Sepsis is a complex syndrome caused by multiple pathogens and involves multiple organ failure, particularly spleen dysfunction. In 2017, the worldwide incidence was 48.9 million sepsis cases and 11 million sepsis-related deaths were reported (Rudd et al., 2020). Inflammation, oxidative stress, and apoptosis are the most common pathologies seen in sepsis. Liensinine (LIE) is a bisbenzylisoquinoline-type alkaloid extracted from the seed embryo of Nelumbo nucifera. Lotus seed hearts have high content of LIE which mainly has antihypertensive and antiarrhythmic pharmacological effects. It can exert anti-carcinogenic activity by regulating cell, inflammation, and apoptosis signaling pathways (Manogaran et al., 2019). However, its protective effect from sepsis-induced spleen damage is unknown. In this research, we established a mouse sepsis model induced by lipopolysaccharide (LPS) and investigated the protective effects of LIE on sepsis spleen injury in terms of inflammatory response, oxidative stress, and apoptosis.
Mice ; Animals ; Lipopolysaccharides/pharmacology* ; Spleen ; Inflammation ; Apoptosis ; Sepsis ; Oxidative Stress

Objective:To analyze the effectiveness and immunogenicity of enterovirus-A71(EV-A71) vaccine in immunization program.Methods:A cohort study was conducted in immunization clinics in Jing’an district in Shanghai from October to December 2017. Children who received EV-A71 vaccine based on a 2-dose schedule (on day 0 and day 30) were enrolled as vaccine group and those who received no EV-A71 vaccine were enrolled as control group. After 1-year follow-up, the effectiveness and neutralizing antibody level and the positive results of antibody immunogenicity in vaccine group were analyzed.Results:A total of 3 018 children aged 8-20 months were enrolled, in whom 1 211 were in vaccine group and 1 807 were in control group. The vaccine effectiveness was 100% against EV-A71-associated hand, foot, and mouth disease (HFMD) indicated by 1 year follow-up (95 %CI: -66.99%-100.00%). The geometric mean titer of neutralizing antibody (GMT) was 41.76 (95 %CI: 35.60-49.34) at day 60 and 28.44(95 %CI: 23.59-34.54) at day 365 in 124 children in vaccine group. Conclusions:In children, EV-A71 vaccine elicited EV-A71-specific immune response. Less EV-A71-associated HFMD cases have been observed, further observation is needed.

OBJECTIVE： To study the effects and mechanism of Le’ermai capsule on oxidative stress injury in the cerebral cortex of cerebral ischemia-reperfusion injury rats. METHODS： Totally 65 rats were randomly divided into sham operation group （normal saline）， model group （normal saline）， positive control group （Naoxintong capsule， 3.40 g/kg）， Le’ermai capsule high-dose and low-dose groups （0.37， 0.18 g/kg）， with 13 rats in each group. Except that sham operation group received sham operation， and middle cerebral artery occlusion/reperfusion （MCAO/R） model was induced by suture-occluded method. 24 h after modeling， they were given relevant medicine intragastrically， once a day， for consecutive 7 d. 2 h after last administration， cerebral ischemic area was determined by TTC staining. The pathological changes of cerebral tissue were observed by HE staining. The protein expressions of HO-1， SOD1， SOD2 and Nrf2 in cerebral cortex were detected by Western blot assay. RESULTS： Compared with sham operation group， the area of cerebral ischemic was increased significantly in model group（P＜0.05）， interstitial edema was serious， inflammatory cell infiltration increased significantly； and the protein expression levels of HO-1 and SOD1 in cortex tissue were significantly increased （P＜0.05）， and the protein expression levels of SOD2 and Nrf2 were significantly decreased （P＜0.05）. Compared with model group， the area of cerebral ischemic area of Le’ermai capsule high-dose and low-dose groups were significantly decreased （P＜0.05）. The interstitial edema， inflammatory cell infiltration and microcytes proliferation were decreased. The protein expression levels of HO-1， SOD1， SOD2 and Nrf2 in the cerebral cortex tissue were significantly increased （P＜0.05）. CONCLUSIONS：Le’ermai capsule can improve cerebral ischemia/reperfusion injury to certain extent， and which may be associated with up-regulating the protein expression of antioxidant factors HO-1， SOD1， SOD2 and Nrf2 in the cortex.

The quality and safety of traditional Chinese medicines directly affect the development of the entire Chinese medicine industry. Establishing and improving traceability systems for Chinese medicine quality will play a decisive role in improving the quality of Chinese medicine. The traceability system of Chinese herbal medicines as an important part of the quality traceability system of traditional Chinese medicine overcomes the inability of existing technologies to achieve traceability, control, and queryability of information on the whole process of planting Chinese medicinal materials. The recording, inquiry and traceability of important information to track and supervise the whole process of cultivation of Chinese herbal medicines is an effective measure to realize the availability, retrievability and accountability of Chinese medicines, and to strengthen quality safety management and risk control throughout the entire process.

Objective To investigate the prognostic factors of renal cell carcinoma and to establish a prognostic model for patients with non-metastasis renal cell carcinoma (RCC) after operation.Methods We retrospectively reviewed the clinical data of patients with RCC who underwent radical or partial nephrectomy from January 2008 to December 2012,including 392 males (67.6％) and 188 females (32.4％),with an average age of 56 years(range 24-86 years).The average diameter of tumor was 4.8 cm (range 1.5-17.5 cm).The pathological slides of tumor tissue were reviewed by pathologist,and the tissue microarray (TMA) were constructed.The immunohistochemical staining of TMA were carried out.All patients were followed up the prognosis information of the overall survival (OS),cancer specific survival (CSS) and progression free survival (PFS).Based on these data,univariate and multivariate analysis and survival analysis were performed.Independent prognostic factors related to different follow-up endpoints of patients were screened out.A Nomogram prognostic model for RCC was established and verified.Internal validation were performed by boots value analysis.Results Among 580 cases,160 cases (27.6％) accepted nephron sparing surgery and 420 cases (72.4％) radical nephrectomy,included 514 cases (88.6％) of laparoscopic surgery and 66 cases (11.4％) of open surgery.There were 468 cases of clear cell carcinoma (80.7％),56 cases of papillary carcinoma (9.7％),32 cases of chromophobe cell carcinoma (5.5％),24 patients with other subtypes of cancer cells (4.1％).In pathological staging,stage Ⅰ,Ⅱ,Ⅲ,Ⅳ were 442 cases (76.2％),88 cases (15.2％),48 cases (8.3％),2 cases (0.3％),respectively.There were 424 cases (73.1％) with high expression of CA9,and 156 cases (26.9％) with low expression.The median followup was 66 (4-82) months,and 41 cases (7.1％) were lost of follow-up.For 3 and 5 years,OS,CSS and PFS were 83.4％,88.2％,72.4％ and 69.6％,73.0％,55.8％ respectively.Multivariate analysis showed that tumor pathological subtypes,tumor stage,tumor diameter and positive expression of carbonic anhydrase 9 (CA9) were independent prognostic factors associated with the survival of RCC patients.The Nomogram prognostic model was established by the above four factors.The established Nomogram prognostic model for RCC patients was verified by Harrell's consistency index,and the c-index of OS,CSS and PFS of RCC patients were 0.72 (95％ CI 0.69-0.75),0.77 (95％ CI 0.74-0.81),0.79 (95％ CI 0.76-0.83),respectively.Conclusions Tumor pathological subtypes,staging,tumor diameter and CA9 are independent risk factors for patients with non metastatic renal cell carcinoma.The established Nomogram prognostic model certified by internal validation should be tested by large samples and multicenter studies need tested.

Objective To discuss the significance of three-dimensional reconstruction as a method of preoperative planning of laparoscopic radiofrequency ablation (LRFA).Methods Thirty-two cases of LRFA admitted from January 2014 to December 2015 in Department of Hepatobiliary Surgery,Chinese People's Liberation Army General Hospital were analyzed (3D-LRFA group).Three-dimensional (3D) reconstruction were taken as a method of preoperative planning in 3D-LRFA group.Other 64 LRFA cases were paired over the same period without three-dimensional reconstruction before the operation (LRFA group).Hepatobiliary system contrast enhanced CT scan of 3D-RFA patients were taken by multi-slice spiral computed tomography(MSCT),and the DICOM data were processed by IQQA(R)-Liver and IQQA(R)-guide to make 3D reconstruction.Using 3D reconstruction model,diameter and scope of tumor were measured,suitable size (length and radiofrequency length) and number of RFA electrode were chosen,scope and effect of radiofrequency were simulated,reasonable needle track (s) was planed,position and angle of laparoscopic ultrasound (LUS) probe was designed and LUS image was simulated.Data of operation and recovery were collected and analyzed.Data between two sets of measurement data were compared with t test or rank sum test,and count data with x2 test or Fisher exact probability test.Tumor recurrence rate was analyzed with the Kaplan-Meier survival curve and Log-rank (Mantel-Cox) test.Results Compared with LRFA group ((216.8±66.2) minutes,(389.1 ±183.4) s),3D-LRFA group ((173.3 ±59.4) minutes,(242.2 ± 90.8) s) has shorter operation time(t =-3.138,P =0.002) and shorter mean puncture time(t =-2.340,P =0.021).There was no significant difference of blood loss (P =0.170),ablation rate (P =0.871) and incidence of complications(P =1.000).Compared with LRFA group ((6.3 ± 3.9)days,(330 ± 102)U/L,(167 ±64) ng/L),3D-LRFA group ((4.3 ± 3.1) days,(285 ± 102) U/L,(139 ± 43) ng/L) had shorter post-operative stay(t =-2.527,P =0.016),less post-operation ALT changes (t =-2.038,P =0.048) and post-operative TNF-αt changes (t =-2.233,P =0.027).Disease-free survival between two groups was significantly different (x2 =4.049,P =0.046).Disease-free survival of 12 months survival rates were 77.6％ and 65.7％ in 3D-LRFA group and LRFA group,respectively.The median disease-free survival was 16.0 months in LRFA group and over 24.0 months in 3D-LRFA group.Conclusions Three-dimensional model of liver reconstruction based on image information is a powerful tool in liver surgery planning.It helps to simulate tumor location and vital tubular structure,make plan for interventional treatment,and therefore mean puncture time and operation time is shortened,influence on liver function is reduced,hospital stay is decreased and DFS is prolonged.

Objective To discuss the significance of three-dimensional reconstruction as a method of preoperative planning of laparoscopic radiofrequency ablation (LRFA).Methods Thirty-two cases of LRFA admitted from January 2014 to December 2015 in Department of Hepatobiliary Surgery,Chinese People's Liberation Army General Hospital were analyzed (3D-LRFA group).Three-dimensional (3D) reconstruction were taken as a method of preoperative planning in 3D-LRFA group.Other 64 LRFA cases were paired over the same period without three-dimensional reconstruction before the operation (LRFA group).Hepatobiliary system contrast enhanced CT scan of 3D-RFA patients were taken by multi-slice spiral computed tomography(MSCT),and the DICOM data were processed by IQQA(R)-Liver and IQQA(R)-guide to make 3D reconstruction.Using 3D reconstruction model,diameter and scope of tumor were measured,suitable size (length and radiofrequency length) and number of RFA electrode were chosen,scope and effect of radiofrequency were simulated,reasonable needle track (s) was planed,position and angle of laparoscopic ultrasound (LUS) probe was designed and LUS image was simulated.Data of operation and recovery were collected and analyzed.Data between two sets of measurement data were compared with t test or rank sum test,and count data with x2 test or Fisher exact probability test.Tumor recurrence rate was analyzed with the Kaplan-Meier survival curve and Log-rank (Mantel-Cox) test.Results Compared with LRFA group ((216.8±66.2) minutes,(389.1 ±183.4) s),3D-LRFA group ((173.3 ±59.4) minutes,(242.2 ± 90.8) s) has shorter operation time(t =-3.138,P =0.002) and shorter mean puncture time(t =-2.340,P =0.021).There was no significant difference of blood loss (P =0.170),ablation rate (P =0.871) and incidence of complications(P =1.000).Compared with LRFA group ((6.3 ± 3.9)days,(330 ± 102)U/L,(167 ±64) ng/L),3D-LRFA group ((4.3 ± 3.1) days,(285 ± 102) U/L,(139 ± 43) ng/L) had shorter post-operative stay(t =-2.527,P =0.016),less post-operation ALT changes (t =-2.038,P =0.048) and post-operative TNF-αt changes (t =-2.233,P =0.027).Disease-free survival between two groups was significantly different (x2 =4.049,P =0.046).Disease-free survival of 12 months survival rates were 77.6％ and 65.7％ in 3D-LRFA group and LRFA group,respectively.The median disease-free survival was 16.0 months in LRFA group and over 24.0 months in 3D-LRFA group.Conclusions Three-dimensional model of liver reconstruction based on image information is a powerful tool in liver surgery planning.It helps to simulate tumor location and vital tubular structure,make plan for interventional treatment,and therefore mean puncture time and operation time is shortened,influence on liver function is reduced,hospital stay is decreased and DFS is prolonged.

OBJECTIVETo analyze the clinicopathological characteristics and the factors affecting the prognosis of intrahepatic biliary cystadenocarcinoma (IBC).

METHODSForty-six patients with histologically confirmed IBC from January, 2000 to April, 2014 were included. The clinical characteristics of the patients with IBC were compared with those of 58 patients with intrahepatic biliary cystadenoma (IBCA). Kaplan-Meier analysis was used to identify the factors affecting the prognosis of IBC.

RESULTSThe 46 patients with IBC included 15 men and 31 women with a mean age of 57.0 ± 10.5 years. Compared with the patients with IBCA, IBC patients had an older mean age (57.0 ± 10.7 vs 44.3 ± 15.3 years, P=0.03) and a greater proportion of male patients (15/46 vs 8/58, P=0.02). The differential diagnosis between IBC and IBCA was difficult on the basis of preoperative laboratory and imaging findings. The median overall survival of IBC patients was 56 months with 1-, 3-, and 5-year survival rates of 85.9%, 65.2%, and 47.7%, respectively. Gender, surgical approach, tumor growth pattern and distant metastasis were all significant prognostic factors for the overall survival of the patients.

CONCLUSIONIBC is a rare cystic lesion occurring primarily in middle-aged men. Complete resection is recommended for curative treatment and close follow-up is essential especially for male patients and patients with tumors exhibiting an invasive growth.

Adult ; Aged ; Bile Duct Neoplasms ; pathology ; Bile Ducts, Intrahepatic ; pathology ; Cystadenocarcinoma ; pathology ; Diagnosis, Differential ; Diagnostic Imaging ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Prognosis ; Retrospective Studies

OBJECTIVETo describe the treatment and prognosis of solid pseudopapillary neoplasms (SPN) with metastases or recurrence.

METHODSThe clinical date of 24 patients with histological confirmed SPN with metastases or recurrence from January 2000 to April 2014 were retrospectively analyzed. There were 22 females and 2 males, with mean age of (36 ± 16) years. Fourteen patients had local recurrence or metastasis after surgery, with a mean time of recurrence (44 ± 29) months. Ten patients were defined SPN with distant metastasis at first admission. Nineteen patients underwent surgical resection, among them, 11 patients received complete resection. Nine cases underwent chemotherapy. Kaplan-Meier method was used to identify prognostic factors.

RESULTSTwenty-four patients were followed-up, 9 patients died. Median survival time was 47 months, and 1-year, 3-year, and 5-year survival was 91.7%, 65.1%, 49.6%, respectively. Age (χ(2) = 6.858, P = 0.009), primary tumor diameter (χ(2) = 4.322, P = 0.038), extrahepatic metastasis (χ(2) = 5.279, P = 0.022) and complete resection of metastases and recurrence (χ(2) = 4.666, P = 0.031) were important prognostic factors for survival (P < 0.05).

CONCLUSIONSFor SPN with metastases or recurrence, good prognosis can also obtain after complete resection. Age, primary tumor diameter, extrahepatic metastasis and complete resection of metastases and recurrence are influence factors on prognosis of patients.

Adult ; Antineoplastic Combined Chemotherapy Protocols ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; surgery ; Pancreatic Neoplasms ; pathology ; surgery ; Prognosis ; Retrospective Studies ; Survival Rate ; Young Adult

This study was aimed to optimize the extraction process of resveratrol by central composite design (CCD) and response surface method (RSM), based on the result of single factor experiment. Resveratrol was extracted from Polygonum cuspidatum by water bath extraction of organic solvent. And content of resveratrol was taken as index in the investigation of solvent concentration effect, extraction time and solvent content on extraction process. The results showed that the optimum condition was 12.7 times amount of 72.0% ethanol and extract for 2 times under the temperature of 50℃, 1.1 h for each time; the average deviation between the maximum theoretical value and measured value was 0.83%. It was concluded that this extraction process was highly predictive, which provided experimental evidence for the industrial production of P. cuspidatum extraction.