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1Analysis of in vivo patterns of caspase 3 gene expression in primary hepatocellular carcinoma and its relationship to p21^(WAF1) expression and hepatic apoptosis显示文摘AIM To detect the expression of caspase 3gene in primary human hepatocellular carcinoma(HCC)and investigate its relationship to p21WAF1gene expression and HCC apoptosis.METHODS In situ hybridization was employedto determine caspase 3 and p21WAF1expression inHCC.In situ end-labeling was used to detecthepatocytic apoptosis in HCC.RESULTS Twenty-one of 39(53.8%)cases ofHCC were found to express caspase 3transcripts,while 45.2% of HCC failed toexpress caspase 3.Non-cancerous adjacent livertissues showed more positive caspase 3(87.5%,7/8)as compared with HCC(P<0.05).The expression of caspase 3 is correlated withHCC differentiation,72.2%(13/18)ofmoderately to highly differentiated HCC showedcaspase 3 transcripts positive,while only 38.1%of poorly differentiated HCC harbored caspase 3transcripts(P<0.05).No relationship wasfound between caspase 3 expression and tumorsize or grade or metastasis,although 52.5%(5/8)of HCC with metastasis were caspase 3positive and a little higher than that with nometastasis(51.6%,P>0.05).Expression of caspase 3 alone did not affect the apoptosisindex(AI)of HCC.The AI was 7.12%o in caspase3-positive tumors(n=21),while in caspase 3-negative cases(n=18)6.59%0(P>0.05).Expression of caspase 3 clearly segregated withp21WAF1positive tumors as compared withp21WAF1-negative cases(16 of 23,69.6% versus5 of 16,31.3%)with statistical significance(P=0.017).In the cases with positive caspase 3and negative p21WAF1,the Al was found slightlyhigher,but with no statistical significance,thanthat with expression of p21WAF1and caspase 3(7.21‰ vs 6.98‰,P>0.05).CONCLUSION Loss of caspase 3 expressionmay contribute to HCC carcinogenesis,althoughthe expression of caspase 3 does not correlatewell with cell apoptosis in HCC.p21WAF1may bemerely one of the inhibitors which can reducecaspase 3 mediated cell apoptosis in HCCs.Bao Hua Sun Jun Zhang Bao JǜWang Xi Ping Zhao You Kun Wang Zhi Qun Yu Dong Liang Yang Lian Jie Hao Department of Clinical Immunology,Tongji Hospital,Tongji Medical University,Wuhan 430030,Hubei Province,China 2000World Journal of Gastroenterology2000,6,3:65
2Ultrasonically activated scalpel versus monopolar electrocautery shovel in laparoscopic total mesorectal excision for rectal cancer显示文摘AIM: To investigate the feasibility and safety of monopolar electrocautery shovel (ES) in laparoscopic total mesorectal excision (TME) with anal sphincter preservation for rectal cancer in order to reduce the cost of the laparoscopic operation, and to compare ES with the ultrasonically activated scalpel (US). METHODS: Forty patients with rectal cancer, who underwent laparoscopic TME with anal sphincter preservation from June 2005 to June 2007, were randomly divided into ultrasonic scalpel group and monopolar ES group, prospectively. White blood cells (WBC) were measured before and after operation, operative time, blood loss, pelvic volume of drainage, time of anal exhaust, visual analogue scales (VAS) and surgery-related complications were recorded. RESULTS: All the operations were successful; no one was converted to open procedure. No significant differences were observed in terms of preoperative and postoperative d 1 and d 3 WBC counts (P = 0.493, P = 0.375, P = 0.559), operation time (P = 0.235), blood loss (P = 0.296), anal exhaust time (P = 0.431), pelvicdrainage volume and VAS in postoperative d 1 (P = 0.431, P = 0.426) and d 3 (P = 0.844, P = 0.617) between ES group and US group. The occurrence of surgery-related complications such as anastomotic leakage and wound infection was the same in the two groups. CONCLUSION: ES is a safe and feasible tool as same as US used in laparoscopic TME with anal sphincter preservation for rectal cancer on the basis of the skillful laparoscopic technique and the complete understanding of laparoscopic pelvic anatomy. Application of ES can not only reduce the operation costs but also benef it the popularization of laparoscopic operation for rectal cancer patients.Bao-Jun Zhou, Wei-Qing Song, Qing-Hui Yan, Jian-Hui Cai, Feng-An Wang, Jin Liu, Guo-Jian Zhang, Guo-Qiang Duan, Zhan-Xue Zhang, Department of Gastrointestinal Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China Author contributions: Zhou BJ, Song WQ, Yan QH, Cai JH, Wang FA, Liu J, Zhang GJ, Duan GQ and Zhang ZX contributed equally to this work Zhou BJ, Song WQ, Yan QH, Cai JH and Wang FA designed the research Zhou BJ, Liu J and Zhang GJ performed the research Duan GQ and Zhang ZX analyzed the data and Zhou BJ, Song WQ and Yan QH wrote the paper. 2008World Journal of Gastroenterology2008,14,25:25
3Sorafenib inhibits growth and metastasis of hepatocellular carcinoma by blocking STAT3显示文摘AIM: To investigate the inhibitory role and the underlying mechanisms of sorafenib on signal transducer and activator of transcription 3 (STAT3) activity in hepatocellular carcinoma (HCC).METHODS: Human and rat HCC cell lines were treated with sorafenib. Proliferation and STAT3 dephosphorylation were assessed. Potential molecular mechanisms of STAT3 pathway inhibition by sorafenib were evaluated. In vivo antitumor action and STAT3 inhibition were investigated in an immunocompetent orthotopic rat HCC model.RESULTS: Sorafenib decreased STAT3 phosphorylationat the tyrosine and serine residues (Y705 and S727), but did not affect Janus kinase 2 (JAK2) and phosphatase shatterproof 2 (SHP2), which is associated with growth inhibition in HCC cells. Dephosphorylation of S727 was associated with attenuated extracellular signal-regulated kinase (ERK) phosphorylation, similar to the effects of a mitogen-activated protein kinase (MEK) inhibitor U0126, suggesting that sorafenib induced S727 dephosphorylation by inhibiting MEK/ERK signaling. Meanwhile, sorafenib could also inhibit Akt phosphorylation, and both the phosphatidylinositol-3-kinase (PI3K) inhibitor LY294002 and Akt knockdown resulted in Y705 dephosphorylation, indicating that Y705 dephosphorylation by sorafenib was mediated by inhibiting the PI3K/Akt pathway. Finally, in the rat HCC model, sorafenib signifi cantly inhibited STAT3 activity, reducing tumor growth and metastasis.CONCLUSION: Sorafenib inhibits growth and metastasis of HCC in part by blocking the MEK/ERK/STAT3 and PI3K/Akt/STAT3 signaling pathways, but independent of JAK2 and SHP2 activation.Fang-Ming Gu, Quan-Lin Li, Qiang Gao, Jia-Hao Jiang, Xiao-Yong Huang, Jin-Feng Pan, Jia Fan, Jian ZhouFang-Ming Gu, Quan-Lin Li, Qiang Gao, Jia-Hao Jiang, Xiao-Yong Huang, Jin-Feng Pan, Jia Fan, Jian Zhou, Liver Cancer Institute, Zhongshan Hospital and Shanghai Medical School, Fudan University, Shanghai 200032, China Author contributions: Gu FM, Li QL and Gao Q contributed equally to this work Gu FM and Li QL performed the experi- ments and interpretation of the data and statistical analysis Zhou J and Gao Q contributed to the conception and design of the study Gu FM, Gao Q, Li QL and Zhou J wrote the manuscript Jiang JH, Huang XY, Pan JF and Fan J made substantial contri- bution to the design and conception of the study and interpreta- tion of data all authors read and approved the f inal manuscript. 2011World Journal of Gastroenterology2011,17,34:18
4Increased secretion of pro-inflammatory cytokines by circulating polymorphonuclear neutrophills and regulation by interleukin 10 during intestinal inflammation显示文摘Increasedsecretionofproinflammatorycytokinesbycirculatingpolymorphonuclearneutrophilsandregulationbyinterleukin10duringintes...S Nikolaus 1, J Bauditz 1, P Gionchetti 2, C Witt 3, H Lochs 1 and S Schreiber 1 1Charité University Hospital, 4th Medical Department, Humboldt University, Berlin, Germany 2Clinica Media I, Policlinico S. Orsola, University of Bolog 1998World Journal of Gastroenterology1998,4,3:17
5Tumor size as a prognostic factor in patients with advanced gastric cancer in the lower third of the stomach显示文摘AIM: To explore the impact of tumor size on outcomes in patients with advanced gastric cancer in the lower third of the stomach. METHODS: We retrospectively analyzed the clinical records of 430 patients with advanced gastric cancer in the lower third of the stomach who underwent distal subtotal gastrectomy and D2 lymphadenectomy in our hospital from January 1998 to June 2004. Receiver-operating characteristic (ROC) curve analysis was used to determine the appropriate cutoff value for tumor size, which was measured as maximum tumor diameter. Based on this cutoff value, patients were divided into two groups: those with large-sized tumors (LSTs) and those with small-sized tumors (SSTs). The correlations between other clinicopathologic factors and tumor size were investigated, and the 5-year overall survival (OS) rate was compared between the two groups. Potential prognostic factors were evaluated by univariate KaplanMeier survival analysis and multivariate Cox's propor-tional hazard model analysis. The 5-year OS rates in the two groups were compared according to pT stage and pN stage. RESULTS: The 5-year OS rate in the 430 patients with advanced gastric cancer in the lower third of the stomach was 53.7%. The mean ± SD tumor size was 4.9 ± 1.9 cm, and the median tumor size was 5.0 cm. ROC analysis indicated that the sensitivity and specificity results for the appropriate tumor size cutoff value of 4.8 cm were 80.0% and 68.2%, respectively (AUC=0.795, 95%CI: 0.751-0.839, P=0.000). Using this cutoff value, 222 patients (51.6%) had LSTs (tumor size ≥ 4.8 cm) and 208 (48.4%) had SSTs (tumor size<4.8 cm). Tumor size was significantly correlated with histological type (P=0.039), Borrmann type (P=0.000), depth of tumor invasion (P=0.000), lymph node metastasis (P=0.000), tumor-nodes metastasis stage (P=0.000), mean number of metastatic lymph nodes (P=0.000) and metastatic lymph node ratio (P=0.000). Patients with LSTs had a significantly lower 5-year OS rate than those with SSTs (37.1% vs 63.3%, P=0.000). Univariate analysis showed that depth of tumor invasion (c 2=69.581, P=0.000), lymph node metastasis (c 2=138.815, P=0.000), tumor size (c 2=78.184, P=0.000) and metastatic lymph node ratio (c 2=139.034, P=0.000) were significantly associated with 5-year OS rate. Multivariate analysis revealed that depth of tumor invasion (P=0.000), lymph node metastasis (P=0.019) and tumor size (P=0.000) were independent prognostic factors. Gastric cancers were divided into 12 subgroups: pT2N0; pT2N1; pT2N2; pT2N3; pT3N0; pT3N1; pT3N2; pT3N3; pT4aN0; pT4aN1; pT4aN2; and pT4aN3. In patients with pT2-3N3 stage tumors and patients with pT4a stage tumors, 5-year OS rates were significantly lower for LSTs than for SSTs (P<0.05 each), but there were no significant differences in the 5-year OS rates in LST and SST patients with pT23N0-2 stage tumors (P > 0.05). CONCLUSION: Using a tumor size cutoff value of 4.8cm, tumor size is a prognostic factor in patients with pN3 stage or pT4a stage advanced gastric cancer located in the lower third of the stomach.Hong-Mei Wang, Chang-Ming Huang, Chao-Hui Zheng, Ping Li, Jian-Wei Xie, Jia-Bin Wang, Jian-Xian Lin, Jun Lu, Department of Gastric Surgery, Affiliated Union Hospital of Fujian Medical University, Fuzhou 350001, Fujian Province, China Author contributions: Wang HM and Huang CM conceived of the study, analyzed the data, and drafted the manuscript Zheng CH, Li P and Xie JW helped revise the manuscript critically for important intellectual content Wang JB, Lin JX and Lu J helped collect data and design the study and all authors read and approved the final manuscript. 2012World Journal of Gastroenterology2012,18,38:15
6Subclinical abnormal glucose tolerance is a predictor of death in liver cirrhosis显示文摘AIM:To determine if subclinical abnormal glucose tolerance(SAGT)has influence on survival of non-diabetic patients with liver cirrhosis.METHODS:In total,100 patients with compensatedliver cirrhosis and normal fasting plasma glucose were included.Fasting plasma insulin(FPI)levels were measured,and oral glucose tolerance test(OGTT)was performed.According to OGTT results two groups of patients were formed:those with normal glucose tolerance(NGT)and those with SAGT.Patients were followed every three months.The mean follow-up was932 d(range of 180-1925).Survival was analyzed by the Kaplan-Meyer method,and predictive factors of death were analyzed using the Cox proportional hazard regression model.RESULTS:Of the included patients,30 showed NGT and70 SAGT.Groups were significantly different only in age,INR,FPI and HOMA2-IR.Patients with SAGT showed lower 5-year cumulated survival than NGT patients(31.7%vs 71.6%,P=0.02).Differences in survival were significant only after 3 years of follow-up.SAGT,Child-Pugh B,and high Child-Pugh and Model for EndStage Liver Disease(MELD)scores were independent predictors of death.The causes of death in 90.3%of cases were due to complications related to liver disease.CONCLUSION:SAGT was associated with lower survival.SAGT,Child-Pugh B,and high Child-Pugh and MELD scores were independent negative predictors of survival.Diego García-Compeán Joel Omar Jáquez-Quintana Fernando Javier Lavalle-González José Alberto González-González Linda Elsa Mu?oz-Espinosa Jesús Zacarías Villarreal-PérezEndocrinology Service and Department of Internal Medicine University Hospital 'Dr. José E. González' and Medical School Universidad Autónoma de Nuevo León Monterrey 64320 México Héctor J Maldonado-Garza 2014World Journal of Gastroenterology2014,20,22:12
7Anatomic structural study of cerebellopontine angle via endoscope显示文摘在颅骨底依靠寻找内视镜的技术的可能的解剖基础的背景最低限度地侵略的外科是争论的。这研究的目的是在 cerebellopontine 角度区域观察在主要的血容器和神经之间的空间关系并且为侧面、以后的颅骨底提供解剖基础经由内视镜的 retrosigmoid 锁眼 approach.Methods 的最低限度地侵略的外科这研究在三十个弄干的成年颅骨上被进行测量空间关系在之中出现以后的头部的窝的多骨的标记,并且为 retrosigmoid 锁眼 ap 定位最适当的钻区域在直径与 2.0 厘米在这个点上集中的一个洞对在 cerebellopontine 角度暴露相关结构合适。 Retrosigmoid 锁眼途径罐头减少小脑上的压力并且有效地暴露相关结构它包括面部神经, vestibulocochlear 神经,三叉的神经,舌与喉的神经,迷走神经神经,附件神经,舌下神经神经,前面的劣等的小脑的动脉,以后的劣等的小脑的动脉和迷宫的动脉,内诊镜 retrosigmoid 途径上的准确地点能避免在最低限度地侵略的外科期间拖小脑的 etc.Conclusions 。retrosigmoid 锁眼途径的申请将扩大内视镜的技术的申请。XIA Yin LI Xi-ping HAN De-min ZHENG Jun LONG Hai-shan SHI Jin-feng Department of Otolaryngology,Beijing Tongren Hospital,Capital Medical University Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University),Ministry of Education,Beijing 100730,China (Xia Y,Li XP,Han DM,Zheng J,Long HS and Shi JF) 2007Chinese Medical Journal2007,,20:7
8Impact of virus genotype on interferon treatment of patients with chronic hepatitis C: a multicenter controlled study显示文摘BACKGROUND: Some factors have been reported to besassociated with a greater likelihood of sustained viral re-sponse ( SVR) in the interferon (IFN) treatment of chronichepatitis C. The factors include HCV genotype, HCVRNA level in serum, state of liver disease, baseline bodyweight, age, sex, and race. The aim of this trial was to in-vestigate the influence of HCV genotype on the IFN treat-ment of patients with chronic hepatitis C.METHODS: The genotypes of HCV virus were determinedin the patients with chronic hepatitis C from several hospi-tals of China enrolled into the randomized, opened andcontrolled trial of Peg-IFN alpha-2a (pegasys) treatment,controlled with IFN-α-2a (roferon-A). The serum ALTlevels and HCV RNA concentrations of the patients weredetected before and at the end of treatment and during thefollow-up. The influence of HCV genotype on the IFNtreatment of patients with chronic hepatitis C was analyzedin intention-to-treat (ITT) population.RESULTS: The HCV genotypes of 202 patients were deter-mined. Of these patients, 158(78.22%) were infected withgenotype 1 HCV and 44(21.78%) with genotype non-1.The viral response at the end of treatment (ETVR) andsustained viral response (SVR) rates were 53.80% and25.32% respectively in patients with genotype 1 HCV, butthey were 61.36% and 43.18% in patients with genotypenon-1. The difference of SVR between patients with geno-type 1 HCV and those with genotype non-1 was significant(P =0.021). After being grouped by the used drugs, theETVR rates of patients infected with genotype 1 and non-1HCV were 76.83% and 80.95% in the patients treated withpegasys (P =0.686); but their SVR rates were 35.37% and66.67% (P =0. 01). The viral relapse rate of genotype 1HCV (55.56%) was significantly higher than that of geno-type non-1 HCV (23.53%) (P=0.02). In roferon-A group,the ETVR and SVR rates of patients with genotype 1 HCVwere 28.95% and 14.47% respectively, which were lowerbut not more significant than those of patients with geno-type non-1 HCV (43.48% and 21.74%). Moreover, the vi-ral relapse rate of genotype 1 HCV (72.73%) was higherbut not more significant than that of genotype non-1 HCV(50.00%) (P=0.21).CONCLUSION: HCV genotype could affect the efficacies,mainly sustained responses, of IFN treatment in patientswith chronic hepatitis C, and the effects of IFN are relatedto drugs and therapeutic course.Yao Xie, Dao-Zhen Xu, Zhi-Meng Lu, Kang-Xian Luo, Ji-Dong Jia, Yu-Ming Wang,Gui-Zhen Zhao, Shu-Lin Zhang and Da-Zhi Zhang Department of Infeetious Diseases , Beijing Ditan Hos-pital, Beijing 100011 , China Department of Infec-tious Diseases, Ruijin Hospital, Shanghai 200025, China De-partment of Infectious Diseases, Naifang Hospital, First Military Medical U-niversity, Guangzhou 510515, China (Luo KX) Center of Liver Disease,Beijing Friendship Hospital, Beijing 100050, China (Jia J D ) Institute ofInfectious Disease, Southwest Hospital, Third Military Medical University,Chongqing 410032, China Department of Infectious Disea-ses, Second Hospital, China Medical University, Shenyang 110004, China Department of Infectious Diseases, First Hospital, Xi’ an Jiao-tong University, Xi’ an 710061 , China ) Liver Disease Centerof Chongqing, Second Hospital, Chongqing Medical University,Chongqing 410010, China 2004Hepatobiliary & Pancreatic Diseases International2004,3,3:2
9, a meta analysis显示文摘HOLLINGSWORTH J M ROGERS M A KAUF- MAN S R Medical therapy to facilitate urinary stone passage 2006Lancet2006,368,9542:1
10显示文摘Society of Critical Care Medicine Chinese Medical Association..? 慢性阻塞性肺疾病急性加重患者的机械通气指南(2007)(J)中国危重病急救医学. 2007 (09) 2007中国危重病急救医学2007,,:1
11A review of its effects on knowledge and clinical performance显示文摘Neville A J Problem-based learning and medical education forty years on 2009Medical Principles and Practice2009,18,1:1
12Effect of rnsiglitazone on the frequency of diabetes in patients with impaired glucose tol- erance or impaired fasting glucose: a randomised controlled trial显示文摘DREAM (Diabetes Reduction Assessment with ramipral and rosiglitazone Medication )Trial Investigators Gestein HC Yusuf S Bosch J 2006Lancet2006,,368:1
13High-resolution MR imaging of sequestered lumbar intervertebral disks 显示文摘Masaryk T J Ross J S Medic M T 1988AJR1988,150,5:1
14Medication adherence in schizophrenia:factors influencing adherence and consequences of nonadherence,a systematic literature review显示文摘Higashi K Medic G Littlewood K J 2013Therapeutic Ad- vances Psychopharmacology2013,3,:1
15Association of the TGF-beta receptor genes with abdominal aortic aneurysm显示文摘Baas AF Medic J van't Slot R de Kovel CG Zhernakova A Geelkerken RH 2010Eur J Hum Genet2010,18,2:1
16Quality of life outcomes of immediate or delayed treatment of early epilepsy and single seizures显示文摘Jacoby A Gamble C Doughty J (Medical Research Council MESS Study Group) 2007Neurology2007,68,15:1
17Diagnosis and Treatment of Human Poisoning (Secondedition) 显示文摘Matthew J Ellenhorn Ellenhorn Medical Toxicology 1997Willians & Wilkins1997,,:1
18Rough wall modification of two-layer k-ε 显示文摘Durbin P A Medic G Seo J M 2001J Fluids Engineering2001,123,:1
19Alternative dispute resolution in medical malpractice显示文摘Fraser J Jr Committee on Medical Liability 2001Pediatrics2001,107,3:1
20Guideline for the diagnosis and optimal man- agement of asthma in children 显示文摘The Subspecialty Group of Respiratory Desease th Society of Pe- diatrics Chinese Medical Association the Editoral Board Chi- nese J of Pediatrics 2008Chin J Pediatric2008,10,46:1
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