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Purpose: Small bowel adenocarcinoma (SBA) is a rare malignancy, and most patients present with unresectable or metastatic disease. Thus far, no standard chemotherapeutic regimen has been established and related data are scarce, especially in Eastern countries. The purpose of this multicenter study was to evaluate the efficacy and toxicity of oxaliplatin combined with fluoropyrimidines in Chinese patients with advanced SBA., Methods: Advanced SBA patients who received FOLFOX (5-fluorouracil/5-FU plus leucovorin and oxaliplatin)/ CAPOX (capecitabine plus oxaliplatin) as first-line chemotherapy between February, 2004 and October, 2010 were identified from 3 large medical centers in China. The response rate (RR), progression-free survival (PFS), overall survival (OS), and chemotherapy-associated toxicity were evaluated. Cox models were applied for multivariate analyses., Results: Of 34 patients, with SBA 28 received FOLFOX and 6 CAPOX. The objective response (OR) and disease control (DC) rates were 32.3% and 61.7%, respectively. The median PFS and OS were 6.3 and 14.2 months, respectively. The toxicity was tolerable, grade 3-4 toxicity was rare. In multivariate analysis, only multi-organ metastasis reached borderline significance for shorter PFS (p=0.059), but the variables of age (>65 years; p=0.001), and multi-organ metastasis (p=0.001) were significantly associated with poor OS., Conclusion: To our knowledge, this multicenter retrospective study is the first and largest one among Asian studies at present estimating oxaliplatin combined with fluoropyrimidines as first-line chemotherapy for advanced SBA. FOLFOX/CAPOX is proved effective for advanced SBA in this study, but the results do not absolutely agree with previous studies from Western countries, showing that further studies are still needed.

Huperzia serrata is a producer of huperzine A (HupA), a cholinesterase inhibitor (ChEI). Over 120 endophytic fungi were recovered from this plant and screened for Hup-A and nine were found. These nine represented seven different fungal genera with the most significant producer being Shiraia sp. A total of 127 endophytic fungi isolates obtained from the root, stem, and leaf segments of H. serrata were grouped into 19 genera based on their morphological traits and sequence analysis of the internal transcribed spacers (ITS1-5.8S-ITS2), indicating endophytic fungi in H. serrata are diverse and abundant. Aspergillus, Podospora, Penicillium, Colletotrichum, and Acremonium were the frequent genera, whereas the remaining genera were infrequent groups. Overall, 39 endophytic fungi isolates showed acetylcholinesterase (AChE) inhibition in vitro. Nine endophytic fungi isolates from seven distinct genera were capable of producing HupA verified by thin-layer chromatography and reverse-phase high-performance liquid chromatography (RP-HPLC). Among the HupA-producing fungi, the yield of HupA produced by the Shiraia sp. Slf14 was 327.8 μg/l in potato dextrose broth, and the fungal HupA was further validated by mass spectrometry (ESI-MS). The present study demonstrated that H. serrata was a fascinating fungal reservoir for producing HupA and other ChEIs.

Ozone was applied to study the removal of conventional pollutants and typical endocrine disrupters (EDs), including bisphenol A (BPA), 4-n-nonylphenol(NP), 4-tert-octylphenol (OP), estrone (E1), estradiol (E2), 17alpha-estradiol (17alpha-E2), estriol (E3) and ethinylestradiol (EE2) , from heavily polluted river water. The O3 dose was designed at 28 mg x L(-1) for 30 min and 42 mg x L(-1) for 80 min. Pollutants in terms of chemical oxygen demand (COD) and ammonia nitrogen can not be removed efficiently, ranged from 3% to 7%. The colority of the black water was quickly reduced in the first 5 minutes, while the turbidities increased first and then decreased gradually. It showed that three EDs with relatively high level including BPA, OP and EE2 could be removed efficiently in thirty minutes. Concentrations of E3 increased first then decreased to be lower than the detection limit. Removal efficiencies of E1 and E2 were 41%-70% and 62%-85% respectively. Extension of ozone exposure time can not improve the efficiency of EDs removal any more.

Objective: To explore the possible mechanism of total flavonoids of Litsea coreana (TFLC) on reducing blood glucose level in rat with type 2 diabetes mellitus (T2DM)., Methods: Male SD rats of T2DM allocated in two groups were treated with 400 mg/kg TFLC or metformin respectively via gastrogavage for 6 weeks. Blood routine biochemical indices in rats were measured; pathology of rats' liver was examined with HE stain under transmission electron microscopy; levels of malondialdehyde (MDA) and superoxide dismutase (SOD) in liver homogenate were determined, and the expression of protein tyrosine phosphatase 1B (PTP1B) in liver was detected using RT-PCR at the terminal of the experiment., Results: Biochemical measuring showed that the glucose tolerance of rats after treatment was markedly improved in both groups. Meantime, levels of fast blood glucose (FBG), glycohemoglobin (HbA1c), fast blood insulin (FINS), free fatty acid (FFA), total cholesterol (TC), triglyceride (TG) and low density lipoprotein-cholesterol (LDL-C), as well as MDA level in liver were decreased, while levels of high density lipoprotein-cholesterol (HDL-C) in blood and SOD in liver were significantly increased in both groups after treatment, showing insignificant difference between two treatment groups. Light microscopic examination showed markedly fatty degeneration of liver, and electron microscopic examination found mitochondria swelling and endoplasmic reticulum breakage in liver of T2DM rats, but these changes were ameliorated to some extent after treatment. The elevated PTP1B expression in liver of T2DM rats was decreased in the TFLC treated group, but unchanged in the metformin treated group., Conclusion: TFLC can significantly decrease the blood levels of glucose and lipid and ameliorate oxidation stress in liver; its mechanism of action in improving insulin resistance might be related with its suppression on PTP1B expression in rat's liver to enhance the insulin signaling pathway.

This study was initiated to determine the possible antidiabetic effects of total flavonoids of Litsea Coreana leve (TFLC), an alcohol extract from the dried leaves of Litsea Coreana leve, on type 2 diabetic rats. Male Sprague-Dawley rats (n = 40, 160-180 g) were divided into two groups and fed with normal chow diet (Normal Control group) or high-fat diet (HFD) for a period of 4 weeks. After 4 weeks of dietary manipulation, the HFD-fed rats were injected with 30 mg/kg streptozocin (STZ) to induce diabetes 72 hours after STZ injection. These diabetic rats were randomly divided into 3 groups (n = 10): Diabetic Control group, Diabetic + TFLC group and Diabetic + PIO group. Diabetic + TFLC group and Diabetic + PIO group were orally administered with 400 mg/kg TFLC or 10 mg/kg pioglitazone (all suspended in 0.5% CMC-Na) respectively for 6 weeks. All rats were examined for body weight, serum and hepatic biochemical indices, content of malondialdehyde (MDA), activities of superoxide dismutase (SOD) and pathological changes in liver and pancreas, as well as protein tyrosine phosphatase 1B (PTP1B) expression in liver. The diabetic rats became obese, insulin resistant, hyperglycemic and hyperlipidemic. Treatment with TFLC showed a significant increase in insulin sensitivity, serum HDL-C level and SOD activities, meanwhile marked decrease in body weight, serum FFA, TC, TG, LDL-C, CRP, MDA content. TFLC also attenuated pathologic alterations in liver and pancreatic islet. Furthermore, TFLC was found to decrease the expression of PTP1B in diabetic rat liver. These results suggested that TFLC could ameliorate hyperglycemia, hyperlipoidemia, inflammation and oxidation stress, as well as insulin resistance of type 2 diabetic rats.

Background & Objective: For gastric stromal tumor (GST), the low incidence and high diversity in endoscopic and pathologic manifestations lead to misdiagnosis. This study was to explore the features of GST in endoscopy and clinicopathology., Methods: Clinical data of 42 GST patients, treated at the Second Affiliated Hospital of Sun Yat-sen University from Jan. 1996 to Jan. 2006, were analyzed for their clinicopathologic and endoscopic features. The expression of CD117, CD34, smooth muscle actin (SMA), Desmin and S-100 were detected by immunohistochemistry. Their correlations to clinicopathologic features of GST were analyzed., Results: Of the 42 cases of GST, 21 (50.0%) were at the fundus, 14 (33.3%) at the body, and 7 (16.7%) at the antrum; 17 (40.5%) were benign, 14 (33.3%) borderline, 11 (26.2%) malignant. Endoscopically, GST presented submucosal hemispheroid or polypoid protuberant lesions with clear border. While the positive rate of gastroendoscopic biopsy was low. Of the 42 cases, 29 were spindle cell type, 5 were epithelial cell type, and 8 were mixed type. The positive rates of CD34 and CD117 were 92.86% and 78.57%., Conclusions: GST has unique morphologic features. Combined detection of CD117 and CD34 benefits the diagnosis of GST.

Objective: To explore the clinical characteristics and pathogenetic patterns of acute pancreatitis (AP) in Guangdong region., Methods: Analysis and summary of the clinical data of 1316 AP patients admitted into the Sun Yat-sen Memorial Hospital of Sun Yat-sen University and the Guangdong Provincial People's Hospital between 1986 and 2005 were made., Results: The AP rates among 1986 - 1990, 1991 - 995, 1996 - 2000, 2001 - 2005 year subsections were 0.19%, 0.36%, 0.54% and 0.71%, respectively. 60.48% of the cases was associated with biliary tract disease and the rest were related to hyperlipidemic, idiopathic and alcoholic factors. Epigastric pain was the predominant clinical manifestation, with or without radiating lumbar and back pain. Digestive manifestations such as nausea and vomiting appeared in most of the patients. Contrast-enhanced dynamic computed tomography was a precise imaging technique for diagnosis and severity grading as well as for complication detection. 1104 patients received nonoperative treatment (integrated traditional and western medicine) with 24 deaths. 212 patients received operative treatment with 48 deaths., Conclusions: The incidence of AP increased in the recent 20 years. The pathogenesis of AP is numerous and complicated, and biliary tract disease is still the main etiology. The imaging techniques are beneficial for early diagnosis and severity grading. Nonsurgical treatment integrating traditional and western medicine should be applied for early therapy. Strictly handling the indications for surgery, avoiding early surgery and rationally using endoscopic technique may help to gain satisfactory therapeutic efficacy.