Pectolinarin inhibited LPS-stimulated inflammation in microglial BV_(2) cells via NF-κB signaling pathway

Background:Neuro-inflammation is regarded as one of the critical pathogenesis in neurodegenerative diseases,which is characterized by the activated microglial cells.Pectolinarin(Pec),a natural flavonoid that exists in many Chinese herbal medicines,has been reported to have various biological activities.However,the effects and mechanisms on neuro-inflammation are not clear.Methods:In this study,the inhibitory effects and mechanisms of Pec on neuro-inflammation were investigated in the LPS-stimulated microglial BV_(2) cells.BV_(2) microglial cells were treated with Pec or vehicle,followed by LPS.Enzyme-linked immunosorbent assay,real-time quantitative PCR,nitric oxide and reactive oxygen species assay,and western blot were performed to examine the effects of Pec on neuro-inflammatory responses.Results:We showed that Pec significantly inhibited the expression of tumor necrosis factorαand interleukin 6 in mRNA and protein levels induced by LPS.Moreover,the production of nitric oxide,iNOS,reactive oxygen species,and COX-2 were suppressed by Pec in LPS-stimulated microglial BV_(2) cells.In addition,Pec inhibited LPS-induced inflammation via nuclear factor kappa B signaling pathway,as evidenced by the reduction of the phosphorylation of inhibitor of nuclear factor kappa-B kinase,the degradation of IκBα,and the nuclear translocation of p65.Conclusion:Taken together,Pec exhibited anti-inflammatory effects in LPS-stimulated microglial BV_(2) cells via nuclear factor kappa B signaling pathway,which might provide therapeutic potential for neuro-inflammation and neurodegenerative diseases.

Enhancement of electron–positron pairs in combined potential wells with linear chirp frequency

Effect of linear chirp frequency on the process of electron–positron pairs production from vacuum is investigated by the computational quantum field theory.With appropriate chirp parameters,the number of electrons created under combined potential wells can be increased by two or three times.In the low frequency region,frequency modulation excites interference effect and multiphoton processes,which promotes the generation of electron–positron pairs.In the high frequency region,high frequency suppression inhibits the generation of electron–positron pairs.In addition,for a single potential well,the number of created electron–positron pairs can be enhanced by several orders of magnitude in the low frequency region.

Development of CONTHAC-3D and hydrogen distribution analysis of HPR1000

An in-house code,CONTHAC-3D,was developed to calculate and analyze thermal-hydraulic phenomena in containments during severe accidents.CONTHAC-3D is a three-dimensional computational fluid dynamics code that can be applied to predict gas flow,diffusion,and steam condensation in a containment during a severe hypothetical accident,as well as to obtain an estimate of the local hydrogen concentration in various zones of the containment.CONTHAC-3D was developed using multiple models to simulate the features of the proprietary systems and equipment of HPR1000 and ACP100,such as the passive cooling system,passive autocatalytic recombiners and the passive air cooling system.To validate CONTHAC-3D,a GX6 test was performed at the Battelle Model Containment facility.The hydrogen concentration and temperature monitored by the GX6 test are accurately predicted by CONTHAC-3D.Subsequently,the hydrogen distribution in the HPR1000 containment during a severe accident was studied.The results show that the hydrogen removal rates calculated using CONTHAC-3D for different types of PARs agree well with the theoretical values,with an error of less than 1%.As the accident progresses,the hydrogen concentration in the lower compartment becomes higher than that in the large space,which implies that the lower compartment has a higher hydrogen risk than the dome and large space at a later stage of the accident.The amount of hydrogen removed by the PARs placed on the floor of the compartment is small;therefore,raising the installation height of these recombiners appropriately is recommended.However,we do not recommend installing all autocatalytic recombiners at high positions.The study findings in regard to the hydrogen distribution in the HPR1000 containment indicate that CONTHAC-3D can be applied to the study of hydrogen risk containment.

Postoperative encapsulated hemoperitoneum in a patient with gastric stromal tumor treated by exposed endoscopic full-thickness resection: A case report

BACKGROUND Gastric stromal tumors,originating from mesenchymal tissues,are one of the most common tumors of the digestive tract.For stromal tumors originating from the muscularis propria,compared with conventional endoscopic submucosal dissection(ESD),endoscopic full-thickness resection(EFTR)can remove deep lesions and digestive tract wall tumors completely.However,this technique has major limitations such as perforation,postoperative bleeding,and post-polypectomy syndrome.Herein,we report a case of postoperative serous surface bleeding which formed an encapsulated hemoperitoneum in a patient with gastric stromal tumor that was treated with exposed EFTR.Feasible treatment options to address this complication are described.CASE SUMMARY A 47-year-old male patient had a hemispherical protrusion found during gastric endoscopic ultrasonography,located at the upper gastric curvature adjacent to the stomach fundus,with a smooth surface mucosa and poor mobility.The lesion was 19.3 mm×16.1 mm in size and originated from the fourth ultrasound layer.Computed tomography(CT)revealed no significant evidence of lymph node enlargement or distant metastasis.Using conventional ESD technology for mucosal pre-resection,exposed EFTR was performed to resect the intact tumor in order to achieve a definitive histopathological diagnosis.Based on its morphology and immunohistochemical expression of CD117 and DOG-1,the lesion was proven to be consistent with a gastric stromal tumor.Six days after exposed EFTR,CT showed a large amount of encapsulated fluid and gas accumulation around the stomach.In addition,gastroscopy suggested intracavitary bleeding and abdominal puncture drainage indicated serosal bleeding.Based on these findings,the patient was diagnosed with serosal bleeding resulting in encapsulated abdominal hemorrhage after exposed EFTR for a gastric stromal tumor.The patient received combined treatments,such as hemostasis under gastroscopy,gastrointestinal decompression,and abdominal drainage.All examinations were normal within six months of follow-up.CONCLUSION This patient developed serous surface bleeding in the gastric cavity following exposed EFTR.Serosal bleeding resulting in an encapsulated hemoperitoneum is rare in clinical practice.The combined treatment may replace certain surgical techniques.

Immune mechanisms of Concanavalin A model of autoimmune hepatitis

As a chronic inflammatory disease of the liver,the pathogenic mechanisms of autoimmune hepatitis (AIH) have not yet been elucidated,with prognosis and diagnosis remaining unsatisfied.Currently the only viable treatments of AIH are immunosuppressant application and liver transplantation.It is considered that lack of good animal AIH models is the main reason for the shortage of a simple and efficient cure.The Concanavalin A (Con A) model is a typical and well established model for investigating T-cell and macrophage dependent liver injury in mice,which closely mimics the pathogenesis mechanisms and pathological changes of patients,and is regarded as the best experimental model for AIH research so far.In this paper we eluci-dated the pathogenic mechanisms of AIH and the evolution of relative animal models.We go on to further focus on Con A-induced liver injury from the point of immunological mechanisms and the change of cytokine levels.Finally,we manifested the clinical significance of the AIH animal models and the challenges they would meet during their future development.

Hepatoprotective effects of baicalein against CCl 4-induced acute liver injury in mice

AIM:To investigate the hepatoprotective effect of baicalein against carbon tetrachloride(CCl 4)-induced liver damage in mice.METHODS:Mice were orally administered with baicalein after CCl 4 injection,and therapeutic baicalein was given twice a day for 4 d.The anti-inflammation effects of baicalein were assessed directly by hepatic histology and serum alanine aminotranferease and aspartate aminotransferase measurement.Proliferating cell nuclear antigen was used to evaluate the effect of baicalein in promoting hepatocyte proliferation.Serum interleukin(IL)-6,IL-1β and tumor necrosis factor-α(TNF-α) levels were measured by enzyme-linked immunosorbent assay and liver IL-6,TNF-α,transforming growth factor-α(TGF-α),hepatocyte growth factor(HGF) and epidermal growth factor(EGF) genes expression were determined by quantitative real-time polymerase chain reaction.RESULTS:CCl4-induced acute liver failure model offers a survival benefit in baicalein-treated mice.The data indicated that the mRNA levels of IL-6 and TNF-α significantly increased within 12 h after CCl 4 treatment in baicalein administration groups,but at 24,48 and 72 h,the expression of IL-6 and TNF-α was kept at lower levels compared with the control.The expression of TGF-α,HGF and EGF was enhanced dramatically in baicalein administration group at 12,24,48 and 72 h.Furthermore,we found that baicalein significantly elevated the serum level of TNF-α and IL-6 at the early phase,which indicated that baicalein could facilitate the initiating events in liver regeneration.CONCLUSION:Baicalein may be a therapeutic candidate for acute liver injury.Baicalein accelerates liver regeneration by regulating TNF-α and IL-6 mediated pathways.

Meta-analysis of the efficacy of probiotics in Helicobacter pylori eradication therapy

AIM:To evaluate the role of probiotics in the standard triple Helicobacter pylori therapy.METHODS:In this meta-analysis,we investigated the efficacy of probiotics in a standard triple H.pylori therapy in adults.Searches were mainly conducted in MEDLINE/Pub Med,EMBASE,and the Cochrane Central Register of Controlled Trials.Fourteen studies met our criteria,and the quality of these studies was assessedusing the Jadad scale.We used STATA version 12.0to extract data and to calculate the odds ratios(ORs),which are presented with the corresponding 95%confidence intervals(CIs).The data are presented as forest plots.RESULTS:The pooled ORs for the eradication rates calculated by intention-to-treat analysis and perprotocol analysis in the probiotic group vs the control group were 1.67(95%CI:1.38-2.02)and 1.68(95%CI:1.35-2.08),respectively,using the fixed-effects model.The sensitivity of the Asian studies was greater than that of the Caucasian studies(Asian:OR=1.78,95%CI:1.40-2.26;Caucasian:OR=1.48,95%CI:1.06-2.05).The pooled OR for the incidence of total adverse effects was significantly lower in the probiotic group(OR=0.49,95%CI:0.26-0.94),using the random effects model,with significant heterogeneity(I2=85.7%).The incidence of diarrhea was significantly reduced in the probiotic group(OR=0.21,95%CI:0.06-0.74),whereas the incidence of taste disorders,metallic taste,vomiting,nausea,and epigastric pain did not differ significantly between the probiotic group and the control group.CONCLUSION:Supplementary probiotic preparations during standard triple H.pylori therapy may improve the eradication rate,particularly in Asian patients,and the incidence of total adverse effects.

Association of metabolic syndromes and risk factors with ampullary tumors development: A case-control study in China

AIM:To evaluate the risk factors for ampullary adenoma and ampullary cancer.METHODS:This case-control study included ampullary tumor patients referred to Peking Union Medical College Hospital.Controls were randomly selected from an existing database of healthy individuals at the Health Screening Center of the same hospital.Data on metabolic syndromes,medical conditions,and family history were collected by retrospective review of the patients’records and health examination reports,or by interview.RESULTS:A total of 181 patients and 905 age-and sex-matched controls were enrolled.We found that a history of diabetes,cholecystolithiasis,low-density lipoprotein,and apolipoprotein A were significantly related to ampullary adenomas.Diabetes,cholecystolithiasis,chronic pancreatitis,total cholesterol,high-density lipoprotein,and apolipoprotein A were also significantly related to ampullary cancer.CONCLUSION:Some metabolic syndrome components and medical conditions are potential risk factors for the development of ampullary tumors.Cholelithiasis,diabetes,and apolipoprotein A may contribute to the malignant transformation of benign ampullary adenomas into ampullary cancer.

Action of trichostatin A on Alzheimer’s disease-like pathological changes in SH-SY5Y neuroblastoma cells

The histone deacetylase inhibitor, trichostatin A, is used to treat Alzheimer’s disease and can improve learning and memory but its underlying mechanism of action is unknown. To determine whether the therapeutic effect of trichostatin A on Alzheimer’s disease is associated with the nuclear factor erythroid 2-related factor 2(Nrf2) and Kelch-like epichlorohydrin-related protein-1(Keap1) signaling pathway, amyloid β-peptide 25–35(Aβ25–35) was used to induce Alzheimer’s disease-like pathological changes in SH-SY5 Y neuroblastoma cells. Cells were then treated with trichostatin A. The effects of trichostatin A on the expression of Keap1 and Nrf2 were detected by real-time quantitative polymerase chain reaction, western blot assays and immunofluorescence. Total antioxidant capacity and autophagy activity were evaluated by total antioxidant capacity assay kit and light chain 3-I/II levels, respectively. We found that trichostatin A increased cell viability and Nrf2 expression, and decreased Keap1 expression in SH-SY5 Y cells. Furthermore, trichostatin A increased the expression of Nrf2-related target genes, such as superoxide dismutase, NAD(P)H quinone dehydrogenase 1 and glutathione S-transferase, thereby increasing the total antioxidant capacity of SH-SY5 Y cells and inhibiting amyloid β-peptide-induced autophagy. Knockdown of Keap1 in SH-SY5 Y cells further increased trichostatin A-induced Nrf2 expression. These results indicate that the therapeutic effect of trichostatin A on Alzheimer’s disease is associated with the Keap1-Nrf2 pathway. The mechanism for this action may be that trichostatin A increases cell viability and the antioxidant capacity of SH-SY5 Y cells by alleviating Keap1-mediated inhibition Nrf2 signaling, thereby alleviating amyloid β-peptide-induced cell damage.

加味桃红四物汤对视网膜Müller细胞缺氧损伤的保护作用

目的:探讨加味桃红四物汤(MTSD)对视网膜Müller细胞rMC-1缺氧损伤的保护作用。方法:用加味桃红四物汤含药血清干预缺氧条件下rMC-1细胞,随机分为正常对照组(21%O_(2))、缺氧模型组(1%O_(2))、含药血清低(1%O_(2)+5%含药血清)、中(1%O_(2)+10%含药血清)、高剂量组(1%O_(2)+15%含药血清),CCK-8法检测细胞的活力,ELISA法检测血管内皮生长因子(VEGF)和色素上皮衍生因子(PEDF)分泌,Western blot检测磷酸化转录激活因子3(p-STAT3)、转录激活因子3(STAT3)和缺氧诱导因子-1α(HIF-1α)的蛋白表达,Real time PCR检测VEGF、PEDF、STAT3和HIF-1α的基因表达。结果:在1%O_(2)条件下培养48h,rMC-1细胞活力较正常对照组明显受到抑制(P<0.05),加味桃红四物汤含药血清低、中剂量组均可以改善rMC-1细胞缺氧48h的细胞存活率(P<0.05),而高剂量组无改善作用(P>0.05)。加味桃红四物汤含药血清低、中剂量组均可减少缺氧条件下rMC-1细胞上清液VEGF的蛋白表达量(P<0.05),但不能增加PEDF的蛋白含量(P>0.05),对p-STAT3和HIF-1α在蛋白水平均有下调作用(P<0.05),且低剂量组抑制作用优于中剂量(P<0.05)。加味桃红四物汤含药血清中剂量组对缺氧后rMC-1细胞STAT3的蛋白表达有上调作用(P<0.05)。加味桃红四物汤含药血清低、中剂量组对缺氧后rMC-1细胞VEGF基因表达均有下调作用(P<0.05),对PEDF基因表达均有上调作用(P<0.05),且低剂量组优于中剂量(P<0.05);并且加味桃红四物汤含药血清低剂量可下调缺氧后STAT3和HIF-1α的基因表达(P<0.05)。结论:加味桃红四物汤含药血清可能通过抑制STAT3/HIF-1α通路,下调缺氧诱导的视网膜Müller细胞rMC-1的VEGF蛋白和基因表达,上调PEDF基因表达,减轻该细胞的缺氧损伤。

The biomechanical role of periodontal ligament in bonded and replanted vertically fractured teeth under cyclic biting forces

After teeth are replanted,there are two possible healing responses:periodontal ligament healing or ankylosis with subsequent replacement resorption.The purpose of this study was to compare the fatigue resistance of vertically fractured teeth after bonding the fragments under conditions simulating both healing modes.Thirty-two human premolars were vertically fractured and the fragments were bonded together with Super-Bond C&B.They were then randomly distributed into four groups(BP,CP,CA,BA).The BP and CP groups were used to investigate the periodontal ligament healing mode whilst the BA and CA groups simulated ankylosis.All teeth had root canal treatment performed.Metal crowns were constructed for the CP and CA groups.The BP and BA groups only had composite resin restorations in the access cavities.All specimens were subjected to a 260 N load at 4 Hz until failure of the bond or until 2 x 106 cycles had been reached if no fracture occurred.Cracks were detected by stereomicroscope imaging and also assessed via dye penetration tests.Finally,interfaces of the resin luting agent were examined by scanning electron microscope.The results confirmed that the fatigue resistance was higher in the groups with simulated periodontal ligament healing.Periodontal reattachment showed important biomechanical role in bonded and replanted vertically fractured teeth.

Comprehensive regulation of traditional Chinese medicine on proliferation and differentiation of neural stem cells

Since the diccovery of neural stem cells(NSCs)in the embryonic and adult mammalian central nerous system,it provided novel ideas forneurogenesis as the potential of proliferation and differentiation of NSCs.One of the ways to promote the clinical application of neural stem cells(NSCs)is searching effective methods which regulate the proliferation and differentiation.This is also a problem urgently to be solved in medical field.Plenty of earlier studies have shown that traditional chinese medicine can promote the proliferation and differentiation of NSCs by regulating the related signaling pathway in vivo and in vitro.The reports of Chinese and foreign literatures on regulating the proliferation and differentiation of neural stem cells in recent ten years and their target and signaling pathways is analyzed in this review.The traditional chinese medicine regulate proliferation and differentiation of NSCs by the signaling pathways of Notch,PI3K/Akt,Wnt/β-catenin,and GFs.And,those signaling pathways have cross-talk in the regulation progress.Moreover,some traditional Chinese medicine,such as astragalus,has a variety of active ingredients to regulate proliferation and differentiation of NSCs through different signaling pathways.However,to accelerate the clinical application of neural stem cells,the studies aboutthe proliferation and differentiation of NSCs and Chinese medicine should be further deepened,the mechanism of multiple targets and the comprehensive regulation function of traditional Chinese medicine should be clarified.

Inflammatory myofibroblastic tumor successfully treated with metformin: A case report and review of literature

BACKGROUND Inflammatory myofibroblastic tumor(IMT)is a distinct tumor with a low incidence rate,which can be diagnosed at any age with a predilection for children and adolescents.Although IMT is visible in any tissues and organs,it is more commonly found in the lungs.The clinical and radiological manifestations of IMT lack specificity,hence resulting in frequent misdiagnosis.Surgical resection is currently the main therapeutic approach for IMT.Only scarce cases of IMT treated with metformin have been reported.Here we report the case of an IMT patient with partial penile resection treated with metformin.CASE SUMMARY A 1-year-old boy was born with a shorter penis,and his foreskin could not be completely turned over.When he was 6 month old,a well-circumscribed mass on the glans was found,while it did not attract the attention of his parents.The mass gradually increased in size over time before he was admitted to the hospital,where physical examination was performed.It was revealed that the glans hidden behind the foreskin had a mass with a diameter of about 4 cm surrounding the penis.The mass appeared to be hard with a smooth surface and poor mobility.The two testicles examined at the bottom of the scrotum were revealed to have a normal size.Magnetic resonance imaging showed a tumor with rich blood supply encircling the cavernosum with a size of 3.5 cm×2.1 cm×2.0 cm.A thick urinary line was found without urine dripping,urgency,and urodynia.Surgical treatment was performed.During the operation,it was observed that the mass had surrounded and invaded the cavernosum without obvious boundaries,and that the tumor occupied about one-half of the penis cross-section as well as infiltrated more than one-half of the glans.In addition,the tumor had caused urethral invasion and anterior urethrostenosis.With the intention of keeping the glans and cavernosum,the tumor at the anterior urethra was partially removed,leaving about 30%of the tumor mass.Pathology analysis demonstrated that the tumor was rich in spindle cells with infiltration of inflammatory cells.Immunohistochemistry analysis indicated that the cells were positive for CD4,CD99,Ki67,BCL2,and CD68,and negative for ALK,MyoG,S100,SOX10,PR,and EMA.Hence,the tumor was diagnosed as IMT.Metformin was prescribed for the patient after the operation,following which an oral dose of 7 mg/kg was given three times a day after meals.Three months later,it was observed that the remaining tumor had completely disappeared and that the urination process from the urethra opening had resumed normal.In addition,there were no side effects observed.There was also no tumor recurrence.The growth and development of the boy were unaffected as a result of the treatment.CONCLUSION The tumor was observed to have completely disappeared after treatment with metformin.Our finding is of great significance to facilitate future clinical treatment with IMT.

Large eddy simulation of unsteady flow in gas-liquid separator applied in thorium molten salt reactor

Axial gas-liquid separators have been adopted in fission gas removal systems for the development of thorium molten salt reactors. In our previous study, we observed an unsteady flow phenomenon in which the flow pattern is directly dependent on the backpressure in a gas-liquid separator; however, the underlying flow mechanism is still unknown. In order to move a step further in clarifying how the flow pattern evolves with a variation in backpressure, a large eddy simulation(LES) was adopted to study the flow field evolution. In the simulation, an artificial boundary was applied at the separator outlet under the assumption that the backpressure increases linearly. The numerical results indicate that the unsteady flow feature is captured by the LES approach, and the flow transition is mainly due to the axial velocity profile redistribution induced by the backpressure variation. With the increase in backpressure,the axial velocity near the downstream orifice transits from negative to positive. This change in the axial velocity sign forces the unstable spiral vortex to become a stable rectilinear vortex.

Cefoperazone-sulbactam and ornidazole for Gardnerella vaginalis bloodstream infection after cesarean section:A case report

BACKGROUND Gardnerella vaginalis(G.vaginalis)is a facultative anaerobic bacteria known to cause bloodstream infections.However,cases are very rare in clinics.There is very limited clinical experience in the treatment of bloodstream infections caused by G.vaginalis.Therefore,there is an urgent need for effective antibacterial drugs to treat patients with bloodstream infections caused by G.vaginalis.CASE SUMMARY A woman who underwent a cesarean section presented with a sudden onset of high fever 1-d post-surgery.The blood cultures suggested an infection due to G.vaginalis,and treatment with cefoperazone-sulbactam was started.After 5 d of treatment,there was a decrease in the hemogram;however,the temperature and C-reactive protein levels remained high.Based on clinical experience and a review of literature,the treatment was modified to include ornidazole in combination with cefoperazone-sulbactam.Following a week of treatment,the temperature,hemogram and C-reactive protein levels returned to normal,and blood cultures turned negative,suggesting a therapeutic effect of the combination treatment.CONCLUSION This case highlighted the effective use of cefoperazone-sulbactam combined with ornidazole for bloodstream infection caused by G.vaginalis following a cesarean section.

miR-708-5p靶向GAGE12I抑制胃癌细胞增殖、迁移和侵袭

目的探讨miR-708-5p靶向GAGE12I对胃癌(gastric cancer,GC)细胞增殖、迁移和侵袭的影响.方法 qRT-PCR检测miR-708-5p在GC组织和GC细胞AGS和BGC-823中的表达;MTT法、克隆形成实验和Transwell小室法检测miR-708-5p和GAGE12I对GC细胞AGS和BGC-823增殖、迁移和侵袭的影响;双荧光素酶报告基因实验验证miR-708-5p与GAGE12I之间的靶向关系; Western blot检测miR-708-5p对GAGE12I表达的影响;靶标回复实验验证GAGE12I对miR-708-5p抑制GC细胞AGS和BGC-823增殖、迁移和侵袭作用的影响.结果 miR-708-5p在GC组织和GC细胞AGS和BGC-823中低表达;上调miR-708-5p和沉默GAGE12I抑制GC细胞AGS增殖、迁移和侵袭; GAGE12I是miR-708-5p的靶基因,且miR-708-5p负性调节GAGE12I表达,过表达GAGE12I可部分逆转miR-708-5p对GC细胞AGS和BGC-823增殖、迁移和侵袭的抑制作用.结论 miR-708-5p可靶向GAGE12I抑制GC细胞增殖、迁移和侵袭.

激光选区熔化制备Ti−6Al−4V合金的显微组织及在人工模拟唾液中的电化学腐蚀行为

为了进一步提高植入体的耐腐蚀性,通过激光选区熔化制备Ti−6Al−4V合金。借助扫描电镜、电子背散射、透射电镜、电化学腐蚀试验和接触角试验对其显微组织和在人工模拟唾液中的电化学腐蚀行为进行研究。结果表明:激光选区熔化制备Ti−6Al−4V合金在堆积方向呈现典型的β柱状晶,在扫描方向呈近圆形棋盘状组织,而锻造和锻造+热处理样品呈现典型的等轴晶形貌。在37°C模拟人工唾液中激光选区熔化制备Ti−6Al−4V合金比锻造和锻造+热处理样品具有更好的耐腐蚀性能,这是由于其具有疏水性、更高的晶界密度和分布均匀的合金元素。

Prognostic and survival analysis of 837 Chinese colorectal cancer patients

AIM:To develop a prognostic model to predict survival of patients with colorectal cancer (CRC). METHODS:Survival data of 837 CRC patients undergoing surgery between 1996 and 2006 were collected and analyzed by univariate analysis and Cox proportional hazard regression model to reveal the prognostic factors for CRC. All data were recorded using a standard data form and analyzed using SPSS version 18.0 (SPSS, Chicago, IL, United States). Survival curves were calculated by the Kaplan-Meier method. The log rank test was used to assess differences in survival. Univariate hazard ratios and significant and independent predictors of disease-specific survival and were identified by Cox proportional hazard analysis. The stepwise procedure was set to a threshold of 0.05. Statistical significance was defined asP < 0.05. RESULTS:The survival rate was 74% at 3 years and 68% at 5 years. The results of univariate analysis suggested age, preoperative obstruction, serum carcinoembryonic antigen level at diagnosis, status of resection, tumor size, histological grade, pathological type, lymphovascular invasion, invasion of adjacent organs, and tumor node metastasis (TNM) staging were positive prognostic factors (P < 0.05). Lymph node ratio (LNR) was also a strong prognostic factor in stage Ⅲ CRC (P < 0.0001). We divided 341 stage Ⅲ patients into three groups according to LNR values (LNR1, LNR ≤ 0.33, n = 211; LNR2, LNR 0.34-0.66, n = 76; and LNR3, LNR ≥ 0.67, n = 54). Univariate analysis showed a significant statistical difference in 3-year survival among these groups:LNR1, 73%; LNR2, 55%; and LNR3, 42% (P < 0.0001). The multivariate analysis results showed that histological grade, depth of bowel wall invasion, and number of metastatic lymph nodes were the most important prognostic factors for CRC if we did not consider the interaction of the TNM staging system (P < 0.05). When the TNM staging was taken into account, histological grade lost its statistical significance, while the specific TNM staging system showed a statistically significant difference (P < 0.0001). CONCLUSION:The overall survival of CRC patients has improved between 1996 and 2006. LNR is a powerful factor for estimating the survival of stage Ⅲ CRC patients.

Acute gastrointestinal injury in critically ill patients with COVID-19 in Wuhan,China

BACKGROUND The coronavirus disease 2019(COVID-19)is spreading rapidly around the world.Most critically ill patients have organ injury,including acute respiratory distress syndrome,acute kidney injury,cardiac injury,or liver dysfunction.However,few studies on acute gastrointestinal injury(AGI)have been reported in critically ill patients with COVID-19.AIM To investigate the prevalence and outcomes of AGI in critically ill patients with COVID-19.METHODS In this retrospective study,demographic data,laboratory parameters,AGI grades,clinical severity and outcomes were collected.The primary endpoints were AGI incidence and 28-d mortality.RESULTS From February 10 to March 102020,83 critically ill patients out of 1314 patients with COVID-19 were enrolled.Seventy-two(86.7%)patients had AGI during hospital stay,of these patients,30 had AGI gradeⅠ,35 had AGI gradeⅡ,5 had AGI gradeⅢ,and 2 had AGI gradeⅣ.The incidence of AGI gradeⅡand above was 50.6%.Forty(48.2%)patients died within 28 days of admission.Multiple organ dysfunction syndrome developed in 58(69.9%)patients,and septic shock in 16(19.3%)patients.Patients with worse AGI grades had worse clinical variables,a higher incidence of septic shock and 28-d mortality.Sequential organ failure assessment(SOFA)scores(95%CI:1.374-2.860;P<0.001),white blood cell(WBC)counts(95%CI:1.037-1.379;P=0.014),and duration of mechanical ventilation(MV)(95%CI:1.020-1.340;P=0.025)were risk factors for the development of AGI gradeⅡand above.CONCLUSION The incidence of AGI was 86.7%,and hospital mortality was 48.2%in critically ill patients with COVID-19.SOFA scores,WBC counts,and duration of MV were risk factors for the development of AGI gradeⅡand above.Patients with worse AGI grades had a higher incidence of septic shock and 28-d mortality.

Research progress of tonic Chinese medicine on the immune system

The immune system as an important defense system of the body,bear the resistance to foreign pathogens invasion,removal of foreign heterogeneity,and protect the body′s safety.Modern research shows that tonic Chinese medicine,including single herband compound formula,has the function of improving immune organ index,enhancing immune cellfunction and affecting the immune molecule production and secretion.This article will review the effects of traditional Chinese medicine on immune organs,immune cells and immune molecules,and provide reference for the clinical research of traditional Chinese medicine.