Nanjing, China
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Xu Z.,Nanjing University | Li Y.,Nanjing University | Wang J.,Nanjing University | Wu B.,Jinling Hospital | Li J.,Nanjing University
Clinical Nutrition | Year: 2012

Background & aims: Parenteral nutrition-associated liver disease (PNALD) complicates the treatment of patients with short bowel syndrome (SBS). Some studies have shown omega-3 polyunsaturated fatty acids (ω-3 PUFAs) have favorable effects in treating PNALD in children. We, therefore, investigate the effects of ω-3 PUFAs supplemented intravenous lipid emulsion (ILE) on PNALD in adults. Methods: We performed an open-labeled study of a ω-3 PUFAs based ILE in 15 adults with SBS who developed cholestasis while receiving soybean oil-based ILE. Liver biopsies were performed before and after the initiation of ω-3 PUFAs to confirm the presence and improvement of cholestasis. Blood samples were collected every week for analysis of fatty acid composition and liver function. Results: 12 of the 15 patients had their direct bilirubin normalized within 4 weeks and our data demonstrated a significant decrease in both DB (P≤ 0.001) and TB (P≤ 0.001) after 4 weeks compared to baseline. There were ameliorations of liver function and fatty acid patterns in all patients and serial liver biopsy specimens showed progressive histologic improvement. Conclusions: Parenteral ω-3 PUFAs supplemented fat emulsions are safe and effective in the treatment of PNALD in adults. © 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism.


Gong J.F.,Jinling Hospital
Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery | Year: 2010

OBJECTIVE: To examine the outcome of damage control surgery (DCS) in patients with acute mesenteric ischemia (AMI). METHODS: Clinical data of 15 consecutive AMI cases treated with DCS from May 2001 to March 2009 at the Research Institute of General Surgery, Jinling Hospital were retrospectively analyzed. Eleven patients had acute superior mesenteric vein thrombosis (MVT) on admission, and 4 suffered from acute mesenteric arterial embolism/thrombosis (MAE/MAT). The staged damage control approach included immediate resection of the involved bowel (but no attempts to restore gastrointestinal continuity), open thrombectomy, transfer of the patients to ICU for resuscitation, and thrombolysis prior to the planned definitive reconstructive procedure. RESULTS: Of 15 patients, 10 (66.7%) survived. The mean remnant small bowel length was (209.0+/-53.8) cm (120 to 280 cm). None of the survived patients was parenteral nutrition-dependent. Of the 5 deaths, 2 died of recurrence of thrombosis and necrosis of the remaining bowel,1 of massive gastrointestinal bleeding. One patient abandoned treatment intra-operatively, and another with total small bowel resection abandoned treatment postoperatively. CONCLUSIONS: Damage control approach improves the survival of patients with AMI. Thrombectomy and thrombolysis are necessary for AMI management to prevent progression or further development of the thrombosis.


Zhou S.G.,Jinling Hospital | Lu J.L.,Nanjing Medical University | Hui J.H.,Nanjing Medical University
World Journal of Urology | Year: 2011

Purpose: To compare the efficacy of α 1D-receptor antagonist Naftopidil and α 1A/D-receptor antagonist Tamsulosin in management of distal ureteral stones. Materials and methods: A total of 131 patients with distal ureteral stones were included in the study from December 2008 to September 2010. The patients were randomized to 3 groups: group 1 (43 patients), those receiving 10 mg naftopidil once daily; group 2 (45 patients), those receiving 0.4 mg tamsulosin once daily; and group 3 (43 patients) were given a watchful waiting and served as control group. All patients were followed up for 2 weeks. Ultrasonography and kidney-ureters-bladder (KUB) were performed on day 7 and 14. At the end of the follow-up period, patients who failed to expel the stone were scheduled to undergo ESWL or ureteroscopy. Results: Stone expulsion was observed in 31 patients in group 1 (72.1%), 37 patients in group 2 (82.2%), and 13 patients in group 3 (30.2%). A statistically significant difference was noted with Chi-square testing between groups 1 and 3, and groups 2 and 3 (P = 0.000 and P = 0.000, respectively). Average time to expulsion was 7.6 ± 2.26 days (range 1-12 days) in group 1, 7.7 ± 1.94 days (range 2-11 days) in group 2, and 9.4 ± 2.48 days (range 6-14 days) in group 3. A statistically significant difference was observed in time to expulsion between groups 1 and 3, and groups 2 and 3 (P = 0.000, P = 0.001, respectively) by ANOVA testing. The side effects encountered in the study groups were generally mild and did not require cessation of therapy in any patient. Conclusions: Naftopidil could significantly increase spontaneous passage of distal ureteral stones with low side effects. The stone expulsion rate is similar for the tamsulosin. © 2011 Springer-Verlag.


Li N.,Jinling Hospital
Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery | Year: 2015

Perioperative management includes all the treatments during pre-, intra-, and post-operative periods. The enhanced recovery after surgery applies a series of evidence-based perioperative measures to accelerate patients' recovery by reducing both physical and mental stress caused by surgical operation. Compared with traditional perioperative management, it decreases the rate of complication and re-admission, and shortens the length of hospitalization without any impact on safety. The principle, strategy, and technique of enhanced recovery after surgery will be integrated into the perioperative management of all the patients in the future.


Song H.,Jinling Hospital | Xu B.,Jinling Hospital | Yi J.,Jinling Hospital
Journal of Experimental and Clinical Cancer Research | Year: 2012

Background: Stanniocalcin-1 (STC-1) is a potential marker of disseminated tumor cells (DTCs). The aim of this study was to examine STC-1 expression in peripheral blood (PB) and bone marrow (BM) of esophageal squamous cell carcinoma (ESCC) patients, and to evaluate its clinical significance. Methods: A total of 85 ESCC patients treated with radical resection were enrolled in this study. Immunohistochemistry was used to detect STC-1 protein expression in ESCC tissues. Nested RT-PCR was used to detect STC-1 mRNA expression in PB and BM. Results: There were 71 cases (83.5%) showed a higher level of STC-1 protein expression in tumor tissues than in adjacent normal tissues (P≤0.001). Furthermore, the frequencies of STC-1 mRNA expression detected in PB and BM were 37.6% (32/85) and 21.2% (18/85), respectively, and together increased sensitivity to 48.2% (41/85), which was much higher than that in patients with benign esophageal disease (5.0%, 2/40, P≤0.001). In addition, STC-1 mRNA expression either in PB or BM was correlated with lymph metastasis, advanced stage and adverse 2-year progression free survival (PFS). In a multivariate analysis using the Cox proportional hazard model, STC-1 expression in PB and/or BM was an independent unfavorable prognostic factor for ESCC, apart from lymph metastasis and clinical stage. Conclusions: STC-1 mRNA expression is a reliable marker for detection of DTCs in PB and BM of ESCC patients, and STC-1-positive DTCs may be a promising tool for diagnosis and prognosis assessment in ESCC. © 2012 Song et al.; licensee BioMed Central Ltd.


Zhao M.,JinLing Hospital | Wang X.-X.,JinLing Hospital | Wan W.-H.,JinLing Hospital
Genetics and Molecular Research | Year: 2014

Although ginkgo biloba extract (GBE) was shown to have antioxidant effects, little has been reported on the ability to GBE to help endothelial progenitor cells (EPCs) resist oxidative stress. The present study evaluated the influence of different concentrations of GBE on superoxide dismutase (SOD) and apoptosis of diabetic peripheral blood EPCs. Twenty-five diabetic patients without any vascular complications were included in the experimental group, while 15 healthy adults made up the control group. Peripheral blood mononuclear cells were isolated with density gradient centrifugation, and, after in vitro differentiation, were determined to be EPCs using FITC-UEA-I and Dil-Ac-LDL dual staining. After the colony and fusiform adherent cells were observed, on day 7, various concentrations of ginkgo biloba extract (0, 10, 25, 50 mg/L) were added to the culture medium for a 24-h incubation. EPC-SOD activity and apoptosis were subsequently detected. We found that within the experimental group, GBE significantly improved SOD activity within EPCs and reduced the rate of apoptosis. These effects became more obvious with increasing GBE concentrations (25 mg/L, P < 0.05; 50 mg/L, P < 0.01). GBE also improved SOD activity and reduced the rate of apoptosis within EPCs of the control group; however, the changes were not statistically significant. We conclude that GBE can improve SOD activity and reduce the rate of apoptosis of EPCs within the peripheral blood of diabetic patients, effects that are dose-dependent. © FUNPEC-RP.


Cheng W.,Jinling Hospital | Zhang Z.,Jinling Hospital | Wang J.,Nanjing University
Cancer Letters | Year: 2013

Prostate cancer is the most common type of cancer and frequent cause of cancer-related mortality in men worldwide. Despite its commonness, the underlying molecular mechanism of prostate cancer is not completely understood. Long noncoding RNAs (lncRNAs) are being implicated in the complex network of an apparent cancer initiatome and hundreds of lncRNAs are differentially expressed in various types of cancer including prostate cancer. While many lncRNAs exhibit oncogenic function and are named "Onco-lncRNAs", only a few lncRNAs inhibit cell proliferation or induce apoptosis and, hence, act as tumor suppressors. In this review, we highlight recent findings of emerging roles for lncRNAs in prostate cancer and discuss rapid translational lncRNA research for clinical application in diagnosis, prognosis and potential treatment. © 2013 Elsevier Ireland Ltd.


Yuan S.M.,Jinling Hospital
Zhonghua zheng xing wai ke za zhi = Zhonghua zhengxing waike zazhi = Chinese journal of plastic surgery | Year: 2013

To investigate the role of the expression of PPAR-gamma gene in the adipogenesis in hemangioma evolution. Routine immunohistochemistry staining of Perilipin A, the marker antigen of adipocytes, was performed to observe the adipogenesis in hemangioma. Immunofluorescence staining of PPAR-gamma, the important transcription factor in promoting adipogenesis, was carried out to observe its location in hemangioma tissue, with the co-staining of alpha-SMA and CD31. And RT-PCR was used to examine the expression of PPAR-gamma gene in hemangioma in different stages. In the evolution of hemangioma, the number of adipocytes increased continuously. And the tumor was replaced by fibrofatty tissue finally. PPAR-gamma was located in the nuclei of perivascular cell in hemangioma tissue. The expression of PPAR-gamma gene in hemangioma increased in the evolution of hemangioma, but still was lower than that in normal fat tissue from children. The expression of PPAR-gamma in the perivascular cells suggests that they may contribute to the adipogenesis in hemangioma involution.


Liu G.,Jinling Hospital | Zhao J.,Jinling Hospital | Chang Z.,Jinling Hospital | Guo G.,Jinling Hospital
Cellular and Molecular Neurobiology | Year: 2013

Calcium/calmodulin-dependent protein kinase II (CaMKII) is a ubiquitous, structurally complex multifunctional protein serine/threonine kinase that plays an important role in cell apoptosis via linking the ER stress and mitochondrial apoptosis pathways. Recently, CaMKII has been correlated with apoptosis signal-regulating kinase 1 (ASK1) activity and the ASK1-dependent apoptosis pathway through the direct phosphorylation of Thr845 of ASK1. The specific role of CaMKII in hypoxia-reoxygenation (H/R)-induced spinal astrocyte apoptosis, however, remains unclear. In this study, we investigated the effects of CaMKIIγ (an isoform of CaMKII) on spinal astrocyte apoptosis using an in vitro oxygen-glucose deprivation (OGD/R) model which mimics hypoxic/ischemic conditions in vivo. OGD/R increased cell death and the activation of CaMKII. Deletion of CaMKIIγ results in the reduced activation of CaMKII and apoptosis in astrocytes under OGD/R conditions. Notably, the deletion of CaMKIIγ induced ASK1 phosphorylation at Thr845 in astrocytes. The activation of JNK and p38 and the downstream effect of ASK1 were also reduced. These data suggest that CaMKIIγ is required for the CaMKII-dependent regulation of ASK1, affecting the apoptosis of a biologically important cell type under spinal cord injury. © 2013 Springer Science+Business Media New York.


Yang L.,Hubei Maternal and Child Health Hospital | Han S.,Jinling Hospital | Sun Y.,Nanjing Medical University
Biochemical and Biophysical Research Communications | Year: 2014

Recently, a new generation of PI3K-specific inhibitors, such as GDC0941 and BKM120, are being investigated in clinical trials for treatment against tumors harboring PIK3CA mutations. Nevertheless, not all patients benefit from such treatment, suggesting that their tumors may be resistant to PI3K inhibitors. The investigation of the underlying mechanisms and efficacious personalized treatment remain a large unmet need. In this study, we revealed an IL6-STAT3 positive feedback loop that mediated the resistance to PI3K inhibitors. We found that breast cancer cells with acquired resistance to PI3K inhibitors displayed epithelial-mesenchymal transition (EMT) features and an highly enriched cancer stem cells (CSCs), secreting ∼1000-fold more IL6 than parental cells. Further studies elucidated that activation of the IL6-STAT3 signaling effectively triggered EMT action, expanded the CSCs population, and reduced sensitivity to PI3K inhibitors. Pharmacological inhibition of STAT3 disrupted the IL6-STAT3 signaling and overcome resistance to PI3K inhibitors partially due to increased apoptosis induction. Taken together, our results demonstrated that feedback activation of the IL6-STAT3 loop lead to acquired resistance to PI3K inhibitors by promoting EMT and CSC-like features, and suggested that targeting this loop may be an efficient strategy to overcome resistance to PI3K inhibitors. © 2014 Elsevier Inc. All rights reserved.

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