Objective To compare the differences in gut microbiota between cirrhosis patients receiving transjugular intrahepatic portosystemic shunt(TIPS)and those not,and explore the relationship between TIPS surgery and gut microbiota in order to provide new ideas for improving the prognosis of cirrhosis patients after TIPS surgery based on gut microbiota.Methods Those who had received TIPS surgery previously were assigned into the operation group,and those without the surgery served as the control group.Their stool samples were collected for 16S rRNA sequencing,and the correlation between gut microbiota and clinical indicators was analyzed.Results There were no significant differences in gender,age,body mass index(BMI),etiology and other baseline data between the 2 groups(P＞0.05),but obvious differences were observed in clinical serological indicators between them,including INR,APTT,RBC and PT counts,and HGB,ALP,ALB,total bilirubin(TBIL),and URE levels(P＜0.05).No statistical difference in alpha diversity was observed between the operation group and the control group(P＞0.05),but beta diversity was obviously different(P＜0.01),among which Bacteroides was increased in the operation group(P＜0.01)and Bifidobacterium was increased in the control group(P＜0.05).The function prediction analysis of gut microbiota showed that the metabolism of D-glutamine and D-glutamate(P＜0.05)and biosynthesis with secondary bile acids(P＜0.05)were up-regulated in the operation group compared with the control group.Correlation analysis between clinical indicators and flora indicated that TBIL and direct bilirubin(DBIL)were significantly correlated with the metabolic pathways of Bacteroides and Secondary bile acids biosynthesis.Conclusion Characteristic changes in gut microbiota are found in cirrhosis patients with and without TIPS surgery.Bacteroides may be involved in the regulation of metabolism of bile acids and thus increase bilirubin level.

Objective:To study the treatment outcomes of combining percutaneous transhepatic one-step biliary fistulation (PTOBF) followed by two stages cholangioscopic treatment for type Ⅰ and Ⅱa hepatolithiasis which developed after Roux-en-Y cholangiojejunostomy, and in treatment of cholangiojejunostomy stenosis.Methods:The clinical data of 95 patients with type Ⅰ and Ⅱa hepatolithiasis which developed after Roux-en-Y cholangiojejunostomy and were treated at Shandong Second Provincial General Hospital from September 2016 to December 2020 were analyzed retrospectively. There were 36 males and 59 females, with the age of (51.2±15.3) years (range 14 to 75 years). These patients initially underwent PTOBF rigid choledochoscopy, followed by electronic choledochoscopy via the fistula tract after 6-8 weeks. The hepatolithiasis removal, complications and hepatolithiasis recurrence rates, and the cholangio-intestinal anastomotic stenosis rate and treatments were recorded. The follow-up was performed to analyse prognosis.Results:All 95 patients successfully underwent PTOBF rigid choledochoscopy and electronic choledochoscopy via the fistula tract. In 92 patients (96.8%), stones were completely removed. In 3 patients, small amounts of peripheral bile duct stones were left behind. Of 49 patients had cholangio-intestinal anastomotic strictures. On cholangioscopic examination, the strictures were caused by anastomotic knots in the suture line in 25 patients and cicatricial stenosis in 24 patients. After biliary balloon dilation and removal of anastomotic suture line knots, the strictures were relieved in 49 patients. There were 2 patients who developed biliary bleeding and 2 patients pleural effusion after PTOBF rigid choledochoscopy. Hepatolithiasis recurred in 4 patients in 6 to 36 months later.Conclusion:PTOBF followed by two stages cholangioscopic treatment were safe and effective in treatment of type Ⅰ and Ⅱa hepatolithiasis after Roux-en-Y cholangiojejunostomy. A high hepatolithiasis removal rate was obtained. Balloon dilation and removal of biliary intestinal anastomotic suture knots effectively relieved biliary intestinal anastomotic stenosis. The long-term results needs to be further determined.

BACKGROUND:Periprosthetic infection after artificial joint replacement is a disastrous complication for a patient. Currently, during treating for the periprosthetic infection, most of patients need two-stage revision, which bring about enormous physical and psychological pain for patients, and a heavy burden for the families and society. To make matters worse, the effect is not very perfect, and some of these cases require multi-stage revision, even amputation. OBJECTIVE:To investigate the therapeutic effect of vacuum sealing drainage combined with iodophor douche for the infection after artificial joint replacement. METHODS:Nine cases (six knees and three hips) of infection after artificial joint replacement were col ected, with an average age of 63.4 years. Infection occurred at 7 days-14 months, and a median time of 1 month after replacement. Al patients suffered from purulent or purulent blood secretion. Fistula formed in two cases and incision and drainage sites were not healed in one case. According to the bacterial culture results, above symptoms were accorded with clinical diagnosis of prosthesis infection. The prosthesis was remained for debridement. Vacuum sealing drainage was performed. Iodophor douche (30-50 mL) was conducted every day. The drainage tube at proximal end was occluded for 30 minutes, and then vacuum sealing drainage was performed. Al patients were regularly fol owed up to assess the therapeutic effects of vacuum sealing drainage combined with prosthesis infection after replacement. RESULTS AND CONCLUSION:(1) Except that one case was stil in treatment, one case was dead, and one case of tumor prosthesis was failure and final y amputated, the remaining six patients were healed. (2) The time of vacuum sealing drainage and iodophor douche was 10 to 84 days, with the median time of 57 days. No adverse reactions or complications occurred. Al healed patients were fol owed up for 12-60 months, without recurrence. (3) These results indicated that vacuum sealing drainage combined with iodophor douche retained the prosthesis to the greatest degree, is simple, safe, and effective for the infection after artificial joint replacement, needs a low cost, and is a kind of therapy for prosthesis infection after artificial joint replacement.

Objective: To study the UPLC-MS fingerprint of Bupleurum marginatum DC. in northwest Hubei and establish the quality evaluation system for the herb. Methods:A UPLC-MS method was used to analyze 10 samples of B. marginatum DC with the following chromatographic conditions:an ACQUITY UPLC? RBEH C18 column (100 mm × 2. 1 mm, 1. 7 μm) was used, the mobile phase consisted of acetonitrile-0. 3% formic acid water with gradient elution, the flow rate was 0. 2 ml·min-1, and the detection wavelength was 203nm with ESI(-). Results:There were 8 common peaks in the UPLC-MS fingerprint of B. marginatum DC. Through analyzing the information of mass spectrometry and combining the references, 6 peaks were identified. Conclusion:The UPLC-MS fin-gerprint method is simple,rapid and feasible. The acquired UPLC-MS fingerprint of B. marginatum DC. and the evaluation indices can provide the scientific quality assessment of B. marginatum DC.

OBJECTIVE: To summarize the clinical features of epistaxis in the posterior fornix of inferior meatus and its comprehensive treatment measures. METHOD: We collected and retrospectively analyzed the clinical data of 212 cases of epistaxis hospitalized in our department, among which 23 cases were diagnosed as epistaxis in the posterior fornix of inferior meatus. They underwent nasal endoscopic exploration and coagulation surgery with one case under general anesthesia and the other 22 under local anesthesia. The bleeding from olfactory cleft, spheno-ethmoidal recess and the middle nasal meatus were excluded for all the patients during the surgery. After shifting the inferior turbinate inward by fracture, the active bleeding was found in the posterior fornix of inferior meatus, which was stopped immediately by bipolar coagulation. The areas of coagulation and nasal mucosa erosion were packed with nasopore after operation. RESULT: For all the patients, bleeding spots were definitely located during the operation and successfully coagulated. None of them suffered from recurrent-bleeding within 1 week postoperatively. Followed up for 6 to 12 months, there was no epstaxis recurrence or nasal cavity adhesion at the bled side in all patients. CONCLUSION For intractable epistaxis patient, after excluding the bleeding in olfactory cleft, sphenoethmoidal recess and the middle nasal meatus, it should be considered that the bleeding might come from posterior fornix of inferior meatus. It is the key point to thoroughly expose the posterior fornix of inferior meatus by shifting the inferior turbinate inward by fracture and explore for the bleeding spot carefully.
Adult ; Aged ; Epistaxis ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

Objective To investigate the clinical significance of lymphatic mapping and sentinel lymph nodes (SLNs) biopsy in the diagnosis and treatment of gastric cancer. Methods A retrospective analysis was carried out based on the data of 46 patients who had received D2 gastrectomy from January 2003 to June 2006. The SLNs stained by methylene blue were resected for biopsy. Results The success rate of SLNs biopsy was 83% (38/46). The sensitivity, false-negative rate, accuracy, specificity, negative predictive value and positive predic-tive value of SLNs were 69% (18/26), 31% (8/26), 79% (30/38), 100% (12/12), 60% (12/20) and 100% (12/12). The sensitivity, accuracy and negative predictive value were 100% in patients with tumor in pT1 stage or TNM I stage, or with the diameters of the tumors under 4 era. The tumor site, and the degree of lymph node metastasis affected the success rate of biopsy, and the invasion depth, clinical stage and the degree of lymph node metastasis affected the sensitivity, accuracy and negative predictive value of biopsy. Conclusions The application of sentinel lymph node biopsy using methylene blue in gastrie cancer is feasible. The sensitivity, accuracy and reliability are high in patients at early stage of gastric cancer.

BACKGROUND:Tetramethylpyrazine (TMP) can inhibit the expression of vascular endothelial growth factor (VEGF), but it is uncertain that TMP inhibit the growth and proliferation of HL-60 leukemic cells induced by VEGF.OBJECTIVE:To observe the effect of TMP on the proliferation of HL-60 leukemic cells induced by VEGF.DESIGN:Repetitive measurement and observation.SETTING:School of Medicine, Wuhan University of Science and Technology.MATERIALS:The experiment was carried out in the Molecular Biology Laboratory Center, School of Medicine, Wuhan University of Science and Technology from March to June in 2007. Human leukemic cell line HL-60 cells were purchased from Shanghai Institute of Cell Biology. TMP hydrochloride injection was produced by Wuxi Seventh Pharmaceutical Products Limited (Lot number:011014), protamine sulfate injection was produced by Shanghai First Biochemical Pharmaceuticals (Batch number:010302), and immunohistochemistry kit was purchased from Boster company.METHODS:①Human leukemic cell line HL-60 cells at log phase were used for the experiments. Cells were treated with 100 μg/L VEGF, and then TMP at final concentrations of 1.5, 15, 150 mg/L was added into culture medium. While the cells in medium without TMP were taken as blank control group, and the cells in medium with 20 mg/L protamine as positive control group. Meanwhile cells without treatment of VEGF were served as VEGF control group. After cells were incubated for 48 hours, the growth inhibiting rate of HL-60 cells was detected by MTT assay.②After HL-60 cells were treated with TMP at the final concentrations of 1.5, 15, 150 mg/L for 24 hours, the protein expression of VEGF in HL-60 cells was examined by SP immunohistochemistry.MAIN OUTCOME MEASURES:①Growth inhibiting rate of HL-60 cells.②Protein expression of VEGF.RESULTS:①Growth inhibiting rate of HL-60 cells:After HL-60 cells induced by VEGF were treated with 15 and 150 mg/L TMP, the absorbance value was significantly lower than that in VEGF control group (P < 0.05).②Protein expression of VEGF:After HL-60 cells were treated with TMP for 24 hours, the protein expression of VEGF was down-regulated with increasing TMP concentration in a dependent manner. Significant differences were observed in the protein expression of VEGF between cells treated by TMP and the controls (P < 0.01).CONCLUSION:shRNA, by targeting hTERT mRNA, has no noticeable influence on growth and proliferation of hMSCs, and might be safe for the somatic cells which are normal but do not express hTERT.

Objective To summarize the current value of neoadjuvant chemotherapy(NAC) for potentially resectable gastric cancer.Methods The recent 5-year literatures searched through the PubMed with the key words:stomach neoplasm,gastric cancer/carcinoma,neoadjuvant therapy/chemotherapy and preoperative therapy/chemotherapy as well as the relevant reports presented in the ASCO Annual Meeting in 2007 and 2008 were analyzed.The present status of NAC for advanced gastric cancer was summarized,the necessity and feasibility were evaluated,and the patients features for selecting,the predictors for response,the mainly existing problems and development trend of NAC were analyzed.Results At present,there were 7 randomized control trails(RCT) published,and among them 3 were phase Ⅲ.It was safe,effective and feasible to most of trails in NAC for gastric cancer.However,it was still little to obtain survival benefit for NAC RCT,and short of randomized trial comparing strict preoperative chemotherapy to surgery alone or perioperative chemotherapy to surgery plus adjuvant chemotherapy.It remained lots of problems such as how to select the appropriate patients,the effective induced regimes and the predicted factors,the evaluated indices for response.Conclusion NAC is a safe,feasible and efficient method to potentially resectable gastric cancer,but strict phase Ⅲ randomized trials are needed.In the future,substantial improvements of treatment outcome will likely depend on the novel drugs and molecular biological targeted therapies.

OBJECTIVE: Analysis of the correlation between telomerase and expression of its related proteins may provide insight into the molecular mechanism of nasopharyngeal carcinogenesis. Here, we investigate the effect of short hairpin RNA (shRNA) specific for human telomerase reverse transcriptase (hTERT) mRNA on the expression of proliferating cell nuclear antigen (PCNA) and Caspase-3 in nasopharyngeal carcinoma (CNE) cells. METHOD: shRNA expression vectors targeting the mRNA of hTERT were constructed. Cells were treated with the constructed expression vectors and telomerase activity was measured by telomeric repeat amplification ELISA (TRAP-ELISA). Cell viability was examined using the MTT assay. Cell apoptosis was detected by TUNEL method. The expression of PCNA and Caspase-3 proteins, was determined by Western blotting. RESULT: shRNA specific for hTERT mRNA significantly inhibited telomerase activity, suppressed cell viability and induced apoptosis in CNE cells. In addition, the expression of PCNA was inhibited, while the expression of Caspase-3 was up-regulated. CONCLUSION Our results suggest that shRNA directed against hTERT inhibits cell viability by regulating telomerase activity and its related protein expression in NPC cells. Therefore, RNA-interfering technology may be a promising strategy for the treatment of nasopharyngeal cancer.
Caspase 3 ; metabolism ; Cell Line, Tumor ; Cell Survival ; Humans ; Nasopharyngeal Neoplasms ; genetics ; metabolism ; Proliferating Cell Nuclear Antigen ; metabolism ; RNA, Small Interfering ; Telomerase ; genetics ; Transfection

OBJECTIVE: To investigate the expression and clinical significance of RAD51 in laryngocarcinoma. METHOD: The expression of RAD51 in laryngocarcinoma and polyp of vocal cord tissues were determined by immunohistochemical staining. The results were analyzed and compared with the clinical stage, lymph node metastasis and pathologic grade. RESULT: (1) The expression of RAD51 in laryngocarcinoma group was extremely stronger than that in polyp of vocal cord group (P < 0.01). (2) There was significant difference for RAD51 expression in cancer cells between earlier clinical stage group and advanced clinical stage group (P < 0.01). (3) There was significant difference for RAD51 expression in different pathologic grades (P < 0.05). (4) There was also significant difference for RAD51 expression between groups with and without lymph node metastasis. CONCLUSION RAD51 may play a critical role in tumorigenesis of laryngocarcinoma. RAD51 may be a potential marker for clinical diagnosis and treatment of Laryngocarcinoma. It may be significant in predicting clinical stage, pathologic grade and metastasis.
Female ; Humans ; Laryngeal Neoplasms ; metabolism ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Polyps ; metabolism ; pathology ; Prognosis ; Rad51 Recombinase ; metabolism ; Vocal Cords ; pathology