Search

Background: Schizophrenia is a chronic and severe mental disorder. People with schizophrenia have transferred from hospital-based care to community-based care with the support of mental health legal policies. Challenges faced in the community should be emphasized. Limited qualitative studies have explored the challenges of living with schizophrenia. Aims: To explore the challenges of people living with schizophrenia in the community. Methods: A narrative method was used, including semi-structured, face-to-face interviews. Thematic analysis approach was used to analyze data. Results: Ten clients and their family members participated in the study. Analysis revealed three main themes related to their challenges in the community: deficits in self-management of illness; insufficient community mental health care; and the influence of policy. These challenges prevent those with schizophrenia from effectively managing their illness, returning to a productive role in society, and improving their quality of life. Conclusions: There are challenges in mental health rehabilitation and social reintegration of individuals with schizophrenia. There is a need for continuous community mental rehabilitation services, appropriate policy support, and the need to educate the public to reduce social bias and discrimination which allows individuals with schizophrenia to assume a productive role in the community.

OBJECTIVE: The aim of this study was to evaluate peak serum alanine aminotransferase (ALT) and postoperative clinical outcomes after hypothermic oxygenated machine perfusion (HOPE) versus static cold storage (SCS) in extended criteria donation (ECD) liver transplantation (LT) from donation after brain death (DBD).BACKGROUND: HOPE might improve outcomes in LT, particularly in high-risk settings such as ECD organs after DBD, but this hypothesis has not yet been tested in a randomized controlled clinical trial (RCT).METHODS: Between September 2017 and September 2020, 46 patients undergoing ECD-DBD LT from four centers were randomly assigned to HOPE (n = 23) or SCS (n = 23). Peak-ALT levels within 7 days following LT constituted the primary endpoint. Secondary endpoints included incidence of postoperative complications [Clavien-Dindo classification (CD), Comprehensive Complication Index (CCI)], length of intensive care- (ICU) and hospital-stay, and incidence of early allograft dysfunction (EAD).RESULTS: Demographics were equally distributed between both groups [donor age: 72 (IQR: 59-78) years, recipient age: 62 (IQR: 55-65) years, labMELD: 15 (IQR: 9-25), 38 male and 8 female recipients]. HOPE resulted in a 47% decrease in serum peak ALT [418 (IQR: 221-828) vs 796 (IQR: 477-1195) IU/L, P = 0.030], a significant reduction in 90-day complications [44% vs 74% CD grade ≥3, P = 0.036; 32 (IQR: 12-56) vs 52 (IQR: 35-98) CCI, P = 0.021], and shorter ICU- and hospital-stays [5 (IQR: 4-8) vs 8 (IQR: 5-18) days, P = 0.045; 20 (IQR: 16-27) vs 36 (IQR: 23-62) days, P = 0.002] compared to SCS. A trend toward reduced EAD was observed for HOPE (17% vs 35%; P = 0.314).CONCLUSION: This multicenter RCT demonstrates that HOPE, in comparison to SCS, significantly reduces early allograft injury and improves post-transplant outcomes in ECD-DBD liver transplantation.

Liver transplantation is still associated with a high risk of severe complications and post-operative mortality. This study examines the predictive value of the preoperative C-reactive-protein-to-albumin ratio (CAR) regarding perioperative morbidity and mortality in deceased-donor liver transplantation (DDLT) recipients. In total, 390 DDLT recipients between 05/2010 and 03/2020 were eligible. Predictive abilities of CAR were examined through receiver operating characteristic curve (ROC) analyses. Groups were compared using parametric and non-parametric tests as appropriate. Independent risk factors for morbidity and mortality were identified using uni- and multivariable logistic regression analyses. A good predictive ability for CAR was shown regarding perioperative morbidity (comprehensive complication index >= 75, Clavien-Dindo score >= 4a) and 12-month mortality, with an ideal cut-off of CAR = 26%. Patients with CAR>26% had significantly higher median CCI scores (60 vs. 43, P < 0.001), longer intensive care unit (ICU, 5 vs. 4 days, P < 0.001) and hospital (28 vs. 21 days, P < 0.001) stays and higher 12-month mortality rates (20% vs 6%, P < 0.001). Multivariable analyses identified CAR>26%, pre-OLT inpatient hospitalization (including ICU) and post-operative red blood cell transfusions as independent predictors of severe cumulative morbidity (CCI >= 75). Preoperative CAR might be a reliable additional tool to predict perioperative morbidity and mortality in DDLT recipients.

This study aimed to evaluate whether carbon nanoparticles could improve the accuracy of nodal staging in colorectal cancer (CRC). We performed a randomized controlled trial with CRC at the department of general surgery, the affiliated hospital of Nanjing University Medical School. A total of 160 patients were recruited in this research and 132 patients were included in the safety analyses. Among these patients, 72 cases were classified into control group and 60 cases into study group. The mean number of lymph nodes harvested from patients in study group was 19.3 ± 6.7 (range from 4 to 38), which was higher than that in control group (15.1 ± 5.7 (range from 3 to 29)) (p Trial registration: This study was registered with ClinicalTrials.gov, number ChiCTR1900025127 on 12/8/2019.

BACKGROUND: Platelets (PLT) play an essential functional role in cellular injury and liver regeneration following partial hepatectomy and orthotopic liver transplantation (OLT). Here, we investigated the association of postoperative PLT counts with short- and long-term outcomes in adult OLT recipients.METHODS: Three hundred consecutive patients from our prospective OLT database were analyzed retrospectively (May 2010-November 2017). Ninety-day post-OLT complications were graded using the Clavien-Dindo (CD) classification and quantified by the comprehensive complication index (CCI). To determine the prognostic accuracy of PLT counts, the area under the receiver operating characteristic curve (AUROC) was calculated for major complications (CD ≥ 3b). Parametric and non-parametric tests were applied for subgroup analyses. Uni- and multivariable logistic regression analyses were performed to identify risk factors for major complications. Graft and patient survival were analyzed using the Kaplan-Meier method as well as uni- and multivariable Cox regression analyses.RESULTS: Postoperative day 6 PLT counts CONCLUSION: In OLT patients, a PLT count on POD6 of less than 70 × 109/L bears a prognostic significance warranting further investigations.

Cancers 14(3), 720 (2022). doi:10.3390/cancers14030720 special issue: "Special Issue "Management of Hepatocellular Carcinoma in Liver Disease" / Special Issue Editors: Dr. Adriaan J. van der Meer, Guest Editor; Dr. Dave Sprengers, Guest Editor", Published by MDPI, Basel

Poor healing of cutaneous wounds is a common medical problem in the field of traumatology. Due to the intricate pathophysiological processes of wound healing, the use of conventional treatment methods, such as chemical molecule drugs and traditional dressings, have been unable to achieve satisfactory outcomes. Within recent years, explicit evidence suggests that mesenchymal stem cells (MSCs) have great therapeutic potentials on skin wound healing and regeneration. However, the direct application of MSCs still faces many challenges and difficulties. Intriguingly, exosomes as cell-secreted granular vesicles with a lipid bilayer membrane structure and containing specific components from the source cells may emerge to be excellent substitutes for MSCs. Exosomes derived from MSCs (MSC-exosomes) have been demonstrated to be beneficial for cutaneous wound healing and accelerate the process through a variety of mechanisms. These mechanisms include alleviating inflammation, promoting vascularization, and promoting proliferation and migration of epithelial cells and fibroblasts. Therefore, the application of MSC-exosomes may be a promising alternative to cell therapy in the treatment of cutaneous wounds and could promote wound healing through multiple mechanisms simultaneously. This review will provide an overview of the role and the mechanisms of MSC-derived exosomes in cutaneous wound healing, and elaborate the potentials and future perspectives of MSC-exosomes application in clinical practice.

Crohn's disease (CD) is a chronic nonspecific intestinal inflammatory disease. The aetiology and pathogenesis of CD are still unclear. Anal fistula is the main complication of CD and is a difficult problem to solve at present. The main limitation of developing new therapies is bound up with the short of preclinical security and effectiveness data. Therefore, an ideal animal model is needed to establish persistent anal fistula and an inflamed rectal mucosa.To improve the induction method of colitis and establish a reliable and reproducible perianal fistulizing Crohn's disease animal model to evaluate new treatment strategies.Twenty male New Zealand rabbits underwent rectal enema with different doses of 2,4,6-trinitrobenzene sulfonic acid to induce proctitis. Group A was treated with an improved equal interval small dose increasing method. The dosage of group B was constant. Seven days later, the rabbits underwent surgical creation of a transsphincteric fistula. Then, three rabbits were randomly selected from each group every 7 d to remove the seton from the fistula. The rabbits were examined by endoscopy every 7 days, and biopsy forceps were used to obtain tissue samples from the obvious colon lesions for histological analysis. The disease activity index (DAI), colonoscopy and histological scores were recorded. Perianal endoscopic ultrasonography (EUS) was used to evaluate the healing of fistulas.Except for the DAI score, the colonoscopy and histological scores in group A were significantly higher than those in group B (The improved method of CD colitis induction successfully established a rabbit perianal fistula CD preclinical model, which was confirmed by endoscopy and pathology.

Purpose To explore whether resilience acted as a protective factor between negative life events and depression among Chinese adolescents. Method Using convenient sampling, students (N = 278) in two junior and senior high schools in Wuhan, China were investigated, and structural equation model was used to examine the mediating effect of resilience in the relationship between negative life events and depression. Results Resilience was negatively correlated with negative life events and depression, and negative life events were positively correlated with depression. Resilience partially mediated the effects of negative life events on depression in Chinese adolescents. Conclusions It is important for educators to improve adolescents' resilience to mitigate the effects of negative life events on depression.

Objective: To evaluate the effectiveness of Chinese Herbal Medicine (CHM) on leukopenia/neutropenia induced by chemotherapy in adults with colorectal cancer (CRC). Methods: Eight electronic databases were searched from their inception to June 2020. Randomized controlled trials with clarified sequence generation were qualified. Two reviewers independently conducted the screening and data extraction. Methodological quality was assessed using the Risk of Bias tool. RevMan 5.4 was applied to the meta-analysis. Results: Twenty-seven studies involving 1867 participants were qualified, of which 26 were included in the quantitative synthesis. Meta-analysis showed that CHM significantly reduced the incidence of leukopenia induced by chemotherapy (RR = 0.69; 95% CI 0.59-0.82), as well as the grade 3/4 leukopenia (RR = 0.71; 95% CI 0.55-0.90). Meanwhile,CHM decreased the occurrence of neutropenia (RR = 0.52, 95% CI 0.35-0.77), especially for the grades 3/4 neutropenia (RR = 0.42, 95% CI 0.27-0.64). Twenty-six of the included studies focused on the adverse events related to CHM. Conclusion: CHM may relieve neutropenia/leukopenia induced by chemotherapy in adults with colorectal cancer.

Reservoir sustainability is strongly impacted by the reservoir sedimentation processes. Most of the substantial sedimentation processes occur in non‐stationary flows such as in the case of flash floods, surges and tidal waves. However, a stationary probability assumption is normally adopted to reduce mathematical model complexity. This work develops a non‐stationary Gambler's ruin model using the Monte‐Carlo simulation method. Daily water‐level data for the Xia‐Yun station are used to predict the effective risk that the maximum capacity of the water treatment plant in the Shihmen Reservoir is reached. This non‐stationary model yields fairly accurate probabilities of sedimentation by the transitional probability of a reservoir reaching different levels of turbidity, and the average time to reach a designated reservoir maximum handling turbidity. The extended capacity of the proposed model demonstrates the major particle processes during non‐stationary flows. Such analytical results offer water resources agency to scientifically evaluate the dredging/remediation strategies with the existing reservoirs. Transport capacities of rivers and streams, and the potential consequences of flood risks in response to reservoir sedimentation can then be comprehensively estimated in order to allow effective contingency planning for public safety.

The reservoir siltation has been of critical environmental concerns in recent years. The vulnerability and the overdevelopment in the reservoir watershed are the causes of the reservoir sedimentation. While typhoon events happen, in addition to the great amount of sediment volume transported from the upstream to the reservoir region, the density currents may evolve, which will steeply increase turbidity levels for the periods of time. In particular, the Shihmen Reservoir, one of essential hydraulic engineering projects in northern Taiwan, has been exposed to crisis that the sedimentation may fill up in the next few decades. Therefore, in order to maintain the reservoir capacity to an operational extent, modeling the sediment transport patterns in Shihmen Reservoir will utilize the three-dimensional Environmental Fluid Dynamics Code (EFDC) for quantifying sediment concentrations during the typhoon event. Calibration and validation of EFDC are performed by comparing two independent sets of event-based hydrodynamic and sediment concentration data with assistance of the parameter optimization algorithm. Next, the Backward-forward Stochastic Particle Tracking Model (BF-SPTM) is further incorporated into the EFDC hydrodynamic module to check the likelihood of the potential source of sediment particles. Results of simulations are expected to provide a more precise release timing for flow regulation to ensure the effective slag removal for density currents. Additionally, with probable sedimentation sources available for a reservoir, effective land use change and restrictions on overdevelopment of the risk prone areas can be enforced to decrease the sediment yields into the reservoir. It is expected that this incorporation of BF-SPTM into EFDC can be applied to simulate sediment transport in typhoon events, and to provide appropriate reservoir management alternatives.Keywords: Environmental Fluid Dynamics Code (EFDC), suspended sediment concentration, Backward-forward Stochastic Particle Tracking Model, Probable sedimentation source

Hypothermic oxygenated machine perfusion (HOPE) was recently tested in preclinical trials in kidney transplantation (KT). Here we investigate the effects of HOPE on extended-criteria-donation (ECD) kidney allografts (KA). Fifteen ECD-KA were submitted to 152 ± 92 min of end-ischemic HOPE and were compared to a matched group undergoing conventional-cold-storage (CCS) KT (n = 30). Primary (delayed graft function-DGF) and secondary (e.g. postoperative complications, perfusion parameters) endpoints were analyzed within 6-months follow-up. There was no difference in the development of DGF between the HOPE and CCS groups (53% vs. 33%, respectively; p = 0.197). Serum urea was lower following HOPE compared to CCS (p = 0.003), whereas the CCS group displayed lower serum creatinine and higher eGFR rates on postoperative days (POD) 7 and 14. The relative decrease of renal vascular resistance (RR) following HOPE showed a significant inverse association with serum creatinine on POD1 (r = − 0.682; p = 0.006) as well as with serum urea and eGFR. Besides, the relative RR decrease was more prominent in KA with primary function when compared to KA with DGF (p = 0.013). Here we provide clinical evidence on HOPE in ECD-KT after brain death donation. Relative RR may be a useful predictive marker for KA function. Further validation in randomized controlled trials is warranted.Trial registration: clinicaltrials.gov (NCT03378817, Date of first registration: 20/12/2017).

In the present era of organ transplantation with critical organ shortage, various strategies are employed to expand the pool of available allografts for kidney transplantation (KT). Even though, the use of allografts from extended criteria donors (ECD) could partially ease the shortage of organ donors, ECD organs carry a potentially higher risk for inferior outcomes and postoperative complications. Dynamic organ preservation techniques, modulation of ischemia-reperfusion and preservation injury, and allograft therapies are in the spotlight of scientific interest in an effort to improve allograft utilization and patient outcomes in KT.Preclinical animal experiments are playing an essential role in translational research, especially in the medical device and drug development. The major advantage of the porcine orthotopic auto-transplantation model over ex vivo or small animal studies lies within the surgical-anatomical and physiological similarities to the clinical setting. This allows the investigation of new therapeutic methods and techniques and ensures a facilitated clinical translation of the findings. This protocol provides a comprehensive and problem-oriented description of the porcine orthotopic kidney auto-transplantation model, using a preservation time of 24 hours and telemetry monitoring. The combination of sophisticated surgical techniques with highly standardized and state-of-the-art methods of anesthesia, animal housing, perioperative follow up, and monitoring ensure the reproducibility and success of this model.

Esophageal cancer is one of the most common cancers and a leading cause of cancer‐related death worldwide. However, the mechanism of esophageal cancer pathogenesis remains poorly understood. Long noncoding RNAs (lncRNAs) dysregulation have been reported to involve in various human cancers, which highlights the potential of lncRNAs used as novel biomarkers for cancer diagnosis. Although more efforts have been made to identify novel lncRNAs signature in esophageal cancer, the expression pattern, prognostic value, and biological function of most lncRNAs in esophageal cancer still need to be systematically investigated. In this study, we comprehensively analyzed the expression profile of lncRNAs in more than 200 esophageal cancer patients tissue samples from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO). We identified thousands of lncRNAs are differentially expressed in esophageal cancer tissues, and many of those lncRNAs expression are associated with patients overall survival or recurrence‐free survival time. Moreover, copy number variation analyses revealed that genomic loci copy number amplification or deletion might contribute to these lncRNAs dysregulation. Among these lncRNAs, DUXAP8 and LINC00460 were significantly upregulated, and GO enrichment analyses indicated that the two lncRNAs associated protein‐coding genes involve with many known biological processes, such as cell cycle and cell‐cell adherens junction. Further experimental validation revealed that knockdown of DUXAP8 could impair esophageal cancer cells proliferation and invasion in vitro. Taken together, our findings identified more aberrantly expressed lncRNAs in esophageal cancer that may provide a useful resource for identifying novel esophageal cancer associated lncRNAs.

Maxillary sinus cystic lesions can often be found in cone-beam computed tomography (CBCT) images. However, whether this change affects the implementation of maxillary sinus floor augmentation remains unclear. Combining the common cystic change performance of CBCT, image classification diagnosis of maxillary sinus cystic change was introduced, and the indications and surgical methods of maxillary sinus floor augmentation and postoperative radiographic changes of mucous were analyzed. This procedure may help clinicians evaluate the feasibility and methods of maxillary sinus augmentation in maxillary sinus cystic changes.锥形束CT影像上常常可以发现上颌窦囊性改变的存在，这种改变是否影响上颌窦提升术的实施呢？这对临床医生造成了一定的困惑。本文结合临床上常见的各种囊性改变的锥形束CT影像表现，对上颌窦囊性改变的影像分类诊断进行介绍，并探讨囊性改变时上颌窦提升术的实施可行性、手术方式及术后黏膜的影像学改变等，以帮助临床医生作出正确判断。.

Artesunate (ART) is a semi-synthetic derivative of artemisinin used in the treatment of patients with malaria, which has also been reported to have immunoregulatory, anticancer and anti-inflammatory properties. The aim of the present study was to investigate the possible beneficial effects of ART on ulcerative colitis (UC) rats and to detect the possible mechanisms underlying these effects. A UC rat model was established using dextran sulfate sodium (DSS). Rats were randomly divided into the following groups: Normal control, UC model group, UC rats treated with a low, medium or high dose of ART (10, 30 and 50 mg/kg/day, respectively), and the positive control group (50 mg/kg/day 5-aminosalicylic acid). The damage status of colonic mucosal epithelial tissue was investigated by hematoxylin and eosin staining, and then the weight, colon length and disease activity index (DAI) were measured. Western blotting and reverse transcription-quantitative polymerase chain reaction analysis were used to detect the levels of cytokines associated with UC and proteins associated with Toll-like receptor 4 (TLR4)-nuclear factor (NF)-κB pathway. ELISA was also performed to measure the levels of inflammatory cytokines. In addition, the viability and infiltration of RAW264.7 cells were examined using Cell Counting Kit-8 and Transwell assays. The results demonstrated that treatment with ART significantly alleviated the UC symptoms induced by DSS in the rat model, lowered the DAI, ameliorated pathological changes, attenuated colon shortening, inhibited the levels of pro-inflammatory mediators and myeloperoxidase activity, and increased hemoglobin expression. Additionally, inflammatory and apoptotic markers were found to be significantly downregulated following treatment with ART in UC rats and RAW264.7 cells. To the best of our knowledge, the present study is the first to demonstrate that ART exerts anti-inflammatory effects via regulating the TLR4-NF-κB signaling pathway in UC.

OBJECTIVE To investigate risk factors of lymph node metastasis (LNM) in Chinese early gastric carcinoma (EGC) patients diagnosed using the World Health Organization (WHO) criteria and compare the differences in those factors between proximal (PGC) and distal gastric carcinoma (DGC). METHODS Among 3 176 gastric cancer resections we identified 379 (11.9%) consecutive EGC (104 PGC and 275 DGC) with lymphadenectomy performed at the Affiliated Nanjing Drum Tower Hospital of Nanjing University (Nanjing, Jiangsu Province, China) between January 2005 and December 2012. Endoscopic and clinicopathological features related to LNM were analyzed. RESULTS LNM occurred in 49 (12.9%) EGC, including three PGC and 46 DGC. In early DGC, middle age (41-60 years), tumor size ≥3.1 cm, submucosal invasion, poorly cohesive carcinoma, micropapillary adenocarcinoma and lymphovascular invasion were risk factors by univariate analysis. In contrast, no risk factors of LNM were identified in early PGC. By multivariate analysis, female sex (odds ratio [OR] 2.4), DGC (OR 8.1), poorly cohesive carcinoma (OR 8.8) and lymphovascular invasion (OR 38.8) were found to be significant independent risk factors for LNM. The risk of LNM was effectively stratified using a scoring model of mild (score ≤3.5), moderate (score 4.0-8.5) and high (score ≥16) risk groups. CONCLUSIONS LNM occurred in 12.9% of EGC diagnosed with the WHO criteria in Chinese patients. Independent risk factors of LNM were identified in early DGC only and included female sex, DGC, poorly cohesive carcinoma and lymphovascular invasion. Early PGC has a much lower risk for LNM than early DGC.

To determine the effects of guided bone regeneration (GBR) and delayed loading on autogenous bone ring grafting.Autogenous bone ring augmentation with simultaneous implant insertion was performed in the mandibular premolars region of six Beagle dogs. The Bone quality of four mandibular premolars [second premolar (P2) and fourth premolar (P4)] were detected using cone beam CT (CBCT). The P2s and P4s of bilateral mandible were extracted, with three extracting sites being randomly selected to create buccal defects and the remaining one serving as control. GBR and bone ring grafting with simultaneous implant insertion was performed on two of the three experimental sites with buccal defects 3 months later, while the other one was treated with bone ring grafting with simultaneous implant insertion. Routine implant placement was performed in the control group. Vertical bone resorption and sulcus deep around the implants were measured three months after occlusal loading with abutment.Three months after operations, 83.3% of bone rings grafts were successful and 100% of implants survived. Delayed healing appeared more in the dogs with GBR compared those treated with bone ring grafting with simultaneous implant insertion, resulting in an increase in vertical bone resorption. Compared with the control group, delayed loading had no effects on vertical bone resorption and the health of gingiva tissues after autogenous bone ring transplant.GBR is not a preferred procedure for bone ring grafts, which may increase the risk of delayed healing and site infections, leading to failure of implants. Healed bone ring grafts can resist loadings as normal.

Yu-Xiao Liu,1,* Wen-Jia Liu,2,* Hui-Ru Zhang,1,3 Zhi-Wen Zhang1 1Department of Neurosurgery, First Affiliated Hospital of Chinese PLA General Hospital, Beijing, People’s Republic of China; 2Beijing Institute of Biotechnology, Beijing, People’s Republic of China; 3College of Biological Engineering, HeNan University of Technology, Beijing, People’s Republic of China *These authors contributed equally to this work Background: Many reports have indicated that the intravenous administration of bevacizumab produces a number of systemic side effects. Therefore, we investigated the therapeutic effects of intratumoral bevacizumab administration using a glioma animal model. Methods: The glioma cell lines U251 and U87 that carried luciferase were implanted into the brains of mice to develop glioma models. Glioma-bearing mice were treated with bevacizumab intravenously or intratumorally by Alzet micro-osmotic pumps, and the survival time of mice was monitored. Tumor volumes and location were observed by fluorescence imaging and histological analysis. Levels of microvessel marker, cancer stem cell marker as well as angiogenesis-, invasion-, and inflammation-related factors in tumors were examined by immunohistochemical staining. Results: Mice treated with intratumoral low-dose bevacizumab had smaller tumor volumes, longer survival time, lower microvessel density, and fewer cancer stem cells as compared with untreated and intravenously treated mice. Furthermore, expression levels of inflammation-related factors increased signifiwhereas that of angiogenesis- and invasion-related factors decreased in intratumorally treated animals, compared with intravenously treated mice. Conclusion: These results implied bevacizumab delivery by intratumoral injection via Alzet micro-osmotic pumps may be a more effective and safer protocol for treating gliomas. Keywords: bevacizumab, anti-angiogenic, glioma cell line, intratumoral delivery, fluorescence imaging

Background: Age-related macular degeneration (AMD) is the leading cause of irreversible vision loss among the older population. In China, treatment of age-related ocular diseases is becoming a priority in eye care services. This study was to investigate the clinical characteristics and quality of life of Chinese patients with wet AMD and current treatment types, to evaluate short-term gains in different treatments, and to investigate associations between visual function and vision-related quality of life (VRQoL). Methods: A prospective, observational, noninterventional study was conducted. Basic data were collected from patients with clinical diagnoses of wet AMD before clinical assessments at baseline. VRQoL was measured with the Chinese version of the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25). Correlations of the NEI VFQ-25 subscale scores with best-corrected visual acuity (BCVA) and between-group differences were analyzed. Results: A total of 80 wet AMD patients were enrolled, with the mean age of 68.40 years. About one-quarter of wet AMD patients received intravitreal (IVT) ranibizumab treatment, and 67% of them were treated on a pro re nata basis. The visual acuity of patients treated with IVT ranibizumab at month 3 after treatment was significantly increased, whereas patients treated with traditional Chinese medicine achieved no significant improvement. Cronbach's α for the NEI VFQ-25 subscales ranged from 0.697 to 0.843. Eight subscale and overall composite scores were moderately correlated with the BCVA of the better-seeing eye. Significant differences in the overall NEI VFQ-25 scores and other subscales were observed between patients with BCVA in the better-seeing eye of less than 50 letters and the others. Conclusions: Patients treated with IVT ranibizumab experienced better vision improvement at short-term follow-up. The Chinese version of the NEI VFQ-25 is a valid and reliable tool for assessing the VRQoL of Chinese wet AMD patients.

The impact of HPD722 macroporous resin on the dynamic adsorption and desorption of flavonoids in Emilia Sonchifolia extract is studied. The diameter-height ratio of macroporous resin column is 1:10; the mass concentration of the sample solution is selected to be 50.00 mg•mL-1; while the sample flow rate is 3.00mL min-1; upon dynamic absorption for once, the absorption rate reaches 81.11%; with adoption of 50mL ethanol at a volume ratio of 60% as the desorption agent, the desorption flow rate comes to 3.00mL•min-1; and the desorption rate of flavonoids attains 85.26%. Under optimal conditions, the content of flavonoids increases from 6.05% to 32.65% upon purification by HPD722 macroporous resin.

To investigate risk factors of lymph node metastasis (LNM) in Chinese early gastric carcinoma (EGC) patients diagnosed using the World Health Organization (WHO) criteria and compare the differences in those factors between proximal (PGC) and distal gastric carcinoma (DGC).Among 3 176 gastric cancer resections we identified 379 (11.9%) consecutive EGC (104 PGC and 275 DGC) with lymphadenectomy performed at the Affiliated Nanjing Drum Tower Hospital of Nanjing University (Nanjing, Jiangsu Province, China) between January 2005 and December 2012. Endoscopic and clinicopathological features related to LNM were analyzed.LNM occurred in 49 (12.9%) EGC, including three PGC and 46 DGC. In early DGC, middle age (41-60 years), tumor size ≥3.1 cm, submucosal invasion, poorly cohesive carcinoma, micropapillary adenocarcinoma and lymphovascular invasion were risk factors by univariate analysis. In contrast, no risk factors of LNM were identified in early PGC. By multivariate analysis, female sex (odds ratio [OR] 2.4), DGC (OR 8.1), poorly cohesive carcinoma (OR 8.8) and lymphovascular invasion (OR 38.8) were found to be significant independent risk factors for LNM. The risk of LNM was effectively stratified using a scoring model of mild (score ≤3.5), moderate (score 4.0-8.5) and high (score ≥16) risk groups.LNM occurred in 12.9% of EGC diagnosed with the WHO criteria in Chinese patients. Independent risk factors of LNM were identified in early DGC only and included female sex, DGC, poorly cohesive carcinoma and lymphovascular invasion. Early PGC has a much lower risk for LNM than early DGC.

Upregulation of proton extrusion is critical for tumor cell survival in an ischemic microenvironment with a lower extracellular pH (pHe). Lower pHe and higher intracellular pH (pHi) benefit cancer cells for invasion and growth. Vacuolar H(+)-ATPases (V-H(+)-ATPases) play a critical role in regulating the transmembrane pH gradient. Proton Pump Inhibitors (PPI), mainly treating acid-related diseases, could inhibit the expression of V-H(+)-ATPases. We have investigated whether PPI decreases the pHi of the human gastric adenocarcinoma cell line, SGC7901, by inhibiting V-H(+)-ATPases so as to enhance the cytotoxicity of anti-tumor drugs. We have assessed the optimal treatment time, pretreatment dosage of PPI and the possible mechanism of action. PPI exceeding 10 microg/ml inhibited protein expression of V-H(+)-ATPases in a dose-dependent manner, decreased the pHi value and reversed the transmembrane pH gradient, whereas PPI at final concentration of 1 microg/ml could not. Changes of the pH gradient were positively correlated with PPI concentration. The inhibitory effects of PPI on V-H(+)-ATPases primarily occurs from 12h to 24h after PPI pretreatment (P0.05). The pHi value of SGC7901 was lowest 24h after PPI pretreatment (P0.05). Administration of anti-tumor drugs 24h after PPI pretreatment produced the most cytotoxic effects on SGC7901 (P0.05) and significantly improved the early and total apoptosis rates (P0.01). PPI exceeding 20 microg/ml also significantly reduced the ADR-releasing index, thereby enhancing the intracellular ADR concentration (P0.01). Therefore, PPI could enhance the cytotoxic effects of anti-tumor drugs on the SGC7901 cells.

Gemcitabine (GEM) is a first line chemotherapeutic drug for advanced pancreatic cancer. Dendritic cell (DC) vaccine is a promising method of immunotherapy for malignant tumor. Recent research has indicated that gemcitabine can enhance the efficacy of DC vaccine, but precise mechanism is still unknown. Here, we aimed to investigate the effect of GEM on DCs. The results showed that GEM-treated pancreatic cancer cell medium stimulated maturation of DCs. When co-cultured with autologous T lymphocytes, the pulsed DCs promoted the proliferation of T cells, and exhibited specific cytotoxic T lymphocytes (CTLs) antitumor activity. Further research showed that stimulation of DC maturation may be related to the elevated level of Hsp70 induced by GEM. Our study indicates that GEM changes the immunogenicity of tumor cells, and enhances the efficacy of DC based immunotherapy for pancreatic cancer.

Aiming at the Cache coherence problem that brings by multiple processor cores of CMP(Chip multiprocessors) sharing the single memory space, this paper introduces a new kind of Cache coherence--CSC(Coherence with SC-Cache) based on write-through and write-back mechanism, which contains SC-Cache (Shared Coherence Cache) module. Experiments show that the protocol reduces the number of bus transactions, to a certain extent improves the efficiency of processor data access.

To establish a culture method for a large amount of highly purified osteoclast-like cells in vitro. To investigate the gene expression of some osteoclast marker enzymes. To lay the foundation for the further study of the signal path on the differentiation and formation of osteoclast-like cells.The bone marrow mononuclear cells of rat were treated with 30 ng/mL macrophagecolony-stimulating factor (M-CSF) and 50 ng/mL receptor activator of NF-kappaB ligand (RANKL) and cultured for 6 days. After culturing, cells were evaluated by morphology observation, tartrate-resistant acid phosphatase (TRAP) staining, Giemsa staining, pit staining, and the gene expression of some osteoclast marker enzymes.The TRAP-positive mononuclear cells were more frequently observed than the multinucleated cells and pit staining could be seen on the dentine slice. The transcription expression of TRAP, matrix metalloproteinase-9 (MMP-9), membrane-type1-matrix metalloproteinase (MT1-MMP) and cathepsin K were detected by RT-PCR.The cooperation of M-CSF and RANKL could induce a large amount of highly purified osteoclast-like cells formation in rat bone marrow culture. The typical characteristics of osteoclast-like cells were demonstrated and the enriched osteoclast-like cells expressed TRAP, MMP-9, MT1-MMP and cathepsin K.

Promoter hypermethylation is an alternative mechanism of gene silencing in human cancers including gastric cancer. To date, several reports on methylation of various genes in gastric cancer have been published. However, most of these studies have focused on cancer tissues or only a single gene. In this study, we determined the methylation frequency of 5 genes, including p16, Runx3, MGMT, DAPK, and RASSF1A, by methylation-specific polymerase chain reaction, in a series of formalin-fixed paraffin-embedded tissues including normal gastric mucosa (n = 20), intestinal metaplasia (n = 14), gastric epithelial dysplasia (n = 27), and early gastric adenocarcinoma (n = 16). Immunohistochemistry was used to determine expression of MGMT and RASSF1A protein. All 20 histologically normal gastric biopsy specimens were methylation-free for all 5 genes. Aberrant hypermethylation of RASSF1A was not detected in any case from intestinal metaplasia to early gastric adenocarcinoma. The methylation rate of the other 4 genes increased with the histological progression from intestinal metaplasia to gastric epithelial dysplasia, to early gastric adenocarcinoma. Methylation was detected in 28.6% of intestinal metaplasia (4/14), in 77.8% of gastric epithelial dysplasia (21/27), and in 87.5% of early gastric adenocarcinoma (14/16). The average number of methylated genes in intestinal metaplasia, gastric epithelial dysplasia, and early gastric adenocarcinoma was 0.43, 1.3, and 1.8, respectively. Concurrent methylation in 3 or more genes was found in 7.1% of intestinal metaplasia, 11.1% of gastric epithelial dysplasia, and 31.3% of early gastric adenocarcinoma. No correlation was found between hypermethylation and other clinicopathologic parameters such as age, sex, Helicobacter pylori infection, and location of lesions. However, we observed a significant association between hypermethylation of p16 and MGMT and elevated serum carcinoembryonic antigen level. No reduction or loss of RASSF1A expression was observed in our study. Weak or loss of MGMT expression was found in 20 lesions and was significantly associated with promoter hypermethylation (P < .01). Our results suggest that promoter hypermethylation of the p16, Runx3, MGMT, and DAPK genes may play an important role in the pathogenesis of gastric precancerous lesions and early gastric adenocarcinoma. Hypermethylation and inactivation of RASSF1A, however, could be a later event in malignant transformation. Further studies are warranted to determine whether the presence of promoter hypermethylation in gastric precancerous lesions is associated with higher risk of subsequent cancer development and how to interrupt the malignant transition from intestinal metaplasia and gastric epithelial dysplasia to early gastric adenocarcinoma by developing some gene-targeting therapies that may reverse aberrant methylation.

Ischemic colitis is the most common type of intestinal ischemia and has a clinical spectrum of injury that ranges from mild and transient ischemia to acute fulminant colitis. The aim of this study was to explore endoscopic findings and clinicopathologic characteristics of ischemic colitis and be accurate enough to avoid missed diagnosis or misdiagnosis. A retrospective analysis was undertaken of endoscopy findings and clinicopathologic characteristics of 85 cases of ischemic colitis from March 2005 to April 2008 in the endoscopy center of our hospital. All cases underwent colonoscopy with biopsy within 2 weeks of the onset of symptoms, and all specimens with forceps were stained with hematoxylin-eosin and observed under light microscopy. Of the 85 cases of ischemic colitis (24 men and 61 women, average age 61.36 +/- 14.49 years old, range 29-84), 71 were over 50 years of age. These cases were associated with the basal diseases such as hypertension, cardiovascular disorders, diabetes, and hematological diseases as well as a history of abdominal operation. The clinical features usually presented with sudden onset of abdominal pain, diarrhea, and hematochezia. Ischemic lesions were located mainly in the left colon with segmental form (only descending colon affected 16%, only splenic flexure 14%, and only sigmoid colon 23%). The 85 patients consisted of the non-gangrenous type (82), which were composed of reversible IC (76) and chronic IC (6), and the gangrenous type (3). Endoscopic appearance of the transient ischemic colitis consisted of petechial hemorrhages, edematous and fragile mucosa, segmental erythema, scattered erosion, longitudinal ulcerations, and sharply defined segment of involvement. Ischemic colitis of stricture was characterized by full-thickness mucosa, lumens stricture, and diseased haustrations. The mucosa of gangrenous colitis with cyanotic and pseudopolyps was endoscopically observed as well. Clinicopathologic characteristics showed mucosal inflammation accompanied by erosion, granulation tissue hyperplasia and gland atrophy, lamina propria hemorrhage, and macrophages with hemosiderin pigmentation in submucosa in particular. Although endoscopy findings and clinicopathologic characteristics of ischemic colitis are nonspecific, colonoscopy with biopsy plays a vital role in the early diagnosis of ischemic colitis.

AIM: To make a retrospective analysis of endoscopy findings and clinicopathologic characteristics of colonic schistosomiasis in order to further improve our understanding of the disease and decrease its misdiagnosis. METHODS: Endoscopy findings and clinicopathologic characteristics of 46 intestinal schistosomiasis patients were retrospectively analyzed. All the patients underwent colonoscopy and all biopsy specimens stained with hematoxylin and eosin were observed under a light microscope. RESULTS: Of the 46 colonic schistosomiasis patients, 1 was diagnosed as acute schistosomal colitis, 16 as chronic schistosomal colitis and 29 as chronic active schistosomal colitis according to their endoscopic findings and pathology. Not all patients were suspected of or diagnosed as colonic schistosomiasis. Of the 12 misdiagnosed patients, 4 were misdiagnosed as ulcerative colitis, 1 as Crohn’s disease, and 7 as ischemic colitis. The segments of rectum and sigmoid colon were involved in 29 patients (63.0%). Intact Schistosoma ova were deposited in colonic mucosa accompanying infiltration of eosinocytes, lymphocytes, and plasma cells in acute schistosomal colitis patients. Submucosal fibrosis was found in chronic schistosomal colitis patients. Among the 17 patients with a signal polyp, hyperplastic polyp, canalicular adenoma with a low-grade intraepithelial neoplastic change, tubulovillous adenoma with a high-grade intraepithelial neoplastic change were observed in 10, 5, and 2 patients, respectively. Eight out of the 46 patients were diagnosed as colonic carcinoma. CONCLUSION: Endoscopy contributes to the diagnosis of colonic schistosomiasis although it is nonspecific. A correct diagnosis of colonic schistosomiasis can be established by endoscopy in combination with its clinicopathologic characteristics.