AIM To provide an updated assessment of the safety and efficacy of enhanced recovery after surgery(ERAS) protocols in elective gastric cancer(GC) surgery.METHODS Pub Med, Medline, EMBASE, World Health Organization Int...AIM To provide an updated assessment of the safety and efficacy of enhanced recovery after surgery(ERAS) protocols in elective gastric cancer(GC) surgery.METHODS Pub Med, Medline, EMBASE, World Health Organization International Trial Register, and Cochrane Library were searched up to June 2017 for all available randomized controlled trials(RCTs) comparing ERAS protocols and standard care(SC) in GC surgery. Thirteen RCTs, with a total of 1092 participants, were analyzed in this study, of whom 545 underwent ERAS protocols and 547 received SC treatment.RESULTS No significant difference was observed between ERAS and control groups regarding total complications(P = 0.88), mortality(P = 0.50) and reoperation(P = 0.49). The incidence of pulmonary infection was significantly reduced(P = 0.03) following gastrectomy. However, the readmission rate after GC surgery nearly tripled under ERAS(P = 0.009). ERAS protocols significantly decreased the length of postoperative hospital stay(P < 0.00001) and medical costs(P < 0.00001), and accelerated bowel function recovery, as measured by earlier time to the first flatus(P = 0.0004) and the first defecation(P < 0.0001). Moreover, ERAS protocols were associated with a lower level of serum inflammatory response, higher serum albumin, and superior shortterm quality of life(QOL).CONCLUSION Collectively, ERAS results in accelerated convalescence, reduction of surgical stress and medical costs, improved nutritional status, and better QOL for GC patients. However, high-quality multicenter RCTs with large samples and long-term follow-up are needed to more precisely evaluate ERAS in radical gastrectomy.展开更多
To investigate the expression pattern of rat Eppin （epididymal protease inhibitor; official symbol Spinlwl）, we detected mRNA transcripts and subsequent protein translation of Eppin in several sorts of tissues by RT...To investigate the expression pattern of rat Eppin （epididymal protease inhibitor; official symbol Spinlwl）, we detected mRNA transcripts and subsequent protein translation of Eppin in several sorts of tissues by RT-PCR and westem blotting. Then immunohistochemistry was performed for more detailed observation. The testicular transcription level was monitored by real-time PCR throughout postnatal development. We found that rat Eppin was specifically expressed in the testis and epididymis. The testicular transcription was slight in neonatal （1-day） and infantile stages （5-, 7- and 10-day）. It increased sharply thereafter, with maximum expression level （about 38- fold compared with that of 1-day old rat） detected in prepubertal stage （15-day）. Then a slightly declined but stable level （about 20-fold compared with that of 1-day old rat） was kept in pubertal-early adult （30-day） and adult （60-day） stages of postnatal maturation. In the adult rat, EPPIN protein was mainly localized in the elongated spermatids and epididymal epithelial cells. Sperm in the epididymal duct were all covered with EPPIN and its level kept constant during incubation under conditions used to achieve capacitation. Its stage-specific expression in the testis suggests that EPPIN may be important during spermatogenesis especially for the spermatid elongation. The abundant production of epididymal EPPIN indicated indirectly that it might play a role in the function of the epididymis.展开更多
Human epididymal protease inhibitor （eppin） may be effective as a male contraceptive vaccine. In a number of studies, eppin with an engineered His6-tag has been produced using prokaryotic expression systems. For pro...Human epididymal protease inhibitor （eppin） may be effective as a male contraceptive vaccine. In a number of studies, eppin with an engineered His6-tag has been produced using prokaryotic expression systems. For production of pharmaceutical-grade proteins for human use, however, the His6-tag must be removed. This study describes a method for producing recombinant human eppin without a His6-tag. We constructed plasmid pET28a （＋）-His6-tobacco etch virus （TEV）-eppin for expression in Escherichia coli. After purification and refolding, the fusion protein His6-TEV-eppin was digested with TEV protease to remove the His6-tag and was further purified by NTA-Ni2＋ affinity chromatography. Using this procedure, 2 mg of eppin without a His6-tag was isolated from 1 I of culture with a purity of 〉95%. The immunogenicity of the eppin was characterized using male Balb/c mice.展开更多
基金Supported by the National Natural Science Foundation of China,No.81272711 to Shen LZthe Priority Academic Program Development of Jiangsu Higher Education Institutions,No.JX10231801 to Shen LZthe Key Medical Talents Program of Jiangsu Province,No.ZDRCA2016014 to Shen LZ
文摘AIM To provide an updated assessment of the safety and efficacy of enhanced recovery after surgery(ERAS) protocols in elective gastric cancer(GC) surgery.METHODS Pub Med, Medline, EMBASE, World Health Organization International Trial Register, and Cochrane Library were searched up to June 2017 for all available randomized controlled trials(RCTs) comparing ERAS protocols and standard care(SC) in GC surgery. Thirteen RCTs, with a total of 1092 participants, were analyzed in this study, of whom 545 underwent ERAS protocols and 547 received SC treatment.RESULTS No significant difference was observed between ERAS and control groups regarding total complications(P = 0.88), mortality(P = 0.50) and reoperation(P = 0.49). The incidence of pulmonary infection was significantly reduced(P = 0.03) following gastrectomy. However, the readmission rate after GC surgery nearly tripled under ERAS(P = 0.009). ERAS protocols significantly decreased the length of postoperative hospital stay(P < 0.00001) and medical costs(P < 0.00001), and accelerated bowel function recovery, as measured by earlier time to the first flatus(P = 0.0004) and the first defecation(P < 0.0001). Moreover, ERAS protocols were associated with a lower level of serum inflammatory response, higher serum albumin, and superior shortterm quality of life(QOL).CONCLUSION Collectively, ERAS results in accelerated convalescence, reduction of surgical stress and medical costs, improved nutritional status, and better QOL for GC patients. However, high-quality multicenter RCTs with large samples and long-term follow-up are needed to more precisely evaluate ERAS in radical gastrectomy.
文摘To investigate the expression pattern of rat Eppin （epididymal protease inhibitor; official symbol Spinlwl）, we detected mRNA transcripts and subsequent protein translation of Eppin in several sorts of tissues by RT-PCR and westem blotting. Then immunohistochemistry was performed for more detailed observation. The testicular transcription level was monitored by real-time PCR throughout postnatal development. We found that rat Eppin was specifically expressed in the testis and epididymis. The testicular transcription was slight in neonatal （1-day） and infantile stages （5-, 7- and 10-day）. It increased sharply thereafter, with maximum expression level （about 38- fold compared with that of 1-day old rat） detected in prepubertal stage （15-day）. Then a slightly declined but stable level （about 20-fold compared with that of 1-day old rat） was kept in pubertal-early adult （30-day） and adult （60-day） stages of postnatal maturation. In the adult rat, EPPIN protein was mainly localized in the elongated spermatids and epididymal epithelial cells. Sperm in the epididymal duct were all covered with EPPIN and its level kept constant during incubation under conditions used to achieve capacitation. Its stage-specific expression in the testis suggests that EPPIN may be important during spermatogenesis especially for the spermatid elongation. The abundant production of epididymal EPPIN indicated indirectly that it might play a role in the function of the epididymis.
基金ACKNOWLEDGEMENTS The authors are grateful to Dr Zi-Chun Hua （The State Key Laboratory of Pharmaceutical Biotechnology and Department of Biochemistry, College of Life Science, Nanjing University, China） for kindly providing plasmid pET28a （＋） and TEV endoprotease and to Dr Michael G. O＇Rand （Laboratories for Reproductive Biology and Department of Cell and Developmental Biology, University of North Carolina at Chapel Hill, USA） for English-language editing. This study was supported by grants from the Key Project of the National Natural Science Foundation of China （No. 30930079） and the Chinese National Nature Science Foundation （No. 81001257）.
文摘Human epididymal protease inhibitor （eppin） may be effective as a male contraceptive vaccine. In a number of studies, eppin with an engineered His6-tag has been produced using prokaryotic expression systems. For production of pharmaceutical-grade proteins for human use, however, the His6-tag must be removed. This study describes a method for producing recombinant human eppin without a His6-tag. We constructed plasmid pET28a （＋）-His6-tobacco etch virus （TEV）-eppin for expression in Escherichia coli. After purification and refolding, the fusion protein His6-TEV-eppin was digested with TEV protease to remove the His6-tag and was further purified by NTA-Ni2＋ affinity chromatography. Using this procedure, 2 mg of eppin without a His6-tag was isolated from 1 I of culture with a purity of 〉95%. The immunogenicity of the eppin was characterized using male Balb/c mice.
