed in PubMed, Embase, Cochrane Library, Web of Science, Wanfang Data, CNKI(Chinese National Knowledge Infrastructure), and CBM(China Biological Medicine) databases for clinical researches published before July 2015 that compared RAG with LAG. Operative time, estimated blood loss, harvested lymph nodes, proximal margin, distal margin, hospital stay, conversion and complications were compared using weighted mean differences(WMD) and odds ratios (OR).

RESULTSSixteen studies were included in the analysis, comprising 5 764 patients(1 593 RAGs, 4 171 LAGs). RAG was associated with longer operative time (WMD=49.68, 95% CI: 35.54 to 63.82, P=0.000), less estimated blood loss (WMD=-26.10, 95% CI: -42.90 to -9.31, P=0.002), and shorter hospital stay(WMD=-0.72, 95% CI: -1.35 to -0.09, P=0.024). Conversion, mortality, complications, proximal margin, distal margin and harvested lymph nodes of RAG were similar to LAG. In meta-analysis results of distal gastrectomy and early-stage gastric cancer, RAG had more harvested lymph nodes (distal gastrectomy: WMD=2.23, 95% CI: 0.33 to 4.13, P=0.021; early-stage gastric cancer: WMD=2.58, 95% CI: 1.05 to 4.12, P=0.001).

CONCLUSIONSRAG can be performed safely with less estimated blood loss and more harvested lymph nodes as compared to LAG. Radical resection can be achieved by RAG.

China ; Gastrectomy ; methods ; Humans ; Length of Stay ; Lymph Nodes ; Operative Time ; Robotic Surgical Procedures ; methods ; Stomach Neoplasms ; surgery

AIM:Toinvestigatetheassociationbetweenmethylationstatusofapoptosis-relatedgenesandche-mosensitivity in the lung adenocarcinoma cell line P 15.METHODS: Methylation-specific PCR was applied to detect the methylation status of p73, p14ARF, p16INK4a and bax genes of P15 cells in untreated control group and decitabine (DAC) treatment group.RT-PCR was used to detect the expression of p 73, bcl-xL, bad, bax, p14ARF and p16INK4a at mRNA level. Colony formation assay and cell growth inhibition assay were used to detect the sensitivity of P 15 cells to cis-diaminedichlo-roplatinum ( C-DDP) before and after DAC treatment .DAPI staining was used to determine the apoptosis of P 15 cells ex-posed to C-DDP before and after DAC treatment .RESULTS:p73, p16INK4a and bax were expressed in the methylation sta-tus.After DAC treatment, p16INK4a expression was decreased , and the expression of p73 and bax disappeared .The expres-sion of p73, p16INK4a and bax in the unmethylated status was weak , but the enhanced expression was observed following DAC treatment.After P15 cells were treated with DAC and C-DDP, the colony formation rate of the P15 cells was signifi-cantly decreased as compared with untreated control group .The apoptotic P15 cells in DAC+C-DDP treatment group were significantly higher than those in untreated control group (P<0.05).CONCLUSION:After treated with DAC, the sensi-tivity of P15 cells to C-DDP is increased due to the activation of silenced pro-apoptotic genes .DAC and C-DDP synergisti-cally promote tumor cell apoptosis .They have significant anti-tumor effect .

Objective To investigate the protective effect of acetylated epigallocatechin gallate (AcEGCG) against H2O2-induced oxidative damage to human epidermal melanocytes,and to explore its possible mechanism.Methods Human epidermal melanocytes were isolated and cultured in vitro.Some melanocytes were classified into a H2O2 group induced by H2O2 only,EGCG groups and AcEGCG groups induced by H2O2 after pretreatment with different concentrations of EGCG and AcEGCG,respectively.Three concentrations (10,20 and 40 μmol/L) of EGCG or AcEGCG were used to treat melanocytes for 1 hour in MTS assay and lactate dehydrogenase (LDH) leakage assay and for 2 hours in Western blot assay,while only one concentration (40 μmol/L) was used to treat melanocytes for 0.5,1,2 and 4 hours respectively in flow cytometry assay.Some melanocytes treated with only culture medium and 0.1％ dimethyl sulphoxide (DMSO) served as the control group.After additional culture,MTS assay was performed to determine cell survival rate,flow cytometry to detect the level of reactive oxygen species (ROS) in melanocytes,Western blot to measure the expressions of caspase-9 and caspase-3 proteins.Lactate dehydrogenase (LDH) kit was used to detect the leakage of LDH to culture medium.Statistical analysis was carried out by using one-way analysis of variance for comparisons of multiple group means followed by Student-Newman-Keuls-q (SNK-q) test for multiple comparisons.Results Compared with the control group,the H2O2 group showed significantly decreased cell survival rate (22.99％ ± 0.53％,P ＜ 0.01),but increased LDH leakage level (36.58％ ± 0.73％,P ＜ 0.01),intracellular ROS level (19.08 ± 0.57,P ＜ 0.01),as well as caspase-9 (2.65 ± 0.079,P ＜ 0.01) and caspase-3 (2.36 ± 0.057,P ＜ 0.01) expressions.In comparison with the H2O2 group,the cell survival rate was significantly higher in the 10-,20-and 40-μmol/L AcEGCG groups (79.50％ ± 3.62％,86.52％ ± 5.13％,97.81％ ± 5.21％,respectively,all P＜ 0.01) and EGCG groups (43.19％ ± 1.68％,63.34％ ± 3.60％,70.82％ ± 2.1％,respectively,all P ＜ 0.01).However,the 10-,20-and 40-μ mol/L AcEGCG groups and EGCG groups all showed a significant decrease in the expression levels of caspase-9 (AcEGCG groups:1.44 ± 0.067,1.26 ± 0.059 and 1.10 ± 0.072 respectively;EGCG groups:2.31 ± 0.085,2.13 ± 0.091 and 1.35 ± 0.064 respectively,all P ＜ 0.05) and caspase-3 (AcEGCG groups:1.70 ± 0.053,1.57 ± 0.057 and 1.24 t 0.068 respectively,all P＜ 0.05;EGCG groups:2.09 ± 0.076,1.98 ± 0.093 and 1.79 ± 0.056 respectively,all P ＜ 0.05) compared with the H2O2 group.Similarly,a significant reduction was observed in the leakage level of LDH in these AcEGCG and EGCG groups (all P ＜ 0.01) and in ROS levels in the 40-μmol/L AcEGCG and EGCG groups when compared with the H2O2 group.Conclusions AcEGCG has a stronger protective effect against H2O2-induced oxidative damage to human epidermal melanocytes compared with EGCG,which may be realized through clearance of free radicals,antioxidant effects,and decrease of caspase-9 and caspase-3 expressions.

Objective To investigate the diagnostic value of multiplex polymerase chain reaction (m-PCR) for diagnosing second infection of severe acute pancreatitis ( SAP), and to provide evidence for anti-infection treatment of SAP .Methods From January 2011 to December 2014 , thirty five patients of SAP were enrolled .Seven to fourteen days after SAP onset , patients′blood samples were taken and the presence of infection was determined by mP-CR.In the meantime, peripheral blood or the paracentesis fluid was cultured , and the result of culture was regard as golden standard to diagnose infection .Rseults The m-PCR could simultaneously detect 9 kinds of intestinal resident pathogenic bacteria , and the lower limit of detection was 10~1 000 copies.The detection rates were as follows (cultivation vs. m-PCR):staphylococcus aureus 6 vs 5 cases, staphylococcus epidermidis 11 vs 9 cases, enterococcus faecalis 2 vs 3 cases, enterococcus faecium 6 vs 7 cases, escherichia coli 19 vs 17 cases, klebsiella pneumoniae 2 vs 3 cases, pseudomonas aeruginosa 6 vs 4 cases, acinetobacter baumannii 2 vs 2 cases, malt narrow food aeromonas 4 vs2 cases.The 7th~14th days after SAP onset, the blood or paracentesis fluid culture was positive in 27 patients,and negative in 8 cases. And the m-PCR results were positive in 30 patients, and negative in 8 cases.The m-PCR results were positive in 30 patients, negative in 5 patients.The m-PCR results were positive in 3 patients who had negative culture results.In the remaining 32 cases, the results were consistent between the two detection methods .When the culture result was regarded as golden standard , the sensitivity, specificity and accuracy of m-PCR were 100%, 62.5%and 91.43%, respectively.The positive predictive value and the negative predictive value were 90%and 100%, respectively.It took (26 ±15) hours on average to obtain the result of culture method , and it took (102 ±32) hours on average to obtain the confirmative results .It took (12 ±8) hours on average to obtain the result of the m-PCR method.The time course of m-PCRwas significantly shorter than that of the traditional culture method, and the difference was statistically significant (P<0.05).Conclusions The m-PCR method can be used to monitor the bacterial infection in patients with SAP .The m-PCR method is a highly sensitive and rapid detection approach , which is worth of clinical application .

OBJECTIVETo assess the value of gastric and hepatic surgical treatment in gastric cancer patients with liver metastasis and its prognostic implication.

METHODSLiterature search was performed in pubmed, Embase, Ovid, Springer-Link, Web of Science, CNKI, CBMdisc for clinical research published before March 2013 that compared gastrectomy alone to gastrectomy and hepatectomy. Inclusion criteria and exclusion criteria were performed. Quality assessment was based on NOS scale. Stata12.0 was used for statistical analysis.

RESULTSNine studies including 431 patients were enrolled for analysis, among whom 189 underwent gastrectomy and hepatectomy and 242 underwent gastrectomy alone. Gastrectomy and hepatectomy group had better survival(HR=0.50, 95%CI:0.34-0.72, z=3.66, P=0.000). There was a subgroup analysis. Gastrectomy with hepatectomy group had significant advantages in prognosis in four foreign studies(HR=0.28, 95%CI:0.18-0.44, z=5.77, P=0.000). There was no significant difference in five domestic studies (HR=0.74, 95%CI:0.55-1.00, z=1.95, P=0.051).

CONCLUSIONGastrectomy and hepatectomy in gastric cancer patients with liver metastasis improves long-term survival in select patients.

Gastrectomy ; Hepatectomy ; Humans ; Liver Neoplasms ; secondary ; surgery ; Prognosis ; Stomach Neoplasms ; pathology ; surgery

OBJECTIVETo evaluate the efficacy of different treatments for synchronous liver metastasis from gastric cancer.

METHODSClinicopathological and follow-up data of 271 patients with synchronous liver metastasis from gastric cancer between January 1998 and November 2012 were analyzed retrospectively. Among 271 patients, 34 received surgery alone, 95 received chemotherapy alone, and 120 received combined therapy. The prognosis was compared.

RESULTSThe median survival time was 8 months (3-41 months) in the surgery group and the cumulative 1-, 3- and 5-year survival rates were 32.4%, 2.9% and 0. The median survival time was 7 months (3-50 months) in the chemotherapy group and the cumulative 1-, 3- and 5-year survival rates were 21.1%, 1.1% and 0 respectively. The median survival time was 11 months (3-84 months) in the combined group and the cumulative 1-, 3- and 5-year survival rates were 50.0%, 5.0% and 0.8% respectively. The differences among groups were all statistically significant (all P<0.05). Extent of lymph node metastasis, therapeutic strategies, and liver metastasis management were significantly independent prognostic factors for synchronous liver metastasis from gastric cancer.

CONCLUSIONSComprehensive treatment based on operation may improve the long-term survival of patients with synchronous liver metastasis from gastric cancer.

Humans ; Liver Neoplasms ; secondary ; therapy ; Lymphatic Metastasis ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; pathology ; therapy ; Survival Rate ; Treatment Outcome

Objective To explore the effect of mosapride combined with polyethylene glycol electrolyte powder on cleaning intestinal tract before colonoscopy in patients with chronic constipation.Methods A total of 127 patients with chronic constipation for colonoscopy were randomly divided into observation group of 64 cases,oral administration of mosapride 10 mg and polyethylene glycol electrolyte powder; control group of 63 cases,oral polyethylene glycol electrolyte powder for bowel preparation for colonoscopy.The intestinal cleanness,first defecation time and adverse reaction was compared between two groups.Results The Boston bowel preparation score was (8.32 ± 0.86) scores in observation group,and (7.69 ± 0.95) scores in control group,and there was significant difference between two groups (t =3.918,P＜ 0.05).The first defecation time after taking the medicine was (45.69 ± 13.57) min in observation group and (54.63 ± 11.78) min in control group,and there was significant difference between two groups (t =3.966,P ＜ 0.05).After taking the medicine,5 cases of nausea and vomiting and 11 cases of abdominal distension in observation group,13 patients of nausea and vomiting and 23 cases of abdominal distension in control group,and there was significant difference between two groups (x 2 =4.29,6.04,P ＜0.05).Conclusion Mosapride combined with polyethylene glycol electrolyte powder can improve the intestinal tract cleaning quality,shorten the time of first defecation time,and reduce adverse reaction.