Abstract:Objective To investigate the effect of T cell Ig and mucin 1 (TIM-1) on MUC5AC and Th2 cytokine expression in the airway of asthmatic mice, so as to understand the mechanism of airway mucus hypersecretion.Methods Thirty healthy female C57BL/6 mice were randomly divided into control，asthmatic and TIM-1 mAb treated groups, with 10 mice in each group. The proportion of TIM-1 positive cells in peripheral blood mononuclear cells (PBMCs), MUC5AC mRNA expression in the airway, levels of IL-13, IL-4 and IL-5 in bronchoalveolar lavage fluid (BALF), and the number and volume of airway mucous cells were examined in the three groups. Results The proportions of PBMCs TIM-1 positive cells in asthmatic(11.20%) and TIM-1 mAb treated (5.11%) mice were significantly higher than that in the control group (0.64%, P<0.05), and that in TIM-1 mAb treated mice was significantly lower than that in the asthmatic mice (P<0.05). (2) MUC5AC mRNA expression in the airway mucous cells in the asthmatic (17.3±1.4) and TIM-1 mAb treated (5.6±0.3) mice were significantly higher than that in control mice (P<0.05). The BALF levels of IL-13 (ng/ml), IL-4 (pg/ml), and IL-5 (pg/ml) were 16.80±0.63, 614.72±117.39, and 1 681.13±613.55 in the asthmatic, and were 5.70±0.64, 325.78±86.54, and 513.42±86.87 in TIM-1 mAb treated mice, respectively, which were all significantly higher than those in the control mice ([1.09±0.25] ng/ml for IL-13, [17.56±3.01] pg/ml for IL-4, and [30.78±9.67] pg/ml for IL-5, P<0.05). And all the above parameters in the TIM-1 mAb treated mice were significantly lower than those in the asthmatic mice (P<0.05). (3) MUC5AC and IL-13 expression in the airway was positively correlated with TIM-1 positive cells in asthmatic mice (r1=0.946, P1=0.004; r2=0.984, P2=0.000). Conclusion TIM-1 positive cells are increased in PBMCs in asthmatic mice, which can result in airway mucous cell metaplasia and mucus hypersecretion. Inhibition of TIM-1 expression can reduce mucus hypersecretion. Regulation of TIM-1 might be a novel approach for asthma treatment.

Abstract:Objective To explore the role of integrin β1 and relevant signaling pathway in acquired resistance to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) gefitinib in non-small cell lung cancer (NSCLC). Methods Human lung adenocarcinoma cell line PC-9 and gefitinib-resistant PC-9/G cell lines were used in the present study. Western blotting analysis was used to examine the expression of integrin β1, Akt and phospho-Akt protein. The inhibitory effects of gefitinib and/or hosphoinositide 3-kinase (PI3K) inhibitor LY294002 and extracellular regulated protein kinases (ERK) inhibitor PD98059 on cellular proliferation were tested by MTT assay. Cell apoptosis was analyzed by Annexin Ⅴ/PI and TUNEL method.Results Overexpression of integrin β1 was observed in PC-9/G cell line. Silencing integrin β1 by RNAi method inhibited the proliferation and promoted apoptosis of PC-9/G cells. The inhibitory effect of gefitinib against Akt phosphorylation in PC-9/G cells was weaker than that in PC-9 cells. Knockdown of integrin β1 with RNAi decreased the phosphorylation level of Akt.ERK inhibitor PD98059 failed to restore the sensitivity of PC-9/G cells to gefitinib. PI3K inhibitor LY294002 could restore the sensitivity of PC-9/G cells to gefitinib. Conclusion It is suggested that overexpressed integrin β1 can activate the downstream signaling pathways through PI3K, which may be an important mechanism for resistance to EGFR-TKIs.

Abstract:Objective To investigate the effects of ursolic acid (UA) on leptin-induced NADPH oxidase (NOX) subunits p47Phox expression and ERK1/2 pathway activation of rat hepatic stellate cells (HSC-T6), and to observe the cells proliferation and collagen Ⅰ synthesis. Methods Culture-activated HSC-T6 cells were divided into six groups: normal control group received no treatment; leptin group received recombinant rat leptin (100 ng/ml); the four intervention groups were pretreated with UA(50 μmol/L), JAK inhibitor AG490 (50 μmol/L), NOX inhibitor DPI(20 μmol/L), and ERK inhibitor PD98059 (30 μmol/L) for 30 min, and then stimulated with leptin for different time periods. Western blotting analysis was used to examined the expression of p47Phox protein translocation to the cell membrane, total cellular p47Phox protein and phosphorylated ERK1/2 (p-ERK1/2) protein. Collagen Ⅰ mRNA expression was detected by RT-PCR and cell proliferation was examined by MTT assay. Results Expression of p47Phox membrane protein was significantly increased compared with the normal control 30 min after leptin stumulation (P<0.01), and p-ERK1/2 protein expression was also significantly increased correspondingly (P<0.05). UA, AG490, DPI and PD98059 inhibited the p47Phox protein translocation to membrane and ERK1/2 protein phosphorylation in HSC-T6 cells. Compared with normal control group, leptin stimulation for 12 h significantly up-regulated collagen Ⅰ mRNA expression in HSC-T6 cells (P<0.01); UA, AG490, DPI and PD98059 treatment inhibited collagen Ⅰ mRNA expression in HSC-T6 cells compared with the leptin group (P<0.01). Proliferation rates of HSC-T6 cells were significantly higher at 12, 24 and 48 h after leptin stimulation compared with the control group (all P<0.01); UA, AG490, DPI and PD98059 treatment inhibited leptin-induced cell proliferation at different time points (all P<0.01), with the inhibitory effect of UA being significantly weaker than that of DPI (P<0.01). ConclusionUA can inhibit leptin-induced proliferation of HSC-T6 cells and collagen Ⅰexpression, which might be associated with the inhibition of NOX subunit p47Phox translocation to the cell membrane and the ERK1/2 pathway activation.

Abstract:Objective To evaluate the role of autophagy in doxorubicin-induced apoptosis of Raji cells.Methods Raji cells were treated with different concentrations of doxorubicin. Western blotting analysis was used to observe the expression of autophagy-related protein during doxorubicin-induced cell death, and MDC staining was applied to detect autophgosomes and autolysosomes in Raji cells. Cell viability and apoptosis of Raji cells were examined by MTT assay and flow cytometry after the cells were treated with doxorubicin in combination with PI3K pathway inhibitor 3-MA or autolysosome inhibitor NH4Cl. Results Doxorubicin treatment significantly increased LC3Ⅱ expression and the intensity of MDC staining in Raji cells compared with the control group (P<0.05),indicating that doxorubicin can induce autophagy of Raji cells. Compared with the control group, doxorubicin treatment significantly inhibited cell growth and induced apoptosis of Raji cells (P<0.01). PI3K pathway inhibitor 3-MA or autolysosome inhibitor NH4Cl further enhanced the efficacy of doxorubicin in inhibiting cell growth and inducing apoptosis of Raji cells(P<0.05, P<0.01).Conclusion Doxorubicin can induce cell autophagy when killing Raji cells, and inhibition of autophagy can enhance the killing effect of doxorubicin against Raji cells.

Abstract:Objective To investigate the inhibitory effect of exogenous carbon monoxide-releasing molecule 3 (CORM-3) on activation of the renal dendritic cells (rDCs) and the underlining mechanism. Methods Kidneys harvested from C57BL/6J mice were made into single cell suspension. CD11c + rDCs were then sorted by magnetic cell sorting (MACS) and the purity was assessed by flow cytometry.The rDCs were treated by CORM-3 or inactive CO-releasing molecule (iCORM) together with lipopolysaccharides (LPS). The expression of TLR4 gene was detected by quantitative real-time PCR. TNF-α protein levels in the rDCs culture were determined by ELISA. In addition, TLR4-/-(C3H/HeJ) or TLR4+/+(C3H/HeN) mice were subjected to 30 min bilateral kidney ischemia and 24-h cold preservation. The rDCs were then isolated to detect the expression of TNF-α gene in cells by quantitative real-time PCR. Results CORM-3 significantly inhibited the expression of TLR4 mNRA in immature rDCs in a dose-dependent manner(P<0.05). Compared with iCORM, CORM-3 significantly suppressed the expression of TNF-α in rDCs after LPS stimulation (P<0.01); however, this inhibitory effect of CORM-3 was abrogated in TLR4-/-mice. ConclusionCORM-3 can greatly inhibit TLR4 expression in immature rDCs,and it can also suppress proinflammatory cytokine expression induced by LPS stimulation or ischemia and cold preservation, but not in TLR4 knockout mice, suggesting that CORM-3 suppresses rDCs activation through TLR4 pathway.

Abstract:Objective To reprogram human hepatocellular carcinoma cell Huh7 into pluripotent stem cells. Methods Four recombinant lentiviruses individually carrying Oct4, Sox2, Nanog, and Lin28 were constructed and used to co-infect Huh7 cells in vitro. Post infection, the obtained pluripotent stem-like cells were identified by Alkaline phosphatase staining, immunofluorescence assay, quantitative-PCR and immunohistochemistry. The differentiation capability of the cells was examined by teratogencity test. Results Pluripotent stem-like cell colonies (iHuh7) were observed in cultured Huh7 cells after lentivirus-based induction. These colonies were positive for alkaline phosphatase staining and immunofluorescence assay showed expression of pluripotent factors: Oct4 and TRA-1-60. Quantitative-PCR indicated that several endogenous pluripotency-associated genes and stem cell-specific microRNAs were highly expressed in these pluripotent stem-like cells. In vivo differentiation test showed that iHuh7 cells could lead to teratogencity. ConclusionHuh7 cells can be induced into pluripotent stem-like cells mediated by lentiviruses individually carrying Oct4, Sox2, Nanog, and Lin28.

Abstract:Objective To use liposomal siRNA for silencing UbcH10 gene in human lung squamous carcinoma cell line NCI-H226 and to observe the changes of cell proliferation and cell cycle after silencing. Methods Three siRNA sequences targeting different sites of UbcH10 CDS were designed, and the shRNA recombinant plasmids were constructed. The recombinant plasmids were transfected into NCI-H226 cells via lipofectamine2000. UbcH10 mRNA and protein expression was examined by RT-PCR and Western blotting analysis 48 h after transfection, respectively. The viability of NCI-H226 cells was measured using CCK-8 at 24 and 48 h after transfection with the effective siRNA vector, and the cell cycle was detected by flow cytometry 48 h after transfection. Results The recombinant shRNA plasmids were successfully constructed and transfected into NCI-H226 cells. UbcH10 gene mRNA and protein were noticeably decreased in the three groups 48 h after transfection, with the inhibitory effect of No. 2 siRNA sequence (pshRNA2) being the strongest one(86%). The proliferative activity of NCI-H226 cells was significantly decreased 24 and 48 h after the transfection with the pshRNA2 compared with the control group (P<0.05). Compared with the control group, NCI-H226 cells were blocked in G2 phase 48 h after the transfection with pshRNA2 (P<0.05).ConclusionUbcH10 gene silencing can significantly inhibit the proliferative activity of NCI-H226 cells and block the cells in G2 phase.

Abstract:Objective To investigate the regulatory effect of TNF-α on netrin-1 expression and the related mechanism. Methods The expression of netrin-1 was examined by RT-PCR and Western blotting analysis in HEK-293 cells treated with TNF-α. The netrin-1 gene promoter was amplified by PCR and was cloned into pGL3 basic vector. Then the purified pGL3-netrin-1-promoter was transfected into HEK-293 cells, the luciferase activity of netrin-1 gene promoter was detected by luminometer, and the regulatory effect of TNF-α on netrin-1 expression was observed. Results It was confirmed that TNF-α increased expression of netrin-1. pGL3-netrin-1-promoter vector was successfully constructed as confirmed by sequencing. The pGL3-netrin-1-promoter vector was confirmed to have the promoter activity as confirmed by the luciferase system. The activity of netrin-1 promoter was increased significantly in HEK-293 cells after treated with TNF-α (P<0.05), and the increase was in a time- and concentration-dependent manner. ConclusionTNF-α can regulate netrin-1 expression through modulating netrin-1 promoter activity.

Abstract:Objective To study the effects of positive polarity electret combined with different concentrations of azone in promoting the transdermal delivery of cyclosporin A, so as to explore the feasibility and the rule of electret combined with chemical enhancers in promoting transdermal delivery. Methods Cyclosporin A was used as the model drug in the present study. Positive polarity electret was prepared using corona charge technique. Franz diffusion cell system and HPLC techniques were applied to investigate the roles of positive polar electret, azone of different concentrations and their combination in promoting penetration of cyclosporin A in vitro． Results Satisfactory penetration promoting effects for cyclosporin A was observed in excised skin 24 h after exposure to +500 V , +1 000 V and +2 000 V electret. Compared to the control group, 1%, 3%, and 5% azone promoted the steady-state penetration rates of cyclosporin A by 6.72, 2.11, and 1.43 folds after 24 h exposure. Combination of +1 000V electret plus 1% azone showed better penetration promoting effect than other combinations, but electret with different positive charges and different concentrations of azone showed no synergistic effect in promoting cyclosporin A penetration. ConclusionPositive polarity electret has a penetration promoting effect for transdermal delivery of cyclosporin A. Positive polarity electret and azone show no synergistic effect on promoting penetration of cyclosporin A.

Abstract:Objective To investigate the influence of metformin on AMP-activated Protein Kinaseα2 (AMPK α2) expression in adipose tissue and oxidative stress indices in diabetic rats, so as to understand the possible mechanism of metformin in improving blood glucose control, oxidative stress and insulin-resistance. Methods Totally 32 male SD rats were randomly divided into normal control (NC) group (n=12), model (T2DM) group (n=10) and metformin group (n=10). Rat model of T2DM was established by high fat/high glucose diet (one month) and intraperitoneal injection of streptozotocin (30 mg/kg). Animals in the metformin group were given 50 mg/(kg·d)( i.g.), and those in the other two groups were given same dose of 0.5% HPMC solution. The body masses of rats were determined before and after treatment. The fasting blood glucose (FBG), fasting insulin (FINS), superoxide dismutase (SOD), glutathione (GSH), N-acetyl-beta-D-glucosaminidase (NAG), malonaldehyde (MDA), myeloperoxidase (MPO), monoamine oxidase (MAO), total cholesterol (TC), triacylglycerol (TG), low-density lipoprotein cholesterol (LDL) and high-density lipoprotein cholesterol (HDL) levels were measured by ELISA and Biochemical Analyzer; the ratio of fat to body weight and insulin sensitivity index (ISI) were calculated. RT-PCR was used to evaluate the expression of AMPK α2 mRNA in the adipose tissues. Results Compared with DM group, metformin group had significantly higher AMPK α2 mRNA expression, serum GSH, SOD, ISI and HDL, and significantly lower serum FINS, FBG, NAG, MDA, MPO, MAO, TC, TG and LDL (P<0.05). ConclusionMetformin can increase AMPK α2 expression in the adipose tissue of diabetic rats, regulate glucose metabolism, and improve insulin sensitivity and oxidative stress.

Abstract:Objective To explore the value of AKR1B10 combined with GPC-3 in improving the sensitivity and specificity of immunohistochemical diagnosis of hepatocellular carcinoma (HCC). Methods The microarray including 75 HCC and adjacent tissues was subjected to immunohistochemistry detection of AKR1B10 and GPC-3 expression. A Logistic regression diagnostic model was established using the results of tissue microarray (training group). The ROC curves (the receiver-operating characteristic curve) and area under the curve (AUC) were used to evaluate the sensitivity and specificity of AKR1B10, GPC-3 or their combination. The Logistic regression diagnostic model was validated with 200 HCC and adjacent tissues (testing group). Results For the training group, the AUC values of AKR1B10, GPC-3, and AKR1B10 combined with GPC-3 were 0.773, 0.800, and 0.931, respectively. The sensitivity of AKR1B10 and GPC-3 were 56% and 61.3%, respectively, and their specificity was both 98.7%. AKR1B10 combined with GPC-3 yielded a sensitivity of 88.0% and a specificity of 97.3%.For the testing group, sensitivity and specificity of AKR1B10 combined with GPC-3 were 97.0% and 96.5%, respectively. Conclusion AKR1B10 combined with GPC-3 can greatly improve the sensitivity and specificity of HCC immunohistochemical diagnosis, and it should be used when necessary in addition to the routine pathological assessment.

Abstract:Objective To evaluate the diagnostic accuracy of 320-detector row CT coronary angiography(CTCA)in detecting preoperative coronary artery disease (CAD) in patients with atrial fibrillation (AF) and rheumatic left artrioventricular valve disease (RMVD), so as to assess its feasibility in screening CAD before operation for RMVD. Methods Thirty-five RMVD patients with persistent CAD were enrolled in the present study. All the patients underwent both CTCA and conventional coronary angiography (CCA) before operation. The relationship between mean heart rate and CT image quality was evaluated by Pearson’s correlation coefficient. The sensitivity, specificity, positive predictive value(PPV) and negative predictive value (NPV) of CTCA in diagnosis of stenosis (≥50%) were calculated using the conventional coronary angiography as the reference. Kappa statistics was used to assess the agreement between 320-detector CTCA and CCA in detecting CAD. Results The mean heart rate was 94.7±21.4 beats/min in the 35 patients. There was a significant correlation between the mean heart rate and image quality, especially for middle segment of right coronary artery(r=0.554,P=0.002) and middle segment of the circumflex artery (r=0.559,P=0.016). The sensitivity, specificity, PPV and NPV of CTCA in diagnosing CAD were 87.5%, 99.4%, 82.4% and 99.6% in segment-based analysis, 87.5%, 97.6%, 82.4% and 98.4% in vessel-based analysis, and 84.6%, 86.3%,78.6% and 90.5% in patient-based analysis, respectively. The kappa statistics were 0.843, 0.828 and 0.699, respectively. ConclusionCTCA has a high accuracy in diagnosing CAD, and it can be used for preoperation screening of patients with AF and RMVD.

Abstract:Objective To assess the factors influencing the early and mid-term survival of patients receiving a second replacement of the left atrioventricular valve, so as to provide guidance for clinical practice. Methods We retrospectively analyzed 55 patients who underwent a second replacement of the left atrioventricular valve between Jan. 2005 and Dec. 2010 at Changhai Hospital. Their survival rate and its risk factors were analyzed. The control group included patients who received their first left atrioventricular valve replacement at the same hospital and had matched age, sex, and operation time. Univariate and multivariate Cox survival analyses were used to assess the survival risk factors at 30 days and 3 years after operation. Results The 30-day, 1-year, 3-year and 5-year survival rates of patients after reoperation were 92.7%,89.1%,83.6%,and 81.8%, respectively, which were not significantly different from those of the control group(94.5%, 92.7%, 90.9%, and 87.3%, respectively). The left ventricular ejection fraction was the only independent predictor of 30-day survival of patients after reoperation(P=0.018,RR=15.33). Diabetes mellitus and left ventricular ejection fraction were the independent predictors of 3-year survival (P=0.039,RR=6.242 and P=0.001,RR=91.957, respectively). ConclusionThe early and mid-term mortality rates are not significantly different between the first and second replacement of left atrioventricular valve. Left ventricular ejection fraction is the only independent predictor of early-term survival after re-replacement of left atrioventricular valve; diabetes mellitus and left ventricular ejection fraction are the independent predictors of mid-term survival.

Abstract:Objective To investigate the impact of percutaneous coronary intervention (PCI) on plasma brain natriuretic peptide (BNP) levels and ventricular remodeling in patients with acute right ventricular myocardial infarction (ARVMI) combined with left ventricular inferior wall myocardial infarction (LVIWMI) or anterior wall myocardial infarction (LVAWMI). Methods Totally 207 patients with ARVMI combined with LVAWMI or LVIWMI were included in the present study. The patients were divided into two groups: ARVMI plus LVIWMI (n=159) and ARVMI plus LVAWMI(n=48). The plasma BNP levels, myocardium enzyme, hemodynamic indices and coronary artery disease were compared between the two groups. The plasma BNP level, left ventricular ejection fraction (LVEF) and left ventricular end diastolic diameter (LVEDd) were observed in patients before and after primary PCI or delayed PCI treatment and in those receiving no PCI. Results We found that the plasma BNP level, CK and CK-MB peak value, pulmonary artery systolic pressure, degree of infarct-related coronary artery and incidence of 2-branch involvement in ARVMI plus LVAWMI group were significantly higher than those in the ARVMI plus LVIWMI group (P<0.05). The plasma BNP levels and LVEDd were significantly decreased in patients after treatment with primary PCI or delayed PCI (P<0.05), and the plasma BNP level was significantly lower and improvement of LVEDd was significantly greater in patients receiving primary PCI(P<0.05). Patients receiving no PCI treatment had a significantly higher mortality compared with those receiving primary or delayed PCI(P<0.05). ConclusionPatients with ARVMI plus LVAWMI have higher level of BNP and more severe coronary symptoms. There are noticeable improvement of ventricular remodeling in patients receiving primary PCI, and they also have greatly decreased plasma BNP level.

Abstract:Objective To investigate the effect of sirolimus (SRL)-based immunosuppression regimen on the survival and tumor recurrence in liver transplantation recipients with hepatocellular carcinoma beyond the standard Milan criteria. Methods We retrospectively analyzed 22 patients who received liver transplant in our hospital for HCC beyond the standard Milan criteria from June 2010 to June 2011. Eleven patients received tacrolimus for immunosuppression after liver transplant and the other 11 were converted from tacrolimus to SRL-based immunosuppression. The incidence rate of acute rejection, tumor-free survival period, blood routine, liver function and complications were compared between the two groups. Results The incidence rates of acute rejection were not significantly different between the two groups after a mean follow-up of (12±3) months (range, 7-18 months). Four patients in the SRL group and eight patients in tacrolimus group had HCC recurrence and metastasis. Kaplan-Meier recurrence-free survival curves demonstrated that SRL group had a significantly longer HCC recurrence-free survival than tacrolimus group(P<0.05). Compared with tacrolimus group, SRL group had significantly lower leukocyte and platelet counts (P<0.05). The tacrolimus-related nephrotoxicity was modestly improved in all the three patients after converted to SRL. Two patients suffered oral ulcers after conversion to SRL treatment and no severe complications such as arterial thrombosis were observed. ConclusionSRL can be effectively used for liver transplant recipients with hepatocellular carcinoma beyond the standard Milan criteria; it can achieve a similar anti-rejection effect to tacrolimus and can greatly reduce tumor recurrence.

Abstract:Objective To investigate pathogens, antibiotics sensitivity and prognosis of dialysis-associated polymicrobial peritonitis, so as to provide evidence for prevention and treatment of polymicrobial peritonitis. Methods A total of 151 peritoneal peritonitis episodes in 81 patients, who received dialysis in our department between January 2008 and September 2010, were analyzed in the present study. The causative pathogens, antibiotics sensitivity and prognosis of polymicrobial peritonitis were retrospectively reviewed in these patients. Results Pathogenic culture of effluent peritoneal dialysate was positive in 98(64.9%) of the 151 peritoneal peritonitis episodes, and 20(13.2%) epidoses were polymicrobial peritonitis. The organisms isolated from the effluent peritoneal dialysate included mixed Gram-positive and Gram-negative organisms (30%), mixed Gram-positive and fungi (30%), mixed Gram-negative and fungi (15%), pure Gram-positive organisms (15%), pure Gram-negative organisms infection (5%), and pure fungi (5%). The sensitive rates of Gram-positive organisms in the polymicrobial peritonitis were 100% to vancomycin, 61% to cefazolin sodium, and 52% to levofloxacin; and those of Gram-negative organisms were 100% to meropenem, 100% to cefoperazone-sulbactam, 70% to gentamycin, and 60% to ceftazidime. Fifteen (75%) of the 20 polymicrobial peritonitis episodes were cured and continuously received peritoneal dialysis. One (5%) patient died and 4 (20%) were converted to permanent hemodialysis. ConclusionPolymicrobial peritonitis in our group has been mainly caused by mixed infection of Gram-positive and Gram-negative organisms, mixed infection of Gram-positive organisms and fungi. The Gram-positive organisms are sensitive to vancomycin, and Gram-negative organisms are sensitive to meropenem and cefoperazone-sulbactam. Earlier catheter removal is necessary for fungal peritonitis or refractory peritonitis.

Abstract:Objective To create a simple model for teaching laparoscopic partial nephrectomy(LPN) in a simulated continuous blood supply setting and to introduce the main technical points of the procedure. Methods A fresh porcine kidney was placed on an unfolded metallic box,and the renal artery was infused with red-dyed water to simulate the blood supply of the kidney. The specially designed metallic box could not only fix and position the kidney, but also store the outflow of the kidney while the artery was kept artificially infused. The trainees were required to excise about 2 cm spherical renal parenchyma tissue and to suture the pelvis and renal parenchyma. The trainees had a similar laparoscopic competency and they all completed the dry laboratory training programs. During a 20-day training period, the trainees were assessed by the time periods they needed to complete LPN. The procedure and the quality of the LPN were monitored by the training mentors.Results The mean operating time decreased from (46.1±1.64) min (range, 43-49 min) before training to (27.9±1.79) min (range, 25-31 min) after training (P<0.001). The operating time required for suture-repairing the pelvis and renal parenchyma began to decrease after performing the fourth procedure, with the time decreased from (30.4±1.82) min to (19.4±1.16) min (P<0.001). The mean quality score increased from 2.02±0.19 at the beginning to 4.41±0.14 at the end of the training (P<0.001). The increase of the quality score was faster during the first five procedures. All the trainees became confident in performing a high quality LPN after completing ten procedures. ConclusionThe present model with isolated porcine kidney is simple and economic. It can offer the trainees the opportunities to learn all the skills necessary for LPN.

Abstract:Objective To investigate the changes of plasma decorin in patients with acute ischemic stroke and its clinical significance. Methods The plasma levels of decorin were assessed in 102 patients with acute ischemic stroke (< 7 days) and 120 control subjects using ELISA. Then we evaluated the relationship between decorin level and the TOAST subtypes of stroke, so as to analyze the role of decorin level in diagnosis and treatment of acute ischemic stroke. Results Compared with the control group, the decorin level was significantly decreased in acute ischemic stroke group (P<0.001), and that in the large-artery atherosclerosis group was lower than those in other groups of the same level. According to the receiver operating characteristic curve, decorin level was a diagnostie marker for acute ischemic stroke (P<0.001). Decorin levels <8 500 pg/mL yielded a sensitivity of 79.4% and a specificity of 62.8% for diagnosis of acute ischemic stroke. Logistic regression indicated that decorin level <8 500 pg/ml was an independent risk factor of acute ischemic stroke (OR=4.8; 95%CI: 2.1-11.1; P<0.001). ConclusionDecorin level is significantly decreased in patients following acute ischemic stroke. The changes of decorin level can contribute to the diagnosis and treatment of acute ischemic stroke.

Abstract:Periostin is a newly identified mesenchyme-specific gene encoding a protein of 835 amino acids, with a molecular size about 90 000. Periostin can promote proliferation and differentiation of osteoblasts, recruitment and attachment of osteoblast precursors, and migration of stromal smooth muscle cells. Periostin can be found in many normal tissues in humans, and it is over-expressed in lung caner, colon cancer, liver cancer, esophagus cancer, breast cancer, ovarian cancer, and so on. Periostin can promote neoplasm growth and angiogenesis and may serve as a biomarker of epithelial-mesenchymal transition (EMT). Moreover, the role of periostin in cancer invasion and metastasis is gaining increasing attention and has yielded some progress.

Abstract:Lipidomics, a newly emerged branch of metabolomics, is aimed to systemically study the characters of lipid molecular species in organisms and their roles in regulating protein and gene expression. Lipids play diverse biological roles in organisms, including energy storage, signal transduction and apoptosis. Owning to the rapid progression of novel analytical technique, especially the application of mass spectrometry, lipid examination can be done rapidly and accurately in a high throughput manner. Many studies have demonstrated that abnormal metabolism of lipids is closely related to the development and progression of tumors. Application of lipidomics technique can reveal the changes of tumor-associated lipid and identify the abnormal metabolic pathways. Also, lipidomics has a promising future in recognition of lipid-based tumor markers, early diagnosis of tumors and the discovery of antineoplastic drug targets. In this article, we reviewed the recent progress in the above-mentioned areas.

Abstract:Astrocyte elevated gene 1 (AEG-1), an important oncogene, has been confirmed to play a crucial role in progression (invasion, metastasis, angiogenesis and chemoresistance, etc) of multiple cancers. Over the past decade, studies have shown that AEG-1 is overexpressed in cancers involving almost all organs, including neuroblastoma, melanoma, HCC, breast, prostate cancer, etc. Moreover, AEG-1 is associated with multiple pathways including PI3K/Akt and nuclear factor-κB (NF-κB). This review mainly outlines the multiple regulating role of AEG-1 in the development and progression of tumor and to discuss its role as a novel target for treatment of malignant tumors.

Abstract:Objective To discuss the reasons and management of renal vein injury during percutaneous nephrostolithotomy (PCNL). Methods From 2007 to 2008 renal vein injury was caused in two patients by malposition of nephrostomic catheter in our hospital. The two patients were both males, aged 61 years old and 41 years old. They underwent PCNL due to left kidney stones. The percutaneous nephrostomy (PCN) catheters were malpositioned into the left kidney vein and vena cava, which was confirmed by prograde radiography and spiral CT scan after operation. The PCN catheter in the 41 years old patient was pulled back to renal collecting system on the 7th day, and was extracted on the 10th day under X-ray monitoring. The PCN catheter in the 61 years old patient was pulled back to the renal collecting system on the 14th day and was extracted on the 18th day under X-ray monitoring. Results The bleeding was controlled and the hemodynamic status was stable in the two cases after removal of PCN catheters. There was no renal arteriovenous fistula bleeding, surgical intervention, kidney infections or further damage of kidney function. Conclusion Renal vein injury during the PCNL can be managed by clamping the PCN catheter and gradual withdrawal. The method is safe and reliable, and it can avoid surgical intervention.

Abstract:Objective To study the effects of scopolamine hydrobromide orally disintegrating tablets (DTs) based nanospheres-particles (NiMS) system on the neurological behaviors in mice, so as to provide evidence for clinical administration. Methods The 3 tests in this study were all divided as following: twenty male and 20 female mice were each randomly divided into 4 groups, with 5 mice in each group. Then a female and a male group were merged into one group, so there were 4 groups, each containing 10 mice. The four groups were subjected to the following treatments: control, high dose (24 mg/kg), moderate dose (15 mg/kg) and low dose DTs (6 mg/kg). To study the effects of DTs on the balance capacity, we selected 40 mice with the ability to climb the bar from 50 mice. (1) The spontaneous activities of mice were observed and recorded 20 min after intragastric administration of DTs in each group. (2) Pentobarbital sodium was intraperitoneally injected in mice 20 min after intragastric administration of DTs to observe the sleep of mice, so as to evaluate the synergistic effect between the two drugs. (3) Mice were put on the top of a stainless bar 20 min after intragastric administration of DTs and the time spent by the mice from top to the bottom of bar was recorded to evaluate the impact of the medication on mouse balance capacity. Results (1) DTs at each dose had no significant influence on the spontaneous activity of mice compared with the controls (P>0.05). (2) The sleep time of mice increased with the dose of DTs, and there were significant difference between control group with high dose and moderate dose groups (P<0.05). (3) DTs shortened the time spent by mice from top to the bottom of the bar compared with the control group, with significant differences found in female mice taking three doses of DTs (P<0.01) and in male mice taking high and moderate dose of DT (P<0.01, P<0.05). Conclusion Intragastric administration of DTs has no influence on spontaneous activity of mice, and its synergistic effect with pentobarbital sodium increases with dose. DTs can also decrease the balancing capacity of mice.

Abstract:Objective To evaluate the effect of intravenous dexamethasone on postoperative pain of microvascular decompression. Methods Totally 80 patients receiving elective microvascular decompression were randomized into two groups, with placebo or dexamethasone (10 mg, iv) given before the induction of anesthesia. The patients were generally anesthetized and the postoperative pain was managed with iv fentanyl using patient-controlled analgesia. The visual analog scale scores were recorded for pain at 2, 4, 6, 12 and 24 h after surgery and the side effects were also observed. Results The visual analog scale scores in the dexamethasone group were significantly lower than those in the placebo group at all time points(P<0.05). The total dose of fentanyl (0-24 h after surgery) and the frequency of analgesic use in the dexamethasone group were significantly lower than those in the placebo group(P<0.05). The incidence of nausea and vomiting in the dexamethasone group was lower than that in the placebo group(P<0.05).Conclusion Dexamethasone (iv) before anesthesia induction can intensify the analgesic effect of fentanyl, with less side effects.

Abstract:Objective To study the role of intramuscular phloroglucinol injection in relieving pain of aged patients undergoing hysterescopy. Methods Totally 130 aged patients (aged from 60 to 76 years old) undergoing hysteroscopy were evenly randomized into the phloroglucinol group and placebo group．The phloroglucinol group received phloroglucinol (80 mg i.m.) 5 min before undergoing hysteroscopy; the placebo group received intramuscular injection of normal saline (8 ml)．The pain degrees were measured by visual analog scales (VAS) in the two groups. The heart rate，blood pressure，and saturation of blood oxygen were observed before and 5 min after entering hysteroscope. Results The VAS score of phloroglucinol group was significantly lower than that in the placebo group (2.8±1.5 vs 5.1±2.1, P<0.05). The heart rate of the placebo group was significantly faster at 5 min after hysteroscopy compared with that before hysteroscopy (88.7±18.3/min vs 75.8±18.9/min, P<0.05)．There were no significant differences in the blood pressure and saturation of blood oxygen between the two groups. Conclusion Intramuscular injection of phloroglucinol can alleviate the pain in aged female patients undergoing hysteroscopy.

Abstract:Objective To investigate the effect of the standing position on the amplitudes of QRS waves of 12-lead electrocardiogram (ECG). Methods The ECG was recorded in the supine and standing positions in 60 hospitalized patients or out-patients, and the amplitudes of Q, R, and S waves of all 12 ECG leads were measured and compared between the two positions. Results In inferior leads, the amplitudes of Q waves and R waves in leads Ⅱ, Ⅲ and aVF recorded in standing position were significantly deepened or increased, and S waves in lead Ⅲ recorded in standing position were significantly shallowed compared with those in the supine position(P<0.05). In lateral leads, the amplitudes of Q waves in leads Ⅰ and V5-6, S waves in leads Ⅰ and aVL recorded in the standing positions were significantly shallowed compared with those in the supine positions; R waves in leads Ⅰ and aVL recorded in the standing positions were decreased compared with those in the supine position (P<0.05). In thoracic leads, the amplitudes of R waves in leads V1-4 recorded in the standing position were significantly decreased compared with those in the supine position; the S waves in leads V1-3 waves recorded in the standing position were significantly shallowed compared with that in the supine position(P<0.05); and the R waves of lead aVR recorded in the standing position was significantly increased compared with that in the supine position (P<0.05). Conclusion The amplitudes of QRS waves of ECG are different when recorded in the standing and supine positions.

Abstract:Objective To investigate the association of depression with glycosylated hemoglobin, lipid metabolism and coping style in patients with type 2 diabetes mellitus (DM). Methods A total of 73 patients with type 2 DM were divided into depression group (n=31) and non-depression group (n=42) according to the Results of Zung Self-Rating Depression Scale. The anxiety statuses were evaluated by Zung Self-Rating Anxiety Scale(SAS). The coping style was assessed by Medical Coping Modes Questionnaire (MCMQ). Moreover, the blood HbA1c, triglycerides (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C) were also compared between the two groups. Results The SAS standard score and MCMQ score of resignation in the depression group were significantly higher than those in the non-depression group (P<0.01). The MCMQ score of confronce and avoidance, blood HbA1c, TG, TC, HDL-C, and LDL-C were not significantly different between the 2 groups. Conclusion It is suggested that type 2 DM patients with resignation coping style are more liable to have depression.

Abstract:Objective To observe the clinical effect of oral administration of Fufangejiao liquid after drug-induced abortion. Methods A total of 120 women within 7 weeks' of gestation, who needed to terminate pregnancy and asked for drug-induced abortion, were evenly randomized into two groups: experimental group and control group. The experimental group was given Fufangejiao liquid (20ml, tid, for 7 days) after the drug-induced abortion; the control group was given Chanfukang particles (10g, tid, for 7 days) after drug-induced abortion. The drug-induced abortion and amount of bleeding were observed in the two groups. Results (1) The complete abortion rate was 90.0%(54 cases) in the experimental group and 86.7% (52 cases) in the control group. (2) There were 88.9%(48/54 cases) of the patients in the experimental group and 76.9% (40/52) in the control group had a similar bleeding amounts to the usual menstrual amount. There were 9.3%(5 cases) of the patients in the experimental group and 19.2%(10 cases) in the control group had more bleeding (≤1 fold) than the usual menstrual amount(P<0.05). (3)The days of bleeding, bleeding amount, and menstrual onset were similar in the two groups. Conclusion Administration of Fufangejiao liquid after drug-induced abortion can reduce the amount of bleeding after abortion and is therefore worth popularizing.

Abstract:趋化因子及其受体是近年来肿瘤相关研究的热点之一,研究表明趋化因子可能在包括穿入血管、锚定、穿出血管、免疫逃逸、增殖并血管生成等过程中发挥重要作用[1]。趋化因子受体3（CXCR3）及其配体已被证实在多种肿瘤的发生发展、转移过程中有重要作用[2-4]。CXCR3高表达的恶性肿瘤细胞可能通过迁徙至表达其配体的特异性靶器官,从而导致肿瘤发生转移[5]。研究发现CXCR3与肾细胞癌的血管生成和肿瘤的生长、转移、预后等有关[6]。本研究应用高通量的组芯技术和免疫组织化学染色法检测肾癌组织和对应癌旁正常肾组织中CXCR3的表达,分析其与肾癌临床病理特征的关系,初步探讨CXCR3作为肾癌治疗及预后分子靶标的可能价值。

Abstract:N-亚硝基化合物是环境以及食物中广泛存在的一类化学物质,迄今已发现300多种，这类化合物对动物的致癌性已经得到广泛的实验证实,至今尚未发现一种动物对这类化合物具有抵抗力[1]。

Abstract:体外受精-胚胎移植(IVF-ET) 是辅助受孕技术的主要类型,为确保受孕成功,往往需要移植多个受精卵至宫内,致使多胎妊娠比例大大增加,其中又以双胎妊娠为主。因此,客观评价IVF-ET受孕双胎的妊娠结局,对发现经IVF-ET受孕双胎的高危情况及指导经IVF-ET受孕双胎的孕期保健具有重要意义。为此,本研究回顾性分析2009年2月至2011年7月在本院分娩的35岁以下经IVF-ET受孕双胎孕妇(92例)的妊娠期并发症及新生儿结局,并与同期在本院分娩的同年龄段自然受孕双胎孕妇(218例)进行比较,现将结果报道如下。

Abstract:ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)是目前临床上较为常见的一种心肌梗死类型,及时和正确的诊断对其治愈具有重要意义。心电图和心肌生化标志物(血清酶)检查是目前诊断心肌梗死的主要手段,尤其是后者具有重要的临床指导价值[1]。