Abstract:Hepatocellular carcinoma (HCC) is one of the most frequently diagnosed malignancies and the third leading cause of cancer-related deaths in the world. China is known as "the country with the highest prevalence of liver cancer", and more than half of the cases of HCC worldwide occur in China. Recently, immunotherapy for HCC has drawn wide attention owing to its satisfying effects on specific solid malignancies. Both basic and clinical researches on immunotherapy for HCC have made some progress, which has laid a foundation for future clinical application of immunotherapy in HCC patients. The main immunological strategies for HCC include adoptive immunotherapy, indirect immunotherapy, and indirect non-immunological therapy. Despite the potential benefits for HCC, challenges and obstacles of immunotherapy remain, such as the self-tolerance immune mechanism of the liver and the lack of ideal target antigen. In a word, the application of immunotherapy for HCC in clinical practice is a tough task to accomplish and a long way to go.

Abstract:Objective To explore the causes of nocturnal hemodialysis (NHD) patient dropout and the risk factors for dropout. Methods We collected the clinical data of patients receiving NHD for more than 3 months, of whom 47 patients dropped out and 64 kept receiving NHD from Feb. 2009 to Nov. 2016 in Changzheng Hospital of Second Military Medical University. We investigated the general conditions; and we compared the differences of the blood parameters between the two groups when the patients received NHD for the first time and for the last time, including hemoglobin, platelet, albumin, ferritin, serum calcium, serum phosphorus and parathyroid hormone. We also analyzed the risk factors for NHD dropout or for death using Cox regression analysis model. Results Among 111 patients, 47 patients had withdrawn from NHD, with their average time for NHD being (31.55±20.30) months, and the causes for dropout included death, transferring to other hospitals, turning to conventional hemodialysis (CHD), renal transplantation and others. Univariate Cox regression analysis showed that hypertensive nephropathy (P=0.007, HR=2.913, 95%CI: 1.348-6.293) and diabetic nephropathy (P=0.047, HR=2.401, 95%CI: 1.014-5.685) were risk factors for NHD patient dropout, while chronic nephritis syndrome (P<0.001, HR=0.095, 95%CI 0.046-0.195) was a protective factor; blood albumin (P=0.007, HR=0.904, 95%CI:0.840-0.973) and age (P=0.027, HR=1.052, 95%CI:1.006-1.101) were risk factors for NHD patient dropout. Multivariate Cox regression analysis showed that albumin level (P=0.007, HR=0.911, 95%CI: 0.848-0.991) was an independent risk factor for death in NHD patients. Conclusion Hypertensive nephropathy and diabetic nephropathy are the risk factors for NHD patients dropout, while chronic nephritis syndrome was a protective factor. Low serum albumin level is an independent risk factor for death in NHD patients.

Abstract:Objective To compare the difference of mortality risk between patients undergoing nocturnal hemodialysis (NHD) and conventional hemodialysis (CHD) and to explore the related factors of mortality. Methods The study cohort comprised the maintenance hemodialysis patients receiving either NHD (n=111) or CHD (n=722) in Changzheng Hospital of Second Military Medical University from Feb. 2009 to Feb. 2017. The demographic information, clinical characteristics, survival status, causes of death and laboratory examination indexes were obtained from hemodialysis management system. The urea clearance index (Kt/V), hemoglobin, blood phosphorus concentration and mortality were compared between NHD and CHD patients. The multivariate-adjusted Cox model was used to analyze the mortality risk of all patients. Results Compared with the patients receiving CHD, the proportion of male was more in the NHD group, and the baseline age was younger (P<0.01) and baseline dialysis vintage was longer (P<0.01). There was no significant difference in incidences of primary disease and comorbidities, or laboratory examination results. Compared with the CHD group, the levels of Kt/V and hemoglobin in the NHD group were significantly higher (P<0.01), and the blood phosphorus concentration was significantly lower (P<0.05). Mortality in the NHD and CHD groups was 3.5 per 100 patients-years and 6.2 per 100 patients-years, respectively. After the adjustment by baseline age, dialysis vintage, gender, and comorbidities, Cox model analysis showed that the mortality risk in the NHD group was lower than in the CHD group (HR=0.67, 95%CI:0.39-1.00, P=0.05). Subgroup analysis showed NHD was of more survival benefit for male (P<0.05), non-diabetic patients (P=0.05) and patients with conventional dialysis vintage >3 years (P<0.05). Conclusion NHD can effectively increase the solute clearance, improve anemia and calcium and phosphate metabolism, and thus reduce the mortality risk of maintenance hemodialysis patients.

Abstract:Objective To compare the differences of dialysis complications and tolerability between nocturnal hemodialysis (NHD) and conventional hemodialysis (CHD) patients. Methods Seventy-two NHD and 72 CHD patients from Changzheng Hospital of Second Military Medical University were enrolled in this study. The clinical data were collected and the postdialysis recovery time was recorded. The complications including intradialytic hypotension, postdialytic fatigue, itching, muscle spasms, dizziness, headache, loss of appetite, nausea, vomiting, and sleep disorders, and the mental pressure and daily life (fear of death, worrying about equipment failure, losing freedom, and failing to work) were all investigated using a questionnaire. Results Patients in the NHD group had significantly shortened postdialysis recovery time (P<0.01) and significantly less complications (intradialytic hypotension, postdialytic fatigue, itching, dizziness, headache, loss of appetite, nausea and vomiting) than those in the CHD group (P<0.05, P<0.01). The number of patients who lost freedom significantly was decreased (P<0.01), but the number of patients worrying about equipment failure was significantly increased (P<0.01). Conclusion The NHD patients have less complications associated with hemodialysis than CHD patients, and they also have improved tolerance to maintenance hemodialysis.

Abstract:Objective To investigate the occupational risk of nurses in nocturnal hemodialysis (NHD), and to analyze the relevant factors and coping approach to occupational risk. Methods The occupational risk of 25 nurses at conventional hemodialysis (CHD) and 25 nurses at NHD were investigated using Nursing Occupational Risk Assessment Questionnaire. The Likert Scale 5-grade method was used to score the questionnaire, to obtain occupational risk index, and to analyze the relevant risk factors. Results The scores in 3 dimensions, including accidental risk, chemical risk, and ergonomical, psychosocial and organizational risk, in the NHD nurse group were significantly higher than those in the CHD nurse group (P<0.05). The average risk index scores of the harzard of irregular working hours, interpersonal relation disturbance, frequent shift work, overtime, and night shift, and the hazard of understaffing and overworking were in the top 2 of each sub events, and they belonged to the risks which were order not allowed. Conclusion The average risk index of the nurses at NHD is higher than at CHD, and the formative factors are specific. Hospital managers should take active measures to prevent and reduce the occupational risk.

Abstract:Hemodialysis is one of the main treatment methods for patients with end stage renal disease (ESRD), and conventional hemodialysis (CHD) is the most widely used one. With the development of dialysis technology, the survival time of hemodialysis patients is significantly prolonged, but the mortality remains high. Nocturnal hemodialysis (NHD) was proposed in 1963 as a new type of dialysis, and it has greatly extended time of dialysis as compared with CHD. NHD has advantages in controlling blood pressure and cardiovascular function, correcting anemia, improving calcium and phosphorus metabolism and nutritional status, and enhancing quality of life of hemodialysis patients.

Abstract:Objective To explore the effect of systemic low-level light therapy (LLLT) on early inflammatory response of severe burn rats. Methods Fifty SD rats were randomly divided into control group, burned model group, single short-term LLLT group, single long-term LLLT group and the repeated short-term LLLT group, with 10 rats in each group. After burning the rats in the single short-term LLLT group, the single long-term LLLT group and the repeated short-term LLLT group were treated by low-intensity LED irradiation (640 nm) for 5 min once a day, 15 min once a day and 5 min three times a day, respectively.The levels of tumor necrosis factor α (TNF-α), interleukin (IL)-1β and IL-6 and the leukocyte count in caudal vein were determined at 1 day before modeling, immediately after modeling and on the 1^st, 3^rd, 7^th and 14^th day after modeling; and the wound area was measured on the 3^rd, 7^th and 14^th day after modeling. The wound healing rate was calculated. Results Compared with the control group, the serum TNF-α levels in the burned model and single short-term LLLT groups were significantly increased on the 1^st day after modeling (P<0.05), and the serum TNF-α levels in the single long-term LLLT group on the 1^st day and the repeated short-term LLLT group on the 7^th day were significantly increased (P<0.05); the serum IL-1β levels were significantly decreased on the 1^st day after modeling in all groups (P<0.05), and then gradually recovered with the varied recovery rates; the serum IL-6 levels in the burned model and the repeated short-term LLLT groups were significantly increased on the 1^st day after modeling (P<0.05), then decreased; and the decrease of the burned model group was greater than that of the repeated short-term LLLT group. While the serum IL-6 level was increased on the 3^rd day in the single short-term LLLT group, then decreased; and the level was significantly increased in the single long-term LLLT group (P<0.05). Leukocyte counts of the burned model and the single long-term LLLT groups were significantly increased on the 1^st day after modeling (P<0.05), and it had no significant change in the other groups. The wound healing rate in the single short-term LLLT group, the single long-term LLLT group and the repeated short-term LLLT group was significantly higher than that in the burned model group (P<0.05). Conclusion Systemic LLLT use can reduce the serum levels of TNF-α, IL-1β and IL-6 and leukocyte count in caudal vein of the severe burning rats and promote wound healing, with the effects varied with different irradiation modes.

Abstract:Objective To explore the risk factors of brain metastasis after radical resection of colorectal cancer within 5 years. Methods We retrospectively analyzed the clinical data of 1 104 patients with colorectal cancer in the Department of Colorectal Surgery of Changhai Hospital of Second Military Medical University from Jan. 2003 to Dec. 2011. Thirty of 1 104 cases (2.7%) had brain metastasis. All patients received radical resection of colorectal cancer, and the rectal cancer patients followed the total mesorectal excision (TME) principle. According to the TME stage, the patients of stage Ⅱ or later were treated with capecitabine combined with oxaliplatin (XELOX) or fluorouracil plus oxaliplatin (FOLFOX) chemotherapy. The clinicopathological features that might affect post-operative brain metastasis, including gender, age, tumor location, pre-operative serum carcino-embryonic antigen (CEA) level, tumor histological type, depth of tumor invasion, lymph node metastasis, pulmonary metastases and liver metastases, were analyzed by univariate analysis using Chi square test. Multivariate analysis was performed to search for the independent risk factors of brain metastasis from colorectal cancer using logistic regression. Results Univariate Chi square test indicated that the relative factors associated with the brain metastasis of colorectal cancer within 5 years were tumor location (χ²=5.844, P=0.016), pre-operative CEA level (χ²=5.395, P=0.020), tumor histological type (χ²=4.950, P=0.026) and with pulmonary metastasis (χ²=52.569, P=0.000). Multivariate analysis showed that the tumor location (OR=0.278, 95%CI:0.095-0.817, P=0.020), pre-operative CEA level (OR=0.423, 95%CI:0.192-0.933, P=0.033) and with pulmonary metastasis (OR=10.814, 95%CI:4.705-24.856, P=0.000) were the independent risk factors of brain metastasis of colorectal cancer within 5 years. Conclusion Patients with rectal cancer, higher pre-operative CEA level and pulmonary metastasis have a high risk of brain metastasis of colorectal cancer within 5 years.

Abstract:Objective To compare the effects of genistein, bosentan, and tadalfil in treatment of monocrotaline-induced pulmonary arterial hypertension (PAH) in rats. Methods Monocrotaline-induced PAH SD-rat model was established by injecting monocrotaline (50 mg/kg) intraperitoneally (n=48), while the rats in control group (n=8) were given normal saline injection. Then all model rats were randomly divided into 6 groups (n=8) according to different drugs given by gavage after 3 weeks:PAH group (PAH rats were treated with normal saline), genistein G₃₀, G₆₀, G₁₂₀ groups (PAH rats were treated with genistein 30, 60, 120 mg·kg^-1·d^-1, respectively), bosentan group (PAH rats were treated with bosentan 5 mg·kg^-1·d^-1), and tadalafil group (PAH rats were treated with tadalafil 0.5 mg·kg^-1·d^-1). After 2 weeks of treatment, survival rate, tricupid regurgitation (TR), pulmonary artery diameter (PAD), mean pulmonary arterial pressure (PAP), acetylcholine (ACh)-induced endothelium-dependent relaxation (EDdR), sodium nitroprusside (SNP)-induced endothelium-independent relaxation (EDiR), right ventricular hypertrophy index (RVHI), and lung phathological of rats in each group were compared. Results Compared with the control group, the TR, PAD, mean PAP and RVHI of rats were significantly increased in PAH group (P<0.05). Compared with the PAH group, the TR and RVHI of rats were significantly decreased in G₆₀ and G₁₂₀ groups, PAD was significantly decreased in G₁₂₀ group, mean PAP was significantly decreased in G₃₀, G₆₀ and G₁₂₀ groups, survival rate was significantly increased in G₁₂₀ group, and endothelium-dependent relaxation was significantly improved in G₃₀, G₆₀ and G₁₂₀ groups, while pulmonary vascular luminal stenosis, wall thickening and vascular smooth muscle cell proliferation were significantly inhibited in G₃₀, G₆₀ and G₁₂₀ groups (P<0.05). However, the above effects of genistein were less than bosentan and tadalafil (P<0.05). Conclusion Genistein has a certain effect on monocrotaline-induced PAH in rat; although its efficacy is less than that of bosentan and tadalafil, genistein is cheaper, easy to obtain and has less side effects, and is also expected to be a new auxiliary drug for PAH.

Abstract:Objective To explore the role of Yes-associated protein 1 (YAP1) in the proliferation, cell cycle, migration and invasion of human non-small cell lung cancer (NSCLC) cells. Methods A lenti-siRNA targeting YAP1 (si-YAP1) was used to inhibit the expression of YAP1 gene of human NSCLC cell line A549 cells. CCK-8 assay and flow cytometry were used to determine the effects of silencing of YAP1 expression on A549 cells proliferation and cell cycle, respectively; Transwell assay was used to observe the effect of silencing of YAP1 expression on A549 cell migration and invasion. Results After infection with si-YAP1, the expressions of YAP1 mRNA and protein in A549 cells were significantly down-regulated (P<0.01). YAP1 silencing significantly inhibited A549 cell proliferation, increased the percentage of cells in G₀/G₁ phase (P<0.01), and significantly decreased the migration and invasion of A549 cells (P<0.01). Conclusion YAP1 silencing can inhibit malignant biological characteristics of NSCLC, which suggests that YAP1 gene may serve as an important target in the gene therapy of lung cancer.

Abstract:Objective To prepare methoxy polyethylene glycol (mPEG)-polycaprolactone (PCL) nanoparticles loading a water-quenching fluorescent probe and to evaluate its in vitro characteristics and stability. Methods PCL nanoparticles and mPEG-PCL nanoparticles with different mPEG chain lengths (mPEG_5k, mPEG_2k) loading the water-quenching fluorescent probe P2 were prepared by an emulsification/solvent evaporation method using PCL and mPEG-PCL as materials. In vitro characteristics such as morphology, particle size and distribution were evaluated. The P2 probe displayed fluorescent signals when encapsulated in the matrix of the nanoparticles, but quenched immediately when released into water. Based on this properties of P2 probe, the stability of various nanoparticles in different aqueous media was investigated. Results The prepared mPEG-PCL nanoparticles showed a particle size of about 200 nm, narrow size distribution, polydispersity index below 0.06 and near neutral surface potentials with spherical morphology and smooth surfaces. In buffers of different pHs and simulated bio-relevant media, all nanoparticles showed very good stability without significant change in particle size, polydispersity index and fluorescence intensity. Conclusion mPEG-PCL nanoparticles have promising in vitro characteristics and robust stability. It is fast and convenient to monitor the stability of nanoparticles by using the water-quenching probe.

Abstract:Objective To explore the effect of Ganoderma lucidum extract (GLE) on immune function of Walker-256 ascites rats and its mechanisms. Methods Sixty Wistar rats were randomly divided into 6 groups:control group, model group, high-dose GLE group, medium-dose GLE group, low-dose GLE group and cisplatin group according to different treatments, with 10 rats in each group. After the Walker-256 ascites rat model was successfully established, the rats in the low-dose, medium-dose and high-dose GLE groups were intragastrically administered with 0.84, 1.68 and 3.36 g/(kg·d) GLE, respectively, twice a day, 2 mL each time, for 14 days; the rats in the cisplatin group were intraperitoneally injected with 0.004 g/(kg·d) cisplatin in normal saline once a week; the rats in control group and model group were intragastrically administered with normal saline, 2 mL each time, twice a day for 14 days. The general health status of the rats of each group were observed, the mass of ascites was tested, the spleen, thymus and kidney indexes were calculated, and the renal function was measured. Flow cytometry was used to measure the cell cycles of thymus and bone marrow cells, the distributions of T lymphocyte subsets and the number of NK cells in peripheral blood. Serum immune cytokine protein chip was used to measure the serum levels of immune cytokines of rats in the control group, model group and medium-dose GLE group. Results GLE significantly reduced the mass of ascites in rats (P<0.05). Compared with the control group, thymus, spleen and kidney were damaged in the model group and cisplatin group, and treating rats with GLE significantly increased the thymus index and renal indexes, and significantly decreased serum creatinine and urea nitrogen (P<0.05). G₀/G₁ phase arrest was significantly induced in the thymus and bone marrow cells in the model group and the cisplatin group (P<0.05); and GLE significantly reduced the arrest of G₀/G₁ phase and significantly induced the transformation of thymus and bone marrow cells to G₂/M and S phases (P<0.05). GLE significantly increased the number of CD4⁺ cells, the ratio of CD4⁺ to CD8⁺ cells and the number of NK cells, and significantly decreased the number of CD8⁺ cells in the peripheral blood of rats as compared with the model group (P<0.05). Compared with the model groups, the expressions of interferon-γ (IFN-γ), interleukin (IL)-1α, IL-1β, IL-2, IL-4, IL-10 and tumor necrosis factor-α (TNF-α) in serum of the rats in medium-dose GLE group were significantly increased (P<0.05). Conclusion GLE can effectively reduce the generation of ascites and improve immune function in Walker-256 ascites rats, and has no renal damage effect compared with cisplatin.

Abstract:Objective To explore the effect of R-(-)-α-methylhistamine (RAMH) on the isoflurane exposure induced neuronal apoptosis and memory impairment in the developing rats. Methods Twenty-eight 6-7 days SD rats were randomly divided into four groups:control (CON) group (intraperitoneal injection of 5% glucose[0.1 mL/10 g], isoflurane (ISO) group (intraperitoneal injection of 5% glucose[0.1 mL/10 g] and then exposure to 1.6% ISO for 6 hours), RAMH group (intraperitoneal injection of RAMH[10 mg/kg], and RAMH+ISO group (after intraperitoneal injection of RAMH[10 mg/kg] for 30 min, then exposure to 1.6% ISO for 6 hours). Morris water maze test was employed to investigate the learning and memory ability. Immunofluorescence and Western blotting were employed to determine the neuronal apoptosis and p53 expression in the hippocampus of rats, respectively. Results Morris water maze test showed that the time in the target quadrant of ISO group was significantly shorter than that of CON group (n=7, P<0.01), while the time of RAMH+ISO group was significantly longer than the ISO group (n=7, P<0.05). The number of apoptotic neurons in hippocampus in the ISO group was significantly increased compared with either the CON group or the RAMH+ISO group (n=5, both P<0.01). Compared with the CON group, the expression of p53 protein in hippocampus was significantly increased in the ISO group (n=6, P<0.01), while p53 expression in the RAMH+ISO group was significantly lower than that in the ISO group (n=6, P<0.01). Conclusion RAMH can ameliorate ISO exposure induced neuronal apoptosis and memory impairment in the developing rat.

Abstract:Objective To explore the protective effect of external use of isoflavone cream on ultraviolet radiation induced skin injuries of mice and its mechanisms. Methods A total of 48 male ICR mice were randomly assigned to vehicle (control), ultraviolet radiation (UV), 2% isoflavone+UV and 3% isoflavone+UV groups, with 12 mice in each group, and the naked skin of mice in the four groups were treated with sesame oil (15 min), sesame oil (15 min) in combined UV (first radiation with 1.55 J/cm² long-wave ultraviolet[UVA] for 18 min, and then with 0.95 J/cm² middle-wave ultraviolet[UVB] for 11 min), 2% isoflavone (15 min) in combined UV and 3% isoflavone (15 min) in combined UV, respectively. After radiation for 7 days, the UV-exposed skins were obtained to observe the morphological and histological changes using H-E staining. The contents of interleukin (IL)-1β, IL-6, tumor necrosis factor α (TNF-α), malondialdehyde (MDA), superoxide dismutase (SOD) and catalase (CAT) in the skins were determined using ELISA or corresponding kits. Results (1) UV irradiation caused erythema and crusting in skin, and inflammatory cell infiltration in the dermis and fractured elastic fiber were observed microscopically. Isoflavone pretreatment effectively ameliorated these damages in mice skin. (2) Compared with the control group, contents of IL-1β, IL-6 and TNF-α in the UV group were significantly increased (P<0.05); however, the contents of IL-1β, IL-6 and TNF-α were significantly reversed by isoflavone pretreatment (P<0.05, P<0.01). (3) Compared with the control group, the skin MDA content in the UV group was significantly increased (P<0.05), SOD and CAT contents were significantly decreased (P<0.05); however, the isoflavone pretreatment significantly reversed the alterations of MDA, SOD and CAT (P<0.05, P<0.01). Conclusion Isoflavone exerts protective effects against the ultraviolet induced skin damage in mice through alleviating lipid peroxidation, oxidative stress and inflammatory response.

Abstract:Objective To explore the relationship of pokemon gene expression and drug sensitivity and drug resistance gene in gastric cancer cells. Methods We collected the paraffin specimen of gastric cancer and para-carcinoma tissues from 60 patients with gastric cancer, detected the protein expressions of pokemon, drug resistance-associated protein P-glycoprotein (P-gp), multidrug resistance-associated protein 1 (MRP1), lung resistance protein (LRP) and survivin with immunohistochemistry (IHC) and analyzed the relationship between pokemon protein and other 4 proteins. Sulphorhodamine B (SRB) protein staining assay was performed to detect the inhibition effect of 5-fluorouracil (5-FU), cisplatin (DDP) and oxaliplatin (L-OHP) on gastric cancer cell line SGC7901, multidrug-resistant gastric carcinoma cell line SGC7901/ADR and gastric epithelial cell line GES-1, and qPCR and Western blotting were used to test expression of pokemon and drug resistance genes in the cells. Pokemon-siRNA was established and transfected into SGC7901/ADR cells, and the drug sensitivity and drug resistance genes were analyzed. Results Positive rates of pokemon, P-gp, MRP1, LRP and survivin proteins were significantly higher in gastric cancer tissues than those in para-carcinoma tissues (P<0.05). The protein expression of pokemon was positively correlated with P-gp and survivin (r=0.385 2, P=0.002; r=0.342 4, P=0.007). Protein expressions of pokemon, P-gp, MRP1, and survivin were higher in SGC7901/ADR cells than those in SGC7901 and GES-1 cells. The drug resistance of SGC7901/ADR cells was the strongest, followed by SGC7901, and that of GES-1 was the weakest (P<0.01). After SGC7901/ADR cells was transfected with pokemon-siRNA, pokemon mRNA expression was significantly inhibited, mRNA and protein expressions of P-gp and survivin were decreased and the inhibitory effect of chemotherapy agents on SGC7901/ADR cells was increased (P<0.05). Conclusion The pokemon is involved in drug resistance of gastric cancer by mutual regulation with P-gp and survivin, and pokemon may be a candidate gene for gastric cancer targeted treatment.

Abstract:Objective To evaluate the efficacy and safety of levetiracetam (LTA) for adult seizure (AS). Methods A randomized, double-blinded, double-dummy, positive drug controlled trial was conducted. One hundred and twenty eligible AS patients were randomly divided into two groups:intervention group and control group, with 60 in each group. Patients in the intervention group received LTA tablet plus valproate sodium mimetic tablet, and patients in the control group received valproate sodium tablet and LTA mimetic tablet. The treatment course was 26 weeks in both groups, and the patients was followed up for 3 months after the treatment. The outcomes included total efficacy rate, weekly epilepsy seizure frequency, seizure duration, quality of life (measured by QOLIE-31 Scale) and adverse events related to drugs after 1-3 days of treatment and at 3 months of follow-up. Results The weekly epilepsy seizure frequency, seizure duration and QOLIE-31 score were not significantly different between the two groups before treatment. The total efficacy rates after treatment and at 3 months of follow-up in the intervention group were 95.0%(57/60) and 91.7%(55/60), respectively, and were significantly higher than those in the control group of 71.7%(43/60) and 63.3% (38/60) (P<0.01). The weekly epilepsy seizure frequency, seizure duration and QOLIE-31 score after treatment and at 3 months of follow-up were significantly different as compared with before treatment in both groups (P<0.01); and there were significantly different between the two groups (P<0.01). The adverse events after treatment were similar between both groups. Conclusion The efficacy of LAT is superior to the valproate sodium tablet for AS, with the less toxicity, and it can be clinical drug of choice for AS.

Abstract:Glioma is a highly lethal malignancy and multiple challenges remain for it in the genomic study and clinical treatment. Next-generation sequencing (NGS) holds many advantages, and NGS can comprehensively analyze the whole genome, exome, transcriptome and epigenome to deepen the understanding of tumor genomics; and now, it has been successfully applied in the clinical study of some tumors, especially in personalized treatment for these tumors. At present, NGS has also been a hot in glioma research to clarify the pathogenesis of glioma, so as to draw up a personalized treatment method to benefit the patients.

Abstract:Objective To report a novel technique named anterior controllable antedisplacement and fusion (ACAF) for the treatment of severe ossification of the posterior longitudinal ligament of the cervical spine, which allows for direct decompression of the nerve without resection of the ossification, making up for deficiencies in traditional anterior or posterior decompression. Methods The main surgical procedures of the ACAF included treatment of intervertebral space, removal of the anterior part of vertebrae, installation of titanium plate and interbody fusion cages, bilateral osteotomies of the vertebrae, and antedisplacement of the vertebrae ossification complex. The clinical data of two patients undergoing this surgery for severe ossification of the posterior longitudinal ligament of cervical spine were collected and analyzed. Results ACAF enabled direct decompression of spinal cord and nerve root through antedisplacement of the vertebrae ossification complex. The two patients who underwent ACAF gained satisfactory restoration with decompression of spinal cord and good recovery of neurological function, with no specific complications. Conclusion ACAF surgery takes into account the effectiveness of anterior direct decompression and the safety of posterior indirect decompression. Preliminary results shows that it can be used for severe cervical ossification of the posterior longitudinal ligament.

Abstract:Objective To explore the variation tendency and influencing factors of the hospitalization costs and hospital day of soldiers in a navy hospital, so as to provide reference for the health resource allocation of military hospitals. Methods The data of 16 278 military patients who were hospitalized and treated from Jan. 2008 to Dec. 2016 were extracted from the military health system. The hospitalization costs and status, variation tendency and influencing factors of hospital stay were analyzed by descriptive analysis, Mann-Whitney U test and Kruskal-Wallis H test. Results The average age of admission was (28.33±13.40) years, and the hospitalization period showed a shortening trend, while the hospitalization costs showed an increasing trend during 2008-2016. The polytomous variables, including services, patient's condition, hospitalized times, hepatitis B surface antigen, hepatitis C antibody, human immunodeficiency virus (HIV) antibody, military appointment, age and outcomes, and the dichotomous variables, including severe condition, critical condition, ICU admission, special-grade nursing care, first-grade nursing care, allergies and operation, were the influencing factors of hospitalization expenses (P<0.05). The polytomous variables, including services, patient's condition, hospitalized times, HIV antibody, military appointment, age and outcomes, and the dichotomous variables, including gender, severe condition, critical condition, special-grade nursing care, first-grade nursing care and operation, were the influencing factors of hospitalization stay (P<0.05). Conclusion The decreasing hospitalization day of military patients and increasing hospitalization costs suggest that the medical technology and hospital management efficiency are continuously improving, but facing the pressure of increasing medical costs. From a cost-effective perspective, we should strengthen the graded referral and control hospitalization costs and length of hospital stay.

Abstract:Objective To explore the feasibility of 3D printing technique combined with intra-operative ultrasound for locating completely endophytic renal tumor in laparoscopic nephron-sparing surgery. Methods Fifteen patients with completely endophytic renal tumor, who underwent 3D printing technique combined with intra-operative ultrasound assisted localization of laparoscopic partial nephrectomy from Mar. 2014 to Mar. 2016, received CT image 3D reconstruction and 3D printing kidney model using Formlab Form1+ 3D printer before operation. Among 15 patients aging (55.7±10.5) years, 11 patients were male and 4 were female; the tumor diameter was (2.8±1.0) cm; and 3 cases were ventral and 12 were dorsal, all had solitary tumors. The clinical data, including intra-operative blood loss, warm ischemia time, post-operative pathology and surgical margins, and post-operative renal function, were statistically analyzed in this study. Results Laparoscopic partial nephrectomy was successfully carried out in all cases:the average operation time was (105.0±20.6) min, the average warm ischemia time was (22.8±3.5) min, and the mean intra-operative blood loss was (87.3±15.8) mL. No case received blood transfusion during or after operation, and the average post-operative hospital stay was (6.7±1.0) days. No obvious complication occurred after operation. The surgical margins were all negative. Post-operative pathology confirmed that 1 3 patients were with clear cell renal cell carcinoma, and 2 with papillary renal cell carcinoma. Patients were followed up for (23.7±11.8) months, and no continuous deterioration of renal function or tumor recurrence was found. Conclusion Pre-operative 3D printing technique for patients with completely endophytic renal tumor can help to determine the tumor location and adjacent relationship, reducing the risk of surgery by guiding operation scheme. Meanwhile, propaganda and education using 3D printing kidney model can improve patients' cognition to surgery and simplify pre-operative conversation process. Furthermore, utilizing intra-operative ultrasound to optimize tumor resection scheme can reduce the damage to the renal vessels and collection system, maximizing the clinical benefit by ensuring negative margin and renal function reservation.

Abstract:Objective To explore the feasibility and safety of laparoscopic resection for rectal stromal tumor. Methods Sixteen (10 male and 6 female) patients underwent laparoscopic resection of rectal stromal tumor in our department from May 2013 to Dec. 2016, and the tumor diameter of all patients was less than 5 cm. The patients with the distance of more than 5 cm from the lower margin of the tumor to the anal verge received laparoscopic anterior resection of the rectal carcinoma (Dixon), the patients with the distance of less than 5 cm and more than 3 cm received laparoscopic local resection, and the patients with the distance of less than 3 cm, whose tumor boundary with the surrounding tissue were unclear, received laparoscopic abdominal perineal resection (Miles). Results The rectal stromal tumors of 16 cases were successfully removed under laparoscope without conversion to laparotomy, and no post-operative complications such as perforation, bleeding, obstruction or anastomotic leakage occurred. Of 16 cases, 12 underwent laparoscopic anterior resection of the rectal carcinoma (Dixon), 3 underwent laparoscopic local resection, and 1 underwent laparoscopic perineal resection (Miles). The average operation time was (103.0±23.8) min, the average hospital stay was (7.0±1.2) days, and the average volume of intra-operative bleeding was (14±4.1) mL. The pathological findings were confirmed as stromal tumor with negative margin. There was no recurrence during the follow-up of 8 to 40 months. Two cases with the tumor transferring to the liver eventually died of liver metastasis. Conclusion Laparoscopic resection of rectal stromal tumors is safe and feasible, with less trauma, shorter hospitalization time and quicker post-operative recovery.

Abstract:Objective To clarify the active ingredients of Guanxin Qiwei tablet, and to explore the potential target for its efficacy. Methods We studied the interaction between Chinese medicine ingredients in the Guanxin Qiwei tablet and the therapy targets using a network pharmacology model, which was developed by integrating oral bioavailability prediction, druggability analysis, principal component analysis, molecular docking simulation and network of pharmacophore-target-disease analysis. Results Eighteen principal compounds had high-degree network with 41 therapy targets for coronary heart disease (CHD), and had higher affinity with 18 potential targets via the calculation of molecular docking. Further analysis showed that 7 key targets were closely related to the treatment of CHD. Conclusion We have screened 18 possible active molecules in Guanxin Qiwei tablet and 7 key therapy targets, and preliminarily elucidate the molecular mechanism based on the "multi-ingredient, multi-target, and synergistic effect".

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