Objective To investigate the effect and possible mechanism of Emodin on Doxorubicin(DOX)-induced cardiotoxicity.Methods H9C2 cells were preincubated with low,medium and high doses(5,15 and 25 μmol·L-1)of Emodin for 8 h,and then cardiomyocytes were treated with 2.5 μmol·L-1 DOX for 16 h to establish a cardiotoxic injury model.MTT assay was used to detect the cell survival rate.The levels of cardiac troponin(cTnT),lactate dehydrogenase(LDH),creatine kinase(CK),superoxide dismutase(SOD),reactive oxygen species(ROS),malondialdehyde(MDA),reduced glutathione(GSH),glutathione peroxidase(GSH-Px)and the activities of Caspase-3 and Caspase-9 in H9C2 cells were detected by kit;RT-qPCR was used to detect miR-29a-5p and vascular endothelial growth factor-B(VEGFB)expression levels.The expression levels of VEGFB protein and other apoptosis-related factors were detected by Western blot.After transfection of miR-29a-5p mimics and inhibitors,the targeting of VEGFB to miR-29a-5p was detected by RT-qPCR and Western blot.H9C2 cells were transfected with miR-29a-5p mimics,Under the dose of Emodin 15 μmol·L-1,the activity of H9C2 cells was detected by MTT method,and the expression levels of miR-29a-5p and VEGFB were detected by RT-qPCR and Western blot.Results Compared with the DOX group,Emodin low,medium and high dose groups significantly increased the activity of H9C2 cells(P<0.05,P<0.01),and decreased the levels of cTnT,LDH and CK(P<0.05,P<0.01);RT-qPCR indicated that the expression level of miR-29a-5p decreased significantly and the expression level of VEGFB increased significantly(P<0.05,P<0.01);The levels of ROS and MDA decreased significantly,and the levels of GSH and GSH-Px increased significantly(P<0.05,P<0.01);TUNEL positive cells decreased significantly,and the activities of Caspase-3 and Caspase-9 decreased significantly.Western blot showed that the expression level of VEGFB increased significantly,the expression level of apoptosis-related factor Bax decreased significantly,and the expression levels of Bcl-2 and Bcl-xl increased significantly(P<0.05,P<0.01).After transfection with miR-29a-5p mimics and inhibitors,the expression of VEGFB decreased and increased respectively(P<0.05,P<0.01).After transfection of miR-29a-5p mimics and treatment with Emodin 15 μmol·L-1 of H9C2 cells,the significant decrease in the activity of H9C2 cells induced by DOX was reversed,and the significant decrease in the expression level of VEGFB was also reversed(P<0.05,P<0.01).Conclusion Emodin significantly reduces DOX-induced cardiotoxicity by regulating miR-29a-5p/VEGFB-mediated cardiomyocyte apoptosis.

Objective To evaluate the clinical efficacy of bypass combined with devascularization in the treatment of esophageal variceal bleeding in patients with cirrhotic portal hypertension.Methods Clinical data of 54 patients with cirrhotic portal hypertension who underwent surgery in the Third Affiliated Hospital of Sun Yat-sen University and Yuedong Hospital of the Third Affiliated Hospital of Sun Yat-sen University from January 2008 to January 2018 were retrospectively analyzed.The informed consents of all patients were obtained and the local ethical committee approval was received.Among 54 patients,37 cases were male and 17 female,aged from 37 to 52 years with a median age of 45 years.According to the operation procedure,the patients were divided into bypass combined with devascularization group (BD group,n=22) and selective devascularization groups (SD group,n=32).The perioperative free portal vein pressure (FPP) and the venous pressure at the gastric fundus and cardiac region (GCP) were compared by t test.The incidence of postoperative complications was compared by Chi-square test.Results In BD and SD groups,the FPP was (22±5) and (22±7) mmHg (1 mmHg=0.133 kPa) respectively,significantly lower than the preoperative FPP (32±4) and (31±5) mmHg (t=-17.21,-22.54;P＜0.05);The GCP was (18±7)and (20±3) mmHg respectively,significantly lower than (30±5) and (29±3) mmHg before surgery (t=-13.39,-20.44;P＜0.05).No significant difference was observed in the postoperative GCP and FPP between two groups (t=1.44,0.95;P＞0.05).In BD group,the recurrent rate of esophageal varices and incidence of portal hypertensive gastropathy was 9％ and 18％ respectively,significantly lower than 28％ and 31％ in SD group (x2=5.31,4.89;P＜0.05).The incidence of rebleeding in BD group was 4％ and was 3％ in SD group,where no significant difference was observed (x2=0.21,P＞0.05).Conclusions Compared with selective devascularization,the combination of bypass and devascularization in treating esophageal variceal bleeding yields similar clinical efficacy,and has the advantages of lower postoperative recurrent rate of esophageal varices and incidence of portal hypertensive gastropathy.

Objective: To study the clinical outcome of transoral CO₂ laser surgery for glottic cancer involving the anterior commissure. Methods: Thirty-two cases of glottic cancer involving the anterior commissure treated by transoral CO₂ laser surgery between March 2009 and December 2013 were retrospectively reviewed. Among these cases, 27 were T1bM0M0, 5 were T2N0M0. All cases were followed-up for more than 3 years. Results: All the 32 cases were successfully treated. Perioperative complications included injuries in the soft palate mucosa(13/32, 40.63%), loose incisors(3/32, 9.38%) and subcutaneous emphysema in the neck(2/32, 6.25%). During the follow-up period, granulation was found in all cases. Three cases had local recurrence. Two patients treated by a secondary transoral CO₂ laser surgery and the other case had total laryngectomy, all three cases were followed up for 5 years without recurrence. Two cases had regional recurrence but no primary site recurrence. One patient was treated by neck dissection, and followed up for 5 years without recurrence. The other patient died of supraclavicular and mediastinal lymph node metastasis and lung metastasis 40 months after operation. The overall 5-year survival rate was 90.6%. There was no significant difference in survival rate between T1bN0M0(92.6%) and T2N0M0(80.0%) (Log Rank χ²=0.788, P=0.375). The overall 5-year local regional control rate was 84.4%. In T1bN0M0 lesions, the 5-year local regional control rate was 92.6%, which was significantly higher than that in T2N0M0 lesions(40.0%) (Log Rank χ²=9.504, P=0.002). Conclusion With appropriate surgical indication, detailed preoperative evaluation, good surgical skill, transoral CO₂ laser surgery may achieve satisfactory outcome in the treatment of glottic cancer involving the anterior commissure.

OBJECTIVETo evaluate the effect of cervical esophagostomy for the treatment of patients with dysphagia induced by radiotherapy, in order to improve the therapeutic effects.

METHODSA retrospective study was performed on 53 nasopharyngeal carcinoma (NPC) patients with dysphagia, who received cervical esophagostomy. The nutritional status of these patients was measured at five given time before and after operation. The occurrence of pneumonia and reflux esophagitis before and after operation was recorded, and the quality of life based on SF-36 quality of life (QOL) scale was studied.

RESULTSAfter operation, the nutritional status of these patients improved substantially, including the weight, levels of hemoglobin, total protein, albumin and transferring (P<0.05). The pneumonia-infection decreased from 60.38% (32/53) before operation to 15.22% (7/46) after operation (χ(2)=21.04, P<0.01). The incidences of reflux esophagitis decreased from 26.42% (14/53)without operation to 6.52% (3/46) after operation (χ(2)=5.00, P<0.01). Meanwhile, the status of physical health, mental health as well as physical function and social function of these patients were improved significantly at 1 month, 6 months, 1 year and 2 years after operation (P<0.05).

CONCLUSIONCervical esophagostomy can improve the life quality of patients with dysphagia induced by radiotherapy for nasopharyngeal carcinoma.

Carcinoma ; Deglutition Disorders ; complications ; surgery ; Esophagitis, Peptic ; complications ; Esophagostomy ; Humans ; Incidence ; Nasopharyngeal Neoplasms ; complications ; radiotherapy ; Pneumonia ; complications ; Quality of Life ; Radiotherapy ; adverse effects ; Retrospective Studies

Objective To evaluate the clinical efifcacy of sorafenib in preventing the recurrence of primary liver cancer after radical surgery. Methods Seventy patients with primary liver cancer undergoing radical surgery in the Third Affiliated Hospital of Sun Yat-sen University between June 2009 and June 2012 were enrolled in this prospective study. The informed consents of all patients were obtained and the local ethical committee approval had been received. According to different postoperative therapies, the patients were divided into the sorafenib group (n=24) and control group (n=46). In the sorafenib group, there were 22 males and 2 females with a mean age of (48±10) years. A dose of 400 mg sorafenib was orally administered twice daily for consecutive 6 months. In the control group, there were 40 males and 6 females with a mean age of (48±11) years. The patients were orally administered with placebo. All patients received postoperative follow-up. Postoperative recurrence rate, survival rate and drug-induced adverse reactions were observed. Postoperative recurrence rate and incidence of adverse reactions of two groups were compared using Chi-square test or Fisher exact probability test. Postoperative survival rate was analyzed by Kaplan-Meier plot and Log-rank test. Results In the sorafenib group, the 1-, 2-and 3-year recurrence rates were 25%(6/24), 42%(10/24), 50%(12/24) respectively, and 28%(13/46), 46%(21/46), 53%(25/46) respectively in the control group. No signiifcant difference was observed between two groups (χ2=0.020, 0.102, 0.120;P>0.05). The 1-, 2-and 3-year cumulative survival rates in the sorafenib group were 95.83%, 87.50%and 70.83%, and no signiifcant difference was observed compared with 91.30%, 82.61%and 63.04%in the control group (χ2=0.078, P>0.05). In the sorafenib group, the incidence of hand-foot skin reaction, diarrhea, hypertension and erythema were 42%(10/24), 29%(7/24), 21%(5/24) and 25%(6/24), which were signiifcantly higher compared with 7%(3/46), 7%(3/46), 2%(1/46) and 4%(2/46) in the control group (χ2=10.663, 4.885, 4.828, 4.762;P<0.05). Conclusion Sorafenib can neither decrease postoperative recurrence of peimary liver cancer after radical surgery nor enhance the overall survival rate.

ObjectiveTo investigate the mechanism of activated hepatic stellate cells (aHSC) promote the angiogenesis of hepatocellular carcinoma (HCC).MethodsaHSCs were collected after being cultured for 1, 3, 5, 7 d respectively . The relative expression of aHSC angiopoietin-1 (Ang-1) messenger ribonucleic acid (mRNA) was detected by real-time fluorescence quantitative polymerase chain reaction (PCR). The expression of aHSC Ang-1 protein was observed by immunolfuorescence staining. The impact of aHSC on the proliferation of hepatic vascular endothelial cells (HVEC) was observed by Transwell chamber. The impact of aHSC on HVEC tube formation was observed by tube formation assay. The experimental data were compared using one-way analysis of variance and LSD-t test.ResultsAfter aHSC were cultured for 1, 3, 5, 7 d, the relative expression of aHSC Ang-1 mRNA was respectively 1.000±0.024, 1.920±0.080, 6.230±0.320 and 7.820±0.380, which gradually increased as the culture time went on (LSD-t=7.32, 13.68, 8.34;P<0.05). The immunolfuorescence staining showed that Ang-1 and smooth muscle actin antibody (aSMA) were co-expressed in the aHSC. Transwell chamber indirect co-culture showed that aHSC could promote the proliferation of HVEC, and the effect weakened after Ang-1 antibody was added. Tube formation assay showed that HVEC could polymerize and gradually developed tubular structure in the aHSC conditioned medium, and the effect signiifcantly weakened after Ang-1 antibody was added. ConclusionaHSC may promote the proliferation and angiogenesis of HVEC in HCC by secreting Ang-1.

OBJECTIVE: To investigate the effect of operation on Benign thyroid nodules with hoarseness as primary symptom. METHOD: Twelve patients were underwent the operation of subtotal thyroidectomy and exposing of recurrent laryngeal nerve. We evaluating the effect by fibrolaryngoscope and voice acoustic analysis before and after operation. RESULT: All the 12 patients underwent surgery successfully. The hoarseness improved obviously and vocal cords were reactivate. Jitter, shimmer and dysphonia severity index showed significant difference pre and one month after surgery. CONCLUSION Benign thyroid nodules could also cause vocal cord paralysis and hoarseness, the effect can be satisfying by subtotal thyroidectomy and exposing of recurrent laryngeal nerve if it can be early diagnosed.
Adult ; Aged ; Female ; Follow-Up Studies ; Hoarseness ; etiology ; Humans ; Male ; Middle Aged ; Thyroid Nodule ; complications ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVE: To define the oncologic efficacy of transoral endoscopic CO2 laser surgery in early glottic carci noma. METHOD: A retrospective study of 112 patients with laryngocarcinoma treated. Surgical treatment included endoscopic CO2 laser cordectomies according to the classification of the European Laryngological Society. After the patients were given the general anesthesia and oral intubation, the tumors in the study group were resected along the margin of the tumor under larynscope, and the safety margin was reserved as 3-5 mm. All the patients were followed-up for 12-62 months. RESULT: Eight relapses were detected in 112 cases of glottic laryngeal carcinoma after CO2 laser surgery. The local recurernce rate was 7.14% (8/112),of the rate for T1a, T1b and T2 were 0.89%, 0.89% and 5.04% respectively, with significant differences among groups (chi2 = 5.306, P < 0.01) . The rate of local recurrence rate of anterior commissure involvement was 7.14% and that was 7.14% when this site was not compromised by the tumor, which has no statistically significant differences (chi2 = 0.000, P > 0.01). CONCLUSION According to our reaserch, endoscopic CO2 laser sur gery is an effective treatment for early laryngocarcinoma.
Adult ; Aged ; Aged, 80 and over ; Carbon Dioxide ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Laryngeal Neoplasms ; surgery ; Laser Therapy ; Lasers, Gas ; therapeutic use ; Male ; Middle Aged ; Treatment Outcome

Objective To review the diagnosis and treatment of severe complications after transcatheter arterial chemoembolization (TACE) of hepatocellular carcinoma (HCC). Methods Clinical data of 15 patients with severe complications after TACE of HCC in Department of General Surgery, Lingnan Hospital, the Third Afifliated Hospital of Sun Yat-sen University from June 2011 to May 2013 were analyzed retrospectively. The informed consents of all patients were obtained and the ethics committee approval was received. There were 12 males and 3 females with age ranging from 40 to 78 years old and the median age of 55 years old. Results Manifestations of cholangitis such as abdominal pain, fever, rising white blood cell etc. were observed in all the patients. According to the clinical manifestations, history of receiving TACE and imaging examinations, 10 cases were diagnosed with biloma after TACE of HCC, 4 cases with liver abscess and 1 case with ischemic cholangitis. All the patients received basic treatments of anti-infection, cholagogue and liver protection. Ten cases with biloma were cured after receiving ultrasound-guided percutaneous transcatheter drainage of biloma, percutaneous transhepatic cholangial drainage (PTCD) and endoscopic nasobiliary drainage (ENBD). Four cases with liver abscess were cured after receiving ultrasound-guided percutaneous transcatheter drainage of liver abscess, local douche with antibiotics. One case with ischemic cholangitis received drainage of 3 catheters of PTCD and the serum bilirubin went down from 500μmol/L to 300μmol/L, but gave up treatment ifnally because of complicating severe biliary infection and gastrointestinal hemorrhage. Conclusions The diagnosis of severe complications after TACE of HCC is mainly based on the clinical manifestations, history of receiving TACE and imaging examinations. The therapies include basic treatments of anti-infection, cholagogue and liver protection etc., and symptomatic treatments of ultrasound-guided percutaneous drainage, PTCD, ENBD, etc.

10.3969/j.issn.2095-4344.2013.26.014