The 2002 AJCC TNM classification is a better predictor of primary small cell esophageal carcinoma outcome than the VALSG staging system

Small cell carcinoma of the esophagus (SCCE) is a rare and aggressive malignant tumor with a poor prognosis. The optimal disease staging system and treatment approaches have not yet been defined. This study aimed to evaluate the prediction of different staging systems for prognosis and treatment options of SCCE. We retrospectively accessed the clinicopathologic characteristics, treatment strategy, and prognosis of 76 patients diagnosed with primary SCCE between 2001 and 2011. The 1-, 2-, 3-, and 5-year overall survival rates were 58%, 31%, 19%, and 13%, respectively. Univariate analysis showed that the 2002 American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) classification (P=0.002), Veterans Administration Lung Study Group (VALSG) stage (P=0.001), predisposing factors (P<0.001), T category (P=0.023), and M category (P<0.001) were prognostic factors for overall survival. Multivariate analysis showed that the 2002 AJCC TNM stage (P<0.001) was the only independent prognostic factor for survival. The value of the area under the receiver operator characteristic (ROC) curve (AUC) of the 2002 AJCC TNM staging system was larger than that of VALSG staging system with regard to predicting overall survival (0.774 vs. 0.620). None of the single treatment regimens showed any benefit for survival by Cox regression analysis. Thus, the 2002 AJCC TMN staging system improved the prediction of SCCE prognosis; however, the optimal treatment regimen for SCCE remains unclear.

Protective effect of heme oxygenase-1 on Wistar rats with heart failure through the inhibition of inflammation and amelioration of intestinal micro- circulation

BackgroundMyocardial 梗塞(MI ) 多半贡献了心失败(HF ) 的增加的流行。由于减少的心脏的功能，内脏的血流动减少，引起在到肠的障碍的绒毛和损坏的局部缺血。heme oxygenase-1 (HO-1 ) 的正式就职能阻止，或减少应力和发炎的效果。因此，效果和有 HF 的老鼠的肠上的 HO-1 它的机制是有通过左冠的动脉的结扎的心失败的 investigated.MethodsMale Wistar 老鼠与 &#x0003c 的左室的喷射部分被识别；45% 通过 echocardiography 然后基于他们收到了的腹注射的类型划分了成各种各样的试验性的组[MI：盐；MI + 钴 protoporphyrin (CoPP ) ：CoPP 答案；并且 MI + 听 mesoporphyrin IX 二氯化物(简单网络管理协议) ：简单网络管理协议答案] 。没有冠的结扎，控制组由老鼠组成。Echocardiography 在结扎以后为一条基线和八个星期在结扎前被执行以便评估老鼠的心脏的功能。细菌的 translocation (BT ) 发生， mesenteric microcirculation，在静脉浆液的内毒素的数量， HO-1 的回肠层次，碳氧化物(公司) ，氮的氧化物(没有) ， interleukin (IL )-10, 瘤坏死 factor-&#x003b1；(TNF-&#x003b1；) ，并且在收到 MI + CoPP 注射的 operation.ResultsThe 老鼠在心脏的功能展出了恢复以后，回肠形态学八个星期被决定，在形态学的 mesenteric microcirculation 和变化的改善，更低的 BT 发生，在浆液的减小并且肠阻塞没有并且 TNF-&#x003b1；与 MI 相比的在肠阻塞的 HO-1，公司，和 interleukin-10 (IL-10 ) 的层次，和举起层次组织(P &#x0003c；0.05 ) 。收到了 MI + 简单网络管理协议注射的老鼠展出了对 MI 反的结果(P &#x0003c；0.05 ) group.ConclusionsHO-1 由通过 CO 小径禁止 microcirculation 的发炎和改善与 HF 在老鼠的肠上施加了保护的效果。这保护的效果能从心脏的功能的恢复是独立的。

Endoscopic papillary balloon intermittent dilatation and endoscopic sphincterotomy for bile duct stones

AIM: To compare the effectiveness and safety of endoscopic papillary balloon intermittent dilatation (EPBID) and endoscopic sphincterotomy (EST) in the treatment of common bile duct stones. METHODS: From March 2011 to May 2012, endoscopic retrograde cholangiopancreatography was performed in 560 patients, 262 with common bile duct stones. A total of 206 patients with common bile duct stones were enrolled in the study and randomized to receive either EPBID with a 10-12 mm dilated balloon or EST (103 patients in each group). For both groups a conventional reticular basket or balloon was used to remove the stones. After the procedure, routine endoscopic nasobiliary drainage was performed. RESULTS: First-time stone removal was successfully performed in 94 patients in the EPBID group (91.3%) and 75 patients in the EST group (72.8%). There was no statistically significant difference in terms of operation time between the two groups. The overall incidence of early complications in the EPBID and EST groups was 2.9% and 13.6%, respectively, with no deaths reported during the course of the study and follow-up. Multiple regression analysis showed that the success rate of stone removal was associated with stone removal method [odds ratio (OR): 5.35; 95%CI: 2.24-12.77; P=0.00], the transverse diameter of the stone (OR: 2.63; 95%CI: 1.19-5.80; P=0.02) and the presence or absence of diverticulum (OR: 2.35; 95%CI: 1.03-5.37; P=0.04). Postoperative pancreatitis was associated with the EST method of stone removal (OR: 5.00; 95%CI: 1.23-20.28; P=0.02) and whether or not pancreatography was performed (OR: 0.10; 95%CI: 0.03-0.35; P=0.00). CONCLUSION: The EPBID group had a higher success rate of stone removal with a lower incidence of pancreatitis compared with the EST group.

FXR agonist GW4064 alleviates endotoxin-induced hepatic inflammation by repressing macrophage activation

AIM:To examine the effect of farnesoid X receptor(FXR)activation by GW4064 on endotoxin-induced hepatic inflammation in nonalcoholic fatty liver disease(NAFLD)and the underlying mechanism.METHODS:Six-week-old male C57BL/6 mice were fed a normal diet or a high-fat(HF)diet for 8 wk.HF dietfed mice were intraperitoneally injected with GW4064(30 mg/kg)or DMSO(vehicle)once daily for a week and then sacrificed after lipopolysaccharide(LPS,50μg/mouse)administration.Hepatic inflammation,levels of the macrophage marker F4/80,and apoptosis were measured at the end of the study.Additionally,the expression of proinflammatory genes involved in NAFLD(interleukin-6,interleukin-1β,interferon-γ,MCP-1)were analyzed by real-time PCR in the murine macrophagecell line RAW 264.7 cultured with or without GW4064(2μmol/L)before treatment with LPS.RESULTS:In patients with NAFLD,the expression of FXR was detected by immunohistochemical staining and the relation between FXR expression and NAFLD activity score(NAS)was analyzed.Activation of FXR by GW4064 alleviated hepatic inflammation induced by endotoxin in a murine NAFLD model fed an HF diet as reflected by reduced serum levels of aspartate aminotransferase and alanine aminotransferase.Apoptosis and proinflammatory cytokine levels in liver tissues were also reduced by GW4064,and GW4064 could reduce induction of proinflammatory cytokines by LPS in vitro.FXR levels were reduced in patients with nonalcoholic steatohepatitis compared with healthy controls and were negatively correlated with NAS.CONCLUSION:FXR activation attenuates LPS-induced hepatic inflammation in murine NAFLD by reducing expression of proinflammatory cytokines in macrophages.

Olfactory ensheathing cells promote nerve regeneration and functional recovery after facial nerve defects

Olfactory ensheathing cells from the olfactory bulb and olfactory mucosa have been found to increase axonal sprouting and pathfinding and promote the recovery of vibrissae motor performance in facial nerve transection injured rats. However, it is not yet clear whether olfactory ensheathing cells promote the reparation of facial nerve defects in rats. In this study, a collagen sponge and silicone tube neural conduit was implanted into the 6-mm defect of the buccal branch of the facial nerve in adult rats. Olfactory ensheathing cells isolated from the olfactory bulb of newborn Sprague-Dawley rats were injected into the neural conduits connecting the ends of the broken nerves, the morphology and function of the regenerated nerves were compared between the rats implanted with olfactory ensheathing cells with the rats injected with saline. Facial paralysis was assessed. Nerve electrography was used to measure facial nerve-induced action potentials. Visual inspection, anatomical microscopy and hematoxylin-eosin staining were used to assess the histomorphology around the transplanted neural conduit and the morphology of the regenerated nerve. Using fluorogold retrograde tracing, toluidine blue staining and lead uranyl acetate staining, we also measured the number of neurons in the anterior exterior lateral facial nerve motor nucleus, the number of myelinated nerve fibers, and nerve fiber diameter and myelin sheath thickness, respectively. After surgery, olfactory ensheathing cells decreased facial paralysis and the latency of the facial nerve-induced action potentials. There were no differences in the general morphology of the regenerating nerves between the rats implanted with olfactory ensheathing cells and the rats injected with saline. Between-group results showed that olfactory ensheathing cell treatment increased the number of regenerated neurons, improved nerve fiber morphology, and increased the number of myelinated nerve fibers, nerve fiber diameter, and myelin sheath thickness. In conclusion, implantation of olfactory ensheathing cells can promote regeneration and functional recovery after facial nerve damage in rats.