Yan Shi

Southwest Hospital, Nan-ching-hsü, Jiangxi Sheng, China

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Publications (43)61.12 Total impact

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    ABSTRACT: The mechanisms underlying immune evasion by gastric cancer have not been well described due to a lack of gastric tumor models in immunocompetent mice. In the current study, we found that supernatants from MFC cells, a murine gastric cancer line, inhibited the LPS-induced maturation and cross-presentation of BMDCs. Moreover, MFC tumor-derived factors markedly altered the cytokine profiles of BMDCs, leading to a trend of increased levels of IL4, IL6, IL23 and TGFβ, as well as decreased levels of TNFα. qPCR and ELISA revealed that MFC cells expressed a high level of VEGF. Downregulating VEGF expression abrogated the inhibitory effect of MFC-derived factors on the maturation and cross-presentation of BMDCs. In addition, VEGF knockdown greatly impaired the tumorigenicity of MFC cells in immunocompetent mice. Compared with parental MFC tumors, VEGF-low MFC tumors grew much more slowly and the survival of tumor-inoculated mice was significantly improved. More importantly, mice rejecting inoculated VEGF-low MFC tumor cells gained resistance to re-challenged parental tumors, which was attributed to an antitumor immunity response against parental MFC tumors. These results reveal an immunosuppressive role for VEGF in murine gastric cancer.This article is protected by copyright. All rights reserved.
    FEBS Journal 07/2014; · 4.25 Impact Factor
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    ABSTRACT: Poultry intake has been inconsistently associated with incidence or mortality of colorectal cancer (CRC) in epidemiologic studies. The purpose of this study was to assess their relationships by performing a dose-response meta-analysis. We conducted a search of PubMed database between January 1966 and July 2013 for prospective studies that reported relative risks (RRs) with 95 % confidence interval (CIs) of CRC for at least three categories of poultry intake. Dose-response relationships were examined with the generalized least-squares trend estimation. Study-specific results were pooled with a random-effects model. Subgroup, sensitivity, and meta-regression analyses were also conducted to explore heterogeneity. Sixteen studies on poultry intake and CRC incidence, and four studies regarding poultry intake and CRC mortality were identified. These studies involved a total of 13,949 incident CRC cases and 983 CRC deaths. The RRs of CRC for higher compared with lower intake of poultry were reported in these studies, and the reported levels of poultry intake varied substantially. Results of the dose-response meta-analysis conferred a RR of 0.89 (95 % CI 0.81-0.97) for an increase in poultry intake of 50 g/day. The results were not sensitive to any individual studies and were similar for colon and rectal cancer. Poultry intake was not associated with CRC mortality (RR for 50 g/day = 0.97, 95 % CI 0.79-1.20). This meta-analysis indicates that poultry intake may be moderately associated with reduced incidence of CRC.
    European Journal of Nutrition 05/2014; · 3.13 Impact Factor
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    ABSTRACT: To assess the effect of radical laparoscopy-assisted gastrectomy(LG) for patients with chronic obstructive pulmonary disease (COPD). Clinical data of 340 gastric cancer patients with COPD undergoing radical gastrectomy with lymphadenectomy at Southwest Hospital, Third Military Medical University between January 2010 and October 2013 were analyzed retrospectively. The clinical outcomes for the 262 patients with COPD who underwent LG(LG group) were compared with those of 78 patients with COPD who underwent open gastrectomy(OG group). During LG, pneumoperitoneum was maintained at an insuffiation pressure of 8 mmHg to 10 mmHg. The primary endpoint was postoperative pulmonary complication(PPC). To predict factors related to PPC, univariate and multivariate logistic analyses were carried out. Intraoperative blood loss was significantly less in the LG group [(131.2±14.7) ml] than in the OG group [(246.7±49.0) ml; t=-13.445, P=0.000], but operation time was significantly longer [(220.4±19.1) min vs. (194.2±31.5) min; t=6.877, P=0.000]. The findings showed PPC to be significantly less frequent in the LG group(5.3%,14/262) than in the OG group (15.4%, 12/78)(χ(2)=8.581, P=0.003). The severity of COPD was independent risk factor for PPC(P=0.031, HR=1.456, 95%CI:1.306-1.789). No independent predictor of PPCs was found in type of operative approach (open vs laparoscopic; P=0.126). The LG procedure with insuffiation pressure of pneumoperitoneum is tolerated for gastric cancer patients with mild or moderate COPD.
    Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery 04/2014; 17(4):365-8.
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    ABSTRACT: This study investigated the expression of Sonic Hedgehog (Shh) protein in gastric cancer, and correlated it with clinicopathological parameters. The prognostic significance of Shh protein was analyzed.
    International journal of clinical and experimental pathology. 01/2014; 7(8):5144-53.
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    ABSTRACT: Early identification of treatment failure (TF) of nosocomial pneumonia (NP) remains a major challenge. To test whether use of procalcitonin (PCT) kinetics could assess the clinical efficacy in older critically ill patients with NP. A prospective observational study was conducted in 60 patients (≥65 years) admitted to the intensive care unit with severe NP. Serum PCT was measured on day 0, day 3, day 7 and at the end of treatment (EOT). The PCT time course was analyzed according to the therapeutic efficacy. PCT were elevated in all patients (n=60) on day 0 and the median levels (range) were 2.5 ( 0.85-42.7) μg/L. There were no differences between the improvement patients (n=41) and those without improvement ( n=19) in PCT on day 0 ( p>0.05). However, lower PCT on days 3, 7 and at the EOT (all p<0.05) as well as greater rate of PCT decline between day 0 and day 3( ΔPCTD3% ) (29.5 ± 10.8% vs 15.1 ± 5.9%, p = 0.009) were found in the improvement patients than in those without improvement. ΔPCTD3% was the best single predictor of efficacy (area under the curve [AUC], 0.791, p < 0.001) and had a sensitivity of 75.7% and a specificity of 72.0% with threshold of 26.2%. By comparison, traditional parameters and absolute PCT failed to predict treatment response ( p>0.05). Indeed, the combination of ΔPCTD3% > 26.2% and modified clinical pulmonary infection score (mCPIS) < 6 points could improve the predictive value (AUC, 0.890; sensitivity, 81.3%; specificity, 86.5% ). PCT levels were not influenced by aging and PCT kinetics might help to identify TF. ΔPCTD3% combined with CPIS have been shown to be an marker of clinical efficacy at an earlier stage.
    Respiratory care. 12/2013;
  • Yan Shi, Xi Rui
    European Journal of Intensive Care Medicine 09/2013; · 5.17 Impact Factor
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    ABSTRACT: BACKGROUND: Rapid detection of bacteremia is important for critically ill patients. Procalcitonin (PCT) has emerged as a marker of sepsis, but its characterization for predicting bacteremia is still unclear. This study aimed to investigate the role of change of PCT within 6 to 12 hours after new fever in predicting bacteremia. METHODS: An observational study was conducted in the ICU of our hospital from January 2009 to March 2010. Adult patients with new fever were included and grouped as bacteremia and non bacteremia group. Serum PCT concentration was measured at admission and within 6 to12 hours after new fever (designated PCT0 and PCT1). Other results of laboratory tests and therapeutic interventions were recorded. Multivariate Logistic regression analysis was used to identify the risk factors of bacteremia. The area under the ROC curve (AUC) was constructed to evaluate the discriminative power of variables to predict bacteremia. RESULTS: Totally 106 patients were enrolled, 60 of whom had bacteremia and 46 did not have bacteremia,. The acute physiology and chronic health evaluation II (APACHE II) and sequential organ failure assessment (SOFA) scores were 13.1 ± 7.8 and 5.0 ± 2.2 at admission, respectively. There was no significant difference in PCT0 between the bacteremia group and nonbacteremia group; 1.27 µg/L (range, 0.10 - 33.3) vs. 0.98µg/L (range, 0.08 - 25.7), (P = 0.157). However, the PCT1 and the rate of change of PCT were significantly higher in bacteremia group; PCT1 was 6.73 µg/L (1.13 - 120.10) vs. 1.17 µg/L (0.10 - 12.10) (P = 0.001), and the rate of change was 5.62 times (1.05 - 120.6) vs. 0.07 times (-0.03 - 0.18) (P < 0.001). The area under the ROC curve (AUC; 95% confdence interval) of the rate of change of PCT was better for predicting bacteremia than that of PCT1; 0.864 (range, 0.801 - 0.927) vs. 0.715 (range, 0.628 - 0.801), (P < 0.05). The AUCs of PCT0 and other parameters (such as WBC count, granulocyte percentage and temperature) were not significantly different (all P > 0.05). The best cut-off value for the rate of change was 3.54 times, with a sensitivity of 88.5% and a specificity of 98.0%. It was also an independent predictor of bacteremia (odds ratio 29.7, P < 0.0001) and wasn't correlated with the presence or absence of co-infection, neutropenia or immunodefciency (P > 0.05). CONCLUSION: The rate of change of PCT is useful for early detection of bacteremia during new fever and superior to the PCT absolute value and other parameters in non-selected ICU patients.
    Chinese medical journal 05/2013; 126(10):1832-1837. · 0.90 Impact Factor
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    ABSTRACT: To investigate the feasibility and safety of da Vinci robotic surgical system in rectal cancer radical operation, and to summarize its short-term efficacy and clinical experience. Data of 101 cases undergoing da Vinci robotic surgical system for rectal cancer radical operation from March 2010 to September 2012 were retrospectively analyzed. Evaluation was focused on operative procedure, complication, recovery and pathology. All the 101 cases underwent operation successfully and safely without conversion to open procedure. Rectal cancer radical operation with da Vinci robotic surgical system included 73 low anterior resections and 28 abdominoperineal resections. The average operative time was (210.3±47.2) min. The average blood lose was (60.5±28.7) ml without transfusion. Lymphadenectomy harvest was 17.3±5.4. Passage of first flatus was (2.7±0.7) d. Distal margin was (5.3±2.3) cm without residual cancer cells. The complication rate was 6.9%, including anastomotic leakage(n=2), perineum incision infection(n=2), pulmonary infection (n=2), urinary retention (n=1). There was no postoperative death. The mean follow-up time was(12.9±8.0) months. No local recurrence was found except 2 cases with distant metastasis. Application of da Vinci robotic surgical system in rectal cancer radical operation is safe and patients recover quickly The short-term efficacy is satisfactory.
    Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery 05/2013; 16(5):451-4.
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    ABSTRACT: To explore the effects of diagnostic protocols on etiology and outcome in immunocompromised host (ICH) with pulmonary infiltrate. For this historic control study, ICH with acute respiratory failure (ARF) were eligible as study group (n = 65) in 2009 while another ICH cohort was selected as control group (n = 45) in 2007. The protocol consisted of four parts: judgment possible site, determining probable etiology, checking and feedbacks on laboratory test in 12 hours and reassessment and adjustment treatment in 48-72 hours. The etiologies included infection, noninfection and unknown causes. Their average age was 45.3 years (range: 22 - 71). Causes of immune suppression were autoimmune disease (n = 69), hematological disorders (n = 21), solid cancers (n = 10) and others (n = 10). When two groups were compared, basic diseases, organ function and disease severity showed no significant difference, but etiologic diagnoses rate (73.8% vs 57.8%), time from ICU admission to diagnosis (4.0 vs 6.8 days) and 28-day mortality (38.5% vs 62.2%) had significant difference (P < 0.05). Implementation of clinical protocol in ICH with ARF is associated with improved etiologic diagnoses and decreased mortality.
    Zhonghua yi xue za zhi 03/2013; 93(9):684-9.
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    ABSTRACT: The process of peritoneal metastasis involves the diapedesis of intra-abdominal exfoliated gastric cancer cells through the mesothelial cell monolayers; however, the related molecular mechanisms for this process are still unclear. Heterocellular gap-junctional intercellular communication (GJIC) between gastric cancer cells and mesothelial cells may play an active role during diapedesis. In this study we detected the expression of connexin 43 (Cx43) in primary gastric cancer tissues, intra-abdominal exfoliated cancer cells, and matched metastatic peritoneal tissues. We found that the expression of Cx43 in primary gastric cancer tissues was significantly decreased; the intra-abdominal exfoliated cancer cells and matched metastatic peritoneal tissues exhibited increasing expression compared with primary gastric cancer tissues. BGC-823 and SGC-7901 human gastric cancer cells were engineered to express Cx43 or Cx43T154A (a mutant protein that only couples gap junctions but provides no intercellular communication) and were co-cultured with human peritoneal mesothelial cells (HPMCs). Heterocellular GJIC and diapedesis through HPMC monolayers on matrigel-coated coverslips were investigated. We found that BGC-823 and SGC-7901 gastric cancer cells expressing Cx43 formed functional heterocellular gap junctions with HPMC monolayers within one hour. A significant increase in diapedesis was observed in engineered Cx43-expressing cells compared with Cx43T154A and control group cells, which suggested that the observed upregulation of diapedesis in Cx43-expressing cells required heterocellular GJIC. Further study revealed that the gastric cancer cells transmigrated through the intercellular space between the mesothelial cells via a paracellular route. Our results suggest that the abnormal expression of Cx43 plays an essential role in peritoneal metastasis and that Cx43-mediated heterocellular GJIC between gastric cancer cells and mesothelial cells may be an important regulatory step during metastasis. Finally, we observed that the diapedesis of exfoliated gastric cancer cells through mesothelial barriers is a viable route of paracellular migration.
    PLoS ONE 01/2013; 8(9):e74527. · 3.53 Impact Factor
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    ABSTRACT: Background/aims:Peritoneal implantation metastasis of gastric cancer cells is associated with poor prognosis. Peritoneal macrophages are the most important immune cells in the abdominal cavity to control tumor metastasis. In the present study, the immunosuppressive effects of mouse forestomach cells on macrophages were examined. Materials and Methods:Conditioned medium from mouse forestomach cell cultures were used to treat isolated peritoneal macrophages. A colorimetry-based phagocytosis assay was performed to investigate the functional change of macrophages. The alternation in cytokine secretion by macrophages was measured by enzyme-linked immunosorbent assay. Specific markers of macrophage polarization were analyzed by real-time reverse transcription polymerase chain reaction. The transforming growth factor-β1 signaling was evaluated by Western blotting. Neutralization experiments were performed by using transforming growth factor-β1 antibody. Results: The conditioned medium reduced the phagocytotic capability of macrophages. Lower tumor necrosis factor-αand interleukin-1βlevels and higher interleukin-10 and vascular endothelial growth factor levels were observed. Real-time reverse transcription polymerase chain reaction showed increased mRNA levels of M2 macrophage markers. Further study revealed that transforming growth factor-β1 was significantly elevated in the conditioned medium and transforming growth factor-β1 signaling was activated in the macrophages with treatment with conditioned medium. Neutralization of transforming growth factor-β1 reversed the immunosuppressive effects on macrophages. Conclusions: Immunosuppressive macrophages can be induced by conditioned medium from mouse forestomach cell cultures. These effects seemed to be through the production of transforming growth factor-β1 by the tumor cells. Targeting transforming growth factor-β1 intervention might help in the control of peritoneal metastasis of gastric cancers.
    The Turkish journal of gastroenterology: the official journal of Turkish Society of Gastroenterology 12/2012; 23(6):658-65. · 0.48 Impact Factor
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    ABSTRACT: To explore the effects of cefoperazone-sulbactam (C/S) plus minocycline on extensively drug resistant Acinetobacter baumannii (XDRAB) infections in critically ill patients. For this prospective and single-center trial, a total of 101 patients with infection due to XDRAB received the primary therapy of C/S plus minocycline. Combined use of imipenem-cilastatin was considered when primary therapy failed. Among them, 77 patients were evaluated. There were 49 males and 28 females with a mean age of (69 ± 20) years. The Acute Physiology and Chronic Health Evaluation (APACHE) II score was 15 ± 5. Among whom 61 had hospital-acquired pneumonia (n = 61), primary bacteremia (n = 5), intra-abdominal infection (n = 3), skin and soft tissue infection (SSTI)(n = 2) and multiple sites infection (n = 6). Twenty-three patients had mixed bacterial infections. Combined use of imipenem-cilastatin therapy was administered in 7 patients. The treatment duration was (16 ± 4) days. The outcomes were cure (n = 21), marked improvement (n = 27), improvement (n = 26) and ineffectiveness (n = 3). The overall effective rate was 62.3% (48/77) and the microbiological clearance rate 46.8% (36/77). The independent factors of decreased efficacy were underlying co-morbidity of impaired ability for infection control (OR = 5.3, P = 0.020), prolonged infection (OR = 3.8, P = 0.029), co-infecting organism (OR = 3.5, P = 0.032) and septic shock (OR = 2.5, P = 0.037). The combined regimen of C/S and minocycline is efficacious in the treatment of infections caused by XDRAB. But it has a lower rate of microbiological eradication.
    Zhonghua yi xue za zhi 10/2012; 92(40):2847-50.
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    ABSTRACT: To study the effect of different CO2 pneumoperitoneum pressures on the expression of adhesion molecules of human gastric cancer cell line MNK-45. MKN-45 cells in the experimental groups were exposed to simulated CO2 environment maintained at different pressures (1.2, 1.6, 2.0 kPa) for 4 hours. Control groups were exposed to room air. At the 0, 24, 48, 72, 96 hours after treatment, CD44v6, ICAM-1 and E-cadherin were detected by flow cytometry method. CD44v6 and ICAM-1 expressions showed pattern of firstly elevating, then descending to normal under the pressures of 1.2 kPa and 1.6 kPa. The expressions were different from control group significantly at 24 and 48 hours (P<0.01), while the 72 hours expression showed no difference compared with the controls (P>0.05). E-cadherin expression decreased significantly right after treatment compared to the control (P<0.01), but recovered to the level of control at 48 hours (P>0.05). In the 2.0 kPa group the expression changes of CD44v6, ICAM-1 and E-cadherin were more remarkable. CD44v6 and ICAM-1 expressions were increased significantly compared to control right after treatment (P<0.05). E-cadherin expression was significantly decreased even at 48 hours compared to the controls (P<0.01). In vitro CO2 pneumoperitoneum pressures have transient influence on the adhesion molecules expression of gastric cancer cell MKN-45, then those expressions can recover in a short-time.
    Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery 08/2012; 15(8):830-3.
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    ABSTRACT: CD8(+) T cells that produce interleukin (IL)-17 (Tc17 cells) promote inflammation and have been identified in tumors. We investigated their role in the pathogenesis of gastric cancer. We used flow cytometry analyses to determine levels and phenotype of Tc17 cells in blood and tumor samples from 103 patients with gastric cancer. We performed multivariate analysis to identify factors associated with overall survival using the Cox proportional hazards model. CD8(+) T cells and monocytes were isolated and cocultured in an assay for induction of Tc17 cells. Tumor cells and myeloid-derived suppressor cells (MDSCs) were isolated and used in assays of Tc17 cell function. Tc17 cells with distinct cytokine and functional profiles were found in gastric tumor samples from patients. The percentage of Tc17 cells increased with tumor progression and was associated with overall survival time. Tumor-activated monocytes secreted IL-6, IL-1β, and IL-23, which promoted development of Tc17 cell populations. Supernatants from cultured Tc17 cells induced production of the chemokine CXCL12 by tumor cells; this promoted CXCR4-dependent migration of MDSCs and impaired functions of anti-tumor CD8(+) cytotoxic T cells via a cell contact-dependent mechanism. Percentages of Tc17 cells in gastric tumors are associated with survival times of patients. These cells promote chemotaxis of MDSCs, which might promote tumor progression.
    Gastroenterology 06/2012; 143(4):951-962.e8. · 12.82 Impact Factor
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    ABSTRACT: Peritoneal implantation metastasis of gastric cancer cells is associated with poor prognosis. Peritoneal macrophages are the most important immune cells in the abdominal cavity to control tumor metastasis. In the present study, the immunosuppressive effects of mouse forestomach cells on macrophages were examined. Conditioned medium from mouse forestomach cell cultures were used to treat isolated peritoneal macrophages. A colorimetry-based phagocytosis assay was performed to investigate the functional change of macrophages. The alteration of cytokine secretion by macrophages was measured by ELISA assay. Specific markers of macrophage polarization were analyzed by real-time RT-PCR. TGF-β1 signaling was evaluated by western blotting. Neutralization experiments were performed using an anti-TGF-β1 antibody. Conditioned medium reduced the phagocytotic capability of macrophages. Lower TNF-α and IL-1β levels and higher IL-10 and VEGF levels were observed. Real-time RT-PCR showed increased mRNA levels of M2 macrophage markers. Further study revealed that TGF-β1 was significantly elevated in the conditioned medium and TGF-β1 signaling was activated in the macrophages by the treatment of conditioned medium. Neutralization of TGF-β1 reversed the immunosuppressive effects on macrophages. Immunosuppressive macrophages can be induced by conditioned medium from mouse forestomach cell cultures. These effects appeared to occur through the production of TGF-β1 by the tumor cells. Targeted TGF-β1 intervention may help to control peritoneal metastasis of gastric cancers.
    Molecular Medicine Reports 04/2012; 5(4):988-92. · 1.17 Impact Factor
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    ABSTRACT: To assess the value of procalcitonin (PCT) measurement to differentiate infection from non-infection in critically ill patients requiring long-term immunosuppressive therapy. A prospective study was conducted in patients with underlying diseases requiring corticosteroids or chemotherapy in ICU from January 2008 to December 2009. Patients were divided into the infection group and the non-infection group and their PCT levels were compared. A total of 103 patients (65 women) were enrolled in this prospective study [aged (47.9 ± 21.9) years old] with 84 in the infection group and 19 in the non-infection group. The baseline level of PCT was significantly higher in infection than in non-infection patients [2.58 (0.08 - 44.65) pg/L vs 0.62 (0.15 - 6.00) pg/L, P = 0.002]. Different levels of PCT were manifested in different pathogen groups with 3.41 (0.45 - 44.65) pg/L in bacteria infection, 0.99 (0.28 - 6.67) pg/L in fungus infection, 0.11 (0.08 - 0.20) pg/L in virus infection group (P = 0.018). The AUC(ROC) of PCT was 0.867 for diagnostic bacterial infection. By multivariate analysis, the factors associated with the level of PCT were bacteria infection (OR 5.1, P = 0.031) and septic shock (OR 7.5, P = 0.027), while the factors not associated with the level of PCT were age, renal function, infection site and prognosis (P > 0.05). The level of PCT is increased in the critically ill patients requiring immunosuppressive therapy with infection and it can be used for diagnosis for bacterial infection.
    Zhonghua nei ke za zhi [Chinese journal of internal medicine] 03/2012; 51(3):192-6.
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    ABSTRACT: Studies investigating the association between human 8-oxoguanine glycosylase 1(hOGG1) Ser326Cys polymorphism and gastric cancer (GC) risk have reported conflicting results. We performed a meta-analysis of published case-control studies to better compare results between studies. 11 eligible studies with 2,180 GC cases and 3,985 controls were selected. There were 5 studies involving Caucasians and 5 studies involving Asians. The combined result based on all studies did not show significant difference in any genetics models. Ser/Cys + Cys/Cys versus Ser/Ser (OR = 0.91, 95% CI 0.81-1.03), Cys/Cys versus Ser/Cys + Ser/Ser (OR = 1.07, 95% CI 0.80-1.44), Ser/Cys versus Ser/Ser (OR = 0.91, 95% CI 0.80-1.03), Sys/Cys versus Ser/Cys (OR = 1.10, 95% CI 0.83-1.47), Cys/Cys versus Ser/Ser (OR = 0.99, 95% CI 0.74-1.34), Cys versus Ser (OR = 1.01, 95% CI 0.88-1.17).When stratifying for ethnicity, there was still no significant association found between hOGG1 Ser326Cys polymorphism and GC risk. Funnel plot and Egger’s test showed some evidence of publication bias on the basis of all studies. Two studies were the main reason because their samples were too small. However, the result of sensitivity analysis suggested that the influence of these two studies and one mixed population study on the pooled OR was weak. Our result could explain the association between hOGG1 Ser326Cys polymorphism and GC risk. In conclusion, we did not found the evidence that the Cys allele at codon 326 of hOGG1 could increase GC risk in our analysis.
    Molecular Biology Reports 02/2012; 39(6):6563-8. · 2.51 Impact Factor
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    ABSTRACT: To investigate the feasibility and safety of da Vinci robotic-assisted radical gastrectomy for gastric cancer. Forty-one patients with gastric cancer from Southwest Hospital between March 2010 and December 2011 underwent da Vinci robotic-assisted radical gastrectomy including total gastrectomy(n=12) and distal gastrectomy (n=29). Conversion was required in two patients. One was converted to open surgery, and the other to conventional laparoscopic surgery. The remaining thirty-nine patients underwent da Vinci robotic-assisted radical gastrectomy successfully. The mean operative time was (285±61) min for total gastrectomy, and (225±39) min for distal gastrectomy. The mean blood loss was (180±157) ml in total gastrectomy, and (150±127) ml in distal gastrectomy. The mean number of harvested lymph nodes was 34.2±18.5. The mean time for gastrointestinal function recovery was (3.1±1.2) days. The time to ambulation was (2.7±1.5) days. The time to oral liquid intake was(3.7±1.5) days. Two patients had complication including wound infection and pneumonia. After follow up ranging from 1 to 21 months (median 11 months), 4 patients died from peritoneal metastasis, 1 survived with tumor, and the remaining 36 patients survived without disease. da Vinci robotic-assisted radical gastrectomy is a feasible and safe surgical procedure with clear operation field, precise dissection, minimal trauma and fast recovery.
    Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery 02/2012; 15(2):121-4.
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    ABSTRACT: Oxaliplatin is included in a number of effective combination regimens used as first and subsequent lines of therapy for metastatic colorectal cancer. Accumulating evidence indicates that autophagy plays a significant role in response to cancer therapy. However, the role of autophagy in oxaliplatin-induced cell death remains to be clarified. In this study, we showed that oxaliplatin induced cell death and autophagy in Caco-2 colorectal cancer cells. The suppression of autophagy using either pharmacologic inhibitors (3-methyladenine, bafilomycin A1) or RNA interference in essential autophagy genes (ATG5 or Beclin1) enhanced the cell death and reactive oxygen species (ROS) production induced by oxaliplatin in Caco-2 cells. Blocking oxaliplatin-induced ROS production by using ROS scavengers (NAC or Tiron) decreased autophagy. Furthermore, numerous dilated endoplasmic reticula (ER) were present in oxaliplatin-treated Caco-2 cells, and blocking ER stress by RNA interference against candidate of metastasis-1 (P8) and C/EBP-homologous protein (CHOP) decreased autophagy and ROS production. Taken together, these data indicate that oxaliplatin activates autophagy as a cytoprotective response via ER stress and ROS in human colorectal cancer cells.
    PLoS ONE 01/2012; 7(11):e51076. · 3.53 Impact Factor
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    ABSTRACT: To investigate the acid-base abnormalities of the patients with hyperlactatemia and explore the relationship of hyperlactatemia and metabolic acidosis so as to seek a more precise index of reflecting organ perfusion. From August 2009 to April 2010, all consecutive patients admitted into intensive care unit received an analysis of blood gas. Those individuals with arterial lactate ≥ 2 mmol/L were selected. In the group of hyperlactatemic patients, the occurrence of metabolic acidosis as judged by the traditional method was less than that by the Stewart's method (33.9% vs 56.0%). No typical acidemia was found. And all components of metabolic acidosis were calculated. Lactate and SIG (strong ion gap) contributed a certain percentage to metabolic acidosis in the survivor and nonsurvivor groups [(33.6 ± 17.9)% vs (28.6 ± 23.5)%, (42.1 ± 18.5)% vs (44.9 ± 23.0)%]. Among the hyperlactatemic patients (Lac ≥ 2), lactate and unmeasured anions account for most instances of acidosis. These two indicators may offer a more accurate reflection of tissue perfusion.
    Zhonghua yi xue za zhi 09/2011; 91(33):2324-8.