Risk model of breast cancer prognosis based on the expression profile of long non-coding RNA / 中国综合临床

Objective:To construct a prediction model for the prognosis of breast cancer patients with long non-coding RNA expression characteristics.Methods:To construct a long non-coding RNA(LncRNA) model for predicting the prognosis of breast cancer patients.Methods Analyzing LncRNA expression profiles and clinical characteristics of 1 081 breast cancer patients in the cancer genome atlas (TCGA) database.Performing differential expression analysis and univariate analysis on 112 paired breast cancer and normal breast tissues′ transcriptome sequencing data in the TCGA database, and screened for differentially expressed (DELncRNAs) that significantly correlated with the prognosis of BRCA (To reduce batch effects, sequencing data has been normalized using the DESeq function). One thousand eighty-one breast cancer patients were randomly divided into two groups: training set (541) and validation set (540). Performing Cox proportional hazard regression using DELncRNAs and establishing a multi-LncRNA prognosis model in the training set, followed by proportional hazards assumption test(PH assumption test). Patients were divided into high-risk and low-risk groups based on calculated risk score.Kaplan-Meier method was used for survival analysis, and 540 patients′ data were used for validation.To evaluate the prognostic value of the model in patients with squamous cell carcinoma of the lung and hepatocarcinoma in TCGA database.Gene Set Enrichment Analysis (GSEA) was used to analyze the specific mechanism of lncrna affecting the survival of patients.Results:There were 2815 differentially expressed genes screened by transcriptome sequencing, 91 of which were significantly related to the prognosis of breast cancer patients ( P<0.05). Based on the Cox regression analysis of 91 delncrna expression data from 541 breast cancer patients in training set, a Cox proportional risk regression model was constructed based on 5 LncRNA (training set AUC=0.746, validation set AUC=0.650): AC004551.1, MTOR-AS1, KCNAB1-AS2, FAM230G and LINC01283, and PH assumption test( P=0.388). K-M survival analysis showed that the survival time of high-risk group was significantly worse than that of low-risk group (median survival time: 7.049 and 12.21 years, HR 0.367, 95% CI0.228-0.597, P<0.001), and the survival time of high-risk group was significantly shorter than that of low-risk group (median survival time: 7.57 and 10.85 years, HR 0.412, 95% CI0.214-0.793, P<0.001). Similar prediction results were also obtained in other cancer species of TCGA: lung squamous cell carcinoma ( HR 0.604, 95% CI0.383-0.951, P=0.007) and liver cell carcinoma ( HR 0.551, 95% CI0.307-0.987, P=0.011). GSEA results suggested that the expression patterns of the above five LncRNA were related to the cell cycle regulation of tumor cells. Conclusion:The prognostic model constructed based on expression profile of AC004551.1, MTOR-AS1, KCNAB1-AS2, FAM230G and LINC01283 can be used to predict the prognosis of breast cancer patients, which is helpful to further guide clinical treatment.

Risk factors of neurologic complications after surgical resection of carotid body tumor / 中华普通外科杂志

Objective:To investigate risk factors of nerve injury after carotid body tumor resection.Methods:From 1991 to 2016, the clinical data of patients with neurologic complications after resection of carotid body tumor was retrospectively analyzed. Logistic regression analysis was used to investigate the risk factors of nerve injury.Results:A total of 132 patients with 142 tumors underwent surgery. 45 patients (46 sides) suffered nerve injury, including 4 strokes and 44 nerve injuries. After active rehabilitation, 18 cases were left with permanent nerve injury, and the 4 patients with strokes regained self-care ability. By multivariate regression analysis, high-lying tumors ( OR=4.345, P=0.005), Shamblin Ⅲ tumor ( OR=4.382, P=0.047) increase the risks of postoperative nerve injury. Resection of high-lying tumors carried a higher risk of developing permanent nerve injury ( OR=7.290, P=0.001). Conclusions:Neurologic complication could be alleviated by rehabilitation. Intraoperative abrupt rupture of carotid artery is the leading cause of stroke. Shamblin Ⅲ and high-lying tumor are the predictors of postoperative nerve injury.

Clinicopathological significance of poorly differentiated clusters in colorectal adenocarcinoma / 中华病理学杂志

Objective@#To investigate the correlation between poorly differentiated clusters (PDCs) in colorectal adenocarcinomas with clinicopathological parameters and its clinicopathological significance.@*Methods@#One hundred and eighty-three colorectal adenocarcinomas resected by radical proctocolecomy were collected at Nanjing Hospital(Nanjing First Hospital), Nanjing Medical University, from January to December 2017. There were 122 male and 61 female patients with age ranging from 42 to 89 years (mean of 68 years). Tumor diameter ranged from 2 to 14 cm (mean 4.5 cm). There were 124 colon cancers and 59 rectal cancers. The number and grade of PDCs in the colorectal adenocarcinoma were evaluated by H-E staining. The overall peritumoural inflammatory reaction was also evaluated. The relationship between PDCs and tumor grades and clinicopathological features and overall peritumoural inflammatory reaction of colorectal adenocarcinoma was analyzed.@*Results@#Of 183 cases of colorectal adenocarcinoma, PDCs were seen in 104 cases (56.8%), of which 36 cases (19.7%) were grade 1, 28 cases (15.3%) were grade 2, and 40 cases (21.9%) were grade 3. PDCs were positively correlated with lymph node metastasis, vascular invasion, degree of differentiation, depth of invasion, and pTNM staging(P<0.05). The detection rate of PDCs in colon cancer was higher than that of rectal cancer(P<0.05). PDCs was unrelated to age, gender, tumor size, and degree of overall peritumoural inflammatory reaction (P>0.05). Among clinicopathological parameters, the grade of PDCs was correlated with lymph node metastasis and vascular invasion (higher than those without lymph node metastasis and vascular invasion, P<0.05); There was a positive correlation between the grade of PDCs and age, tumor differentiation and pTNM staging(P<0.05), and no significant difference between the grade of PDCs and gender, tumor size, tumor location, and depth of invasion was seen (P>0.05). There was no correlation between the grade of PDCs and the degree of overall peritumoural inflammatory reaction (P>0.05).@*Conclusions@#PDC is a histological feature that predicts the aggressiveness of colorectal adenocarcinoma. Evaluation of PDC grade can better predict the biological behavior of colorectal cancer and more accurately guide the treatment and evaluate prognosis.

Effects of MTA1 on biological behaviors of gastric cancer cells / 中华肿瘤杂志

Objective@#To study the effects of metastasis associated 1 (MTA1) on biological characteristics such as migration, invasion and proliferation of gastric cancer (GC) cells.@*Methods@#pSilencer3.1-MTA1-siRNA vector was used to establish human gastric cancer BGC-823 cell lines with constitutive MTA1-knockdown. Boyden, wound healing, clony forming assay and 3-(4, 5-dimethyl-2-thiazolyl)-2, 5-diphenyl-2H tetrazolium bromide (MTT) assay were performed to identify the effects of MTA1-deficiency on the biological behaviors of BGC-823 cells in vitro. Simultaneously, MTA1 overexpressed BGC-823 cell line was established by pcDNA3-MTA1 plasmid transfection for reverse verification. In addition, the role of MTA1 in the tumorigenicity of gastric cancer BGC823 cells in vivo was examined by subcutaneous injection of BGC-823 cells expressing different MTA1 levels into nude mice. Reverse transcription-polymerase chain reaction (RT-PCR) and western blot were used to detect the expression levels of integrin β1, cyclin D1 and uPAR in pSilencer3.1-MTA1-siRNA, pcDNA3-MTA1 transfected cells and control cells.@*Results@#MTA1 knocked down or upregulated BGC-823 cell lines were successfully generated by transfecting pSilencer3.1-MTA1-siRNA or pcDNA3-MTA1 vector with lipofectamine 2000, respectively. The Boyden and wound healing experiments showed metastasis and invasion ability in MTA1 knocked down cells (25±2, 12±1) were significantly decreased when compared with those of control (78±2, 50±2) and MTA1-overexpressed groups (218±2, 269±3; P<0.05). The results of MTT assay and colony forming assay were significantly decreased when compared with those of showed that MTA1 overexpressed cells grew more rapidly and formed more colonies in vitro and induced worse malignant tumors in vivo, while MTA1 knocked down cells presented the reversed phenotype[control group (1 482.41±511.90) mm3, (1.39±0.29)g; MTA1 overexpressed group [(3 158.73±1 823.22) mm3, (2.23±0.51)g; MTA1-downregulated group (711.32±284.30)mm3, (0.87±0.21) g ; P<0.05)]. In addition, RT-PCR result showed that the expression level of MTA1 was positively correlated with the known metastasis-related genes (integrinβ1, cyclinD1, uPAR).@*Conclusions@#MTA1 promotes the invasion, migration and proliferation of human gastric cancer BGC-823 cells. On the contrary, down-regulation of MTA1 significantly inhibits tumorigenicity of BGC-823 cells and induces favorable phenotypes. MTA1 may promote the malignant phenotype of BGC-23 cells via regulating the expressions of integrinβ1, cyclinD1 and uPAR.

Investigation and Analysis of the Cognition of Physicians to the Prescription Handling of Commonly Used TCM Decoction Pieces in a Third Grade Class A Hospital of TCM from Beijing / 中国药房

OBJECTIVE:To provide reference to promote the proper use of TCM decoction pieces.METHODS:According to Beijing TCM Decoction Piece Dispensing Regulation,stratified random sampling method was adopted to select a group of physicians in our hospital and conduct questionnaire survey about their knowledge of the prescription handling of 8 commonly used TCM decoction pieces including Scutellaria baicalensis,Angelica sinensis,Fritillary,Phellodendron chinense,Aconitum carmichaeli,Eucommia ulmoides,Ziziphus jujuba,Rhei Radix et Rhizoma.Then,the survey data was collected and analyzed.RESULTS:A total of 81 questionnaires were given out and all were returned with effective recovery rate of 100％.In terms of professional titles,associate chief physicians showed the lowest average error rates in prescription handling cognition (27.5 ％),compared with physicians (35.8％) and attending doctors (37.0％).They made most mistakes about Fritillary and E.ulmoides.To the contrary,both physicians and attending doctors made most mistakes about E.ulmoides.In the scope of working life,physicians from different groups showed similar average error rates in prescription handing recognition (31.3％-38.8％).All of them made most mistakes about P.chinense and E.ulmoides.As for major,those who study western internal medicine shared larger average error rates (43.8％) than those who study internal medicine of TCM (36.8％),traumatology and orthopedics of TCM (31.8％) and acupuncture (36.5％).Each major showed the highest error rates in E.ulmoides.The order of 8 TCM decoction pieces from the most mistakes to the least mistakes made by physicians was E.ulmoides,P.chinense,Fritillary,Rhei Radix et Rhizoma,S.baicalensis,A.carmichaeli,Z.jujuba and A.sinensis.CONCLUSIONS:Physicians with different professional titles,working life and majors show deficiency in knowledge about the prescription handling of 8 commonly used TCM decoction pieces.Generally,physicians show the worst understanding of E.ulmoides.

Thinking on the reform of clinical medicine teaching based on the national medical licensing examination / 中华医学教育探索杂志

Objective To summarize and analyze the results of our university graduates' participation in the national medical licensing examination in order to investigate the clinical medical teaching reform.Methods There were 770 candidates who took the NMLE from 2011 to 2013.Excel 2007 was used to statistically analyze the total score,passing rate,average score and mastery rate for each subject,and average score and mastery rate at different cognitive level.Results In these three years,our candidates' total pass rate was higher than the national average total pass rate,respectively higher 17.11％,18.10％,17.82％;the pass rate of practical skills examination was also higher than the national average pass rate,respectively higher 7.30％ and 7.19％ and 5.90％;the pass rate of theory examination was higher than the national average pass rate,respectively higher 12.91％,12.97％ and 14.29％.The average score and mastery rate for each subject,the average score and mastery rate at different cognitive level were also all higher than those of the national average of medical colleges.Conclusions National medical licensure examination can be used as an important reference,through optimization of medical curriculum and teaching mode,optimization of clinical practice skills training system and optimization of clinical practical skill evaluation system etc.,to further improve the clinical medical personnel training mode.

Clinical Study of Low Molecular Weight Heparin Combined with Alteplase for Thrombolysis / 昆明医科大学学报

Objective The aim of this study was to investigate the application of low molecular weight heparin combined with alteplase for thrombolysis in patients with acute myocardial infarction(AMI),and to compare its thrombolysis effect with traditional anticoagulant-general heparin. Methods 35 AMI patients with alteplase intravenous thrombolytic therapy were divided into two groups,among which 15 cases in the study group were treated with 30 mg enoxaparin instant intravenous injection before thrombolysis,40 mg enoxaparin hypodermic injection 15 minutes after thrombolysis,40 mg enoxaparin hypodermic injection every 12 hours for 5 days. The other 20 cases were assigned to the control group and treated with 4 000 u(or 60 u/kg)general heparin instant intravenous injection,then pumped general heparin intravenously in the rate of 800-1 000 u/h. Meanwhile,detected coagulation convention every 3 hours and adjusted the dose of heparin according to the activated partial thromboplastin time(APTT)to keep APTT value within 1.5 to 2.0 times(50-70 s)the standard value. 48 hours later,patients in the control group was given hypodermic injection of 40 mg enoxaparin every 12 hours for 5 days. All cases were given regular treatment as guidelines recommended. Results The patency rate of infarct-related coronary artery assessed by unified clinical criteria was 86.66% and 65.00%,and the average recanalization time was(1.62±0.36)h and(1.81±0.33)h in the study and control groups,respectively. There were no significant differences on patency rate and recanalization time between the two groups(P > 0.05). One case of bleeding complication occurred in the study group(6.66%),while five cases occurred in the control group(25.00%). In the two groups,no cases appeared intracranial hemorrhage and other serious or fatal bleeding occurred. Conclusion The clinical efficacy of low molecular weight heparin was non-inferior to general heparin in AMI patients with alteplas thrombolysis. The application of low molecular weight heparin was simple and easy to operate. It can optimize the procedure of thrombolysis,reduce repetitive coagulation index monitoring and lessen clinical workload,which is worth being promoted to primary hospital and the emergency systems.

Effect and mechanism of CD4+CD25+regulatory T cells on protective effica-cy of protein vaccine against Schistosoma japonicum in mice / 中国血吸虫病防治杂志

Objective To explore the effect and mechanism of CD4+CD25+Tregs(Tregs)on the protective efficacy of glutha?tione?S?transferase(GST)against Schistosoma japonicum in mice. Methods Female BALB/c mice were divided randomly into five groups:a normal control group,an infected control group,an anti?CD25mAb group,a GST immunization group and a com?bination group with GST immunization and anti?CD25 mAb. The GST group and combination group were injected percutaneously with GST 50μg each mouse,the other two groups were injected with equal volume PBS. The immunization was performed for 3 times for two?week interval,and 2 weeks after the last immunization,each mouse was challenged with 40 S. japonicum cercaria. Two weeks post?infection,the combination group and anti?CD25 mAb group were injected intraperitoneally with 300μg anti?CD25 mAb each mouse. The mice were succumbed 2 weeks,3 weeks,4 weeks and 5 weeks post?infection respectively. The per?centages of CD4+CD25+Tregs in splenocytes of mice were measured with flow cytometer. The levels of IFN?γ,IL?2,IL?4,IL?5 and TGF?βin cell cultural supernatants were determined by sandwich?ELISA after stimulation with Con A. The liver sections were stained with hematoxylin and eosin. Results The worm burden in the combination group(15.80 ± 2.74)was significantly lower than those of the infected control group(27.78 ± 3.15),anti?CD25 mAb group(21.50 ± 4.21),and GST group(20.84 ± 6.46). Compared to those of the infected control group,the percentages of CD4+CD25+Tregs were significantly higher in the GST group,while the percentages of CD4+CD25+Tregs were significantly lower post?anti?CD25 mAb?administration. Regardless of GST administration,the levels of IFN?γ,IL?2,IL?4 and IL?5 after anti?CD25 mAb were significantly higher than those of the in?fected control groups. There were no significant differences of egg granuloma and the level of TGF?βbetween each group. Con?clusion CD4+CD25+Tregs could be partially blocked by anti?CD25 mAb while Th1 and Th2 type immunization response could be enhanced,which plays a role in improving the protective efficacy of GST against of S. japonicum.

RASSF1A and RASSF1A methylation′s relationship with breast cancer / 实用肿瘤学杂志

Breast cancer is one of the most common malignant tumors in women.Early diagnosis plays a very important role in the treatment of breast cancer.Recently,with the development of epigenetics,it gives us a new orientation for early detection for cancers.The most understood mechanism of epigenetics is DNA methyla-tion.Ras associated domain family 1A gene(RASSFlA)promoter methylation occurres in tumor′s early stage,and have a statistically concern with tumor′s TNM stage,invasiveness and outcomes.Moreover,DNA methylation can be reversed,so RASSF1A can be a promising candidate for early breast cancer detection biomarker,and can be a potential orientation for breast cancer treatment.

Autophagy facilitates breast cancer cells to resist tamoxifen by p38/c-Jun pathway / 实用肿瘤学杂志

Objective To investigate the effects of autophagy on breast cancer cells to tamoxifen resist-ance.Methods Immunofluorescence was used to count the proportion of the cells with autophagy in MCF -7 and MCF-7/TAMR,as well as ,the average of autophagosome in each cells .Western blotting was used to detect the different expressions of p38,c-jun and LC3 in MCF-7 and MCF-7/TAMR.Stepwise selection was used to detect the duration of resistance to different doses of tamoxifen when upregulating or downregulating of LC 3.West-ern blot was facilitated to investigate changes of activity of p 38/c-jun.Rusults Compared with MCF -7,the proportion of the cells with autophagosome in MCF -7/TAMR was markedly increased ,the same as the average of autophagosome in each cells .Compared with MCF-7,LC3,especially LC3IIprotein expressive levels in MCF -7/TAMR was significantly increased .The expressive level of LC3 during the induction process of TAM resistance was negative correlated with resistant cell lines .The expressions of phosphorylated p 38 and c-Jun in MCF-7/TAMR were significantly increased .Conclusion Autophagy promotes breast cancer cells to resistant to tamox-ifen,due to downregulation of the expression of autophagy related proteins which may inhibit the generation of re -sistant breast cancer cells .This may be a viable treatment strategy for refractory breast cancer .

Diagnostic value of HNF-1βin the diagnosis of ovarian clear cell carcinoma / 临床与实验病理学杂志

Purpose To study the expression of HNF-1β in different type ovarian carcinoma and to explore the diagnostic value of HNF-1β in the diagnosis of ovarian clear cell carcinoma. Methods Immunohistochemical EnVision method was used to detect the ex-pression of HNF-1βin 27 clear cell carcinomas, 35 high-grade serous carcinomas, 21 endometrioid adenocarcinoma, 10 mucious carci-nomas, 13 metastatic Krukenberg tumors, and 2 transitional carcinomas. Results All of ovarian clear cell carcinomas variably ex-pressed HNF-1β and the positive rate of HNF-1β in ovarian cleat cell carcinoma was 85. 2%. Of 21 ovarian serous carcinomas, the nuclear positive of HNF-1β was 4 and HNF-1βpositive rate was 2. 9%. There was 5 HNF-1βexpression in endometrioid adenocarci-noma and the positive rate of HNF-1β was 23. 8%. The positive rate of HNF-1β in mucious carcinoma and metastatic Krukenberg tumor was 60. 0% and 53. 8%, respectively. No HNF-1βexpression was seen in transtional cell carcinoma. The sensitivity and speci-ficity of HNF-1β in the diagnosis of ovarian clear cell carcinoma was 85. 2% and 76. 5%. Conclusions HNF-1β may be a higher sensitive marker for the diagnosis of ovarian clear cell carcinoma. The diffuse and strong positive of HNF-1βmay have higher specific for diagnosis of ovarian clear cell carcinoma.

Effects of preincubation medium and other factors affecting in vitro fertilization rate of post-thawed genetically engineering mouse spermatozoa / 中国比较医学杂志

Objective To discuss the effect of in vitro fertilization ( IVF) and mouse sperm cryopreservation , to establish a simple and economic frozen system for the genetically engineering mice preservation .Methods Sperm from genetically engineering mice were cryopreserved , IVF was performed using post-thawed sperm, then embryo transfer, to compare the effects of cryopreservation medium、age of male mice and sperm preincubation medium .Results Using CPA as sperm cryopreservation medium , when PM was used thawed-sperm preincubation in IVF , the fertility rates were from 82.49%to 91.43%, when HTF was used thawed-sperm preincubation in IVF , the fertility rates were from14.46%to 27.38%, there was a signification difference between PM and HTF sperm preincubation medium;10 to 35 weeks male genetically engineering mice sperm were succeed cryopreservation , and positive mice were procreated after 2-cell embryos were transferred;R18S3、CPM and CPA was used to freeze sperm , the fertility rates were 75.85%、88.89%to 94.27%, positive mice were procreated after 2-cell embryos were transferred;2-cell embryos after IVF were freezed , then thawed and positive mice were procreated after 2-cell embryos were transferred .Conclusion Using CPA as sperm cryopreservation medium , when PM was used thawed-sperm preincubation in IVF , genetically engineering mice sperm were succeed cryopreservation .

Hybrid treatment of aortic arch disease with ascending aorta to carotid artery revascularization and subsequent endovascular repair / 中华外科杂志

<p><b>OBJECTIVE</b>To summarize the experience of treating aortic arch disease with ascending aorta to carotid artery revascularization and subsequent endovascular repair.</p><p><b>METHODS</b>From January 2002 to June 2013, 10 high risk patients with aortic arch disease were treated with ascending aorta to carotid artery revascularization with subsequent endovascular repair in the First Affiliated Hospital, Sun Yat-sen University. There were 9 male and 1 female patients with a mean age of (54 ± 14) years (ranging from 34 to 71 years). Of the 10 patients, 8 were aortic dissection and 2 were thoracic aortic aneurysm. All aortic arch debranching was performed with mid-sternotomy, including 7 ascending aorta to innominate artery and left common carotid artery bypass, and 3 ascending aorta to left common carotid artery and left subclavian artery bypass.Subsequently, simultaneous (n = 5) and staged (n = 5, mean interval (7 ± 4) days) endovascular repair were performed via femoral artery.</p><p><b>RESULTS</b>Technical success rate was 10/10. The 30 day-mortality was 3/10, including 1 brain stem infarction, 1 circulatory failure and 1 aorto-tracheal fistula. Complication included 1 type II endoleak. The median time of follow-up was 24 (14) months. CT scanning was performed at 1, 3 months and annually thereafter. There was no death and no occlusion of bypass during follow-up.No complication occurred except 1 existing type II endoleak.</p><p><b>CONCLUSION</b>Ascending aorta to carotid artery revascularization with subsequent endovascular repair is suitable for high risk aortic arch pathology patients in poor general condition with little tolerance to aortic arch replacement.</p>

Outcomes of endovascular repairing aortic arch disease hybrid with supra-arch debranching procedures / 中华外科杂志

<p><b>OBJECTIVE</b>To summarize the experience of endovascular repairing aortic arch disease hybrid with supra-arch debranching procedures.</p><p><b>METHODS</b>It was a retrospective study. From January 2002 to December 2014, 42 high risk patients with aortic arch disease were treated by supra-arch debranching hybrid with subsequent endovascular repair in the First Affiliated Hospital of Sun Yat-sen University. There were 39 male and 3 female patients with a mean age of (53±13) years (ranging from 34 to 80 years). Of the 42 patients, 7 were thoracic aortic aneurysm, 20 were Stanford type B aortic dissection and 15 were Stanford type A aortic dissection. After the supra-aortic debranching technique, simultaneous (n=16) or staged (n=26, mean interval (7±3) days) endovascular repair were performed. Fisher exact test was used to compare the in-hospital mortality of ascending aorta based debranching and non-ascending aorta based debranching.</p><p><b>RESULTS</b>Technical success rate was 81.0% (34/42). The overall 30-day complication rate was 31.0% (13/42), including 3 cerebral stroke (7.1%), 8 endoleak (19.0%, including 6 type I endoleak and 2 type II endoleak), 1 circulatory failure, 1 aorto-tracheal fistula. The 30-day mortality was 9.5% (4/42), 2 died of cerebral stroke, 1 died of circulatory failure, 1 died of aorto-tracheal fistula. The in-hospital mortality of ascending aorta based debranching group was obviously higher than that of the non-ascending aorta based debranching group (4/16 vs. 0, P=0.02). The median time of follow-up was 64.8 (2 to 156.9) months. CT scanning was performed at 1, 3 months after surgery and annually thereafter. The overall survival rate was 76.6%. During the follow-up period, there was 4 deaths, and 2 of them were aortic artery related (5.3%). There were 4 de novo complications during the follow-up period, 1 stroke attributed to bypass occlusion was cured by medical treatment, 2 pseudoaneurysm was successfully treated with open surgery, 1 stent-graft induced new distal entry tear was successfully treated with a tapered stent-graft, there was no new endoleak during follow up period, 3 type I endoleak disappeared spontaneously, and 1 type II endoleak disappeared after secondary intervention.</p><p><b>CONCLUSIONS</b>Endovascular repair of aortic arch disease hybrid with supra-arch debranching procedure is low invasive with favorable long-term outcomes. It is suitable for high risk patients of poor general condition with little tolerance to aortic arch replacement. The in-hospital mortality is higher in the ascending aorta based debranching group than in the non-ascending aorta based debranching group. Stroke is a critical fatal complication and should be attached attention.</p>

Expression of podoplanin-positive stromal cells in esophageal squamous cell carcinoma and its clinical significance / 临床与实验病理学杂志

Purpose To study the correlation between the expression of podoplanin-positive stromal cells and clinicopathologic features in squamous cell carcinoma ( SCC) of esophagus, and to explore the role of podoplanin-stromal cells in the progression of SCC of e-sophagus. Methods Immunohistochemical EnVision method was used to detect the expression of podoplanin in the stromal cells of e-sophageal SCC. The correlation between the expression of podoplanin-positive stromal cells and clinicopathologic features in SCC of e-sophagus was analyzed. Results Of 69 cases of SCC, podoplanin-positive stromal cells were seen in 43 and the positive rate was 62. 3%. Lymphatic vessel density in SCCs with podoplanin-positive stromal cell was 45. 72 ± 14. 36, which was higher than that with-out podoplanin-positive stromal cell (21. 23 ± 10. 49) (P0. 05). Conclusion Podoplanin-positive stromal cells may promote the lymphangiogenesis and lymph vessel invasion of esophageal SCC.

Diagnostic value of combined detection of HNF-1β and Napsin A in the diagnosis of ovarian clear cell carcinoma / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the diagnostic value of HNF-1β and Napsin A for ovarian clear cell carcinomas, serous carcinomas, endometrioid adenocarcinomas and metastatic Krukenberg tumors.</p><p><b>METHODS</b>Immunohistochemical EnVision method was used to detect the expression of HNF-1β and Napsin A in 38 cases of ovarian clear cell carcinoma, 30 cases of high-grade serous carcinoma, 22 cases of endometrioid adenocarcinoma and 16 cases of metastatic Krukenberg tumor. Expression of HNF-1β and Napsin A were compared, and sensitivity and specificity of clear cell carcinoma of the ovary were analysed.</p><p><b>RESULTS</b>The positive rate of HNF-1β in the ovarian clear cell carcinoma was 100%(38/38), higher than those in high-grade serous carcinoma and endometrioid adenocarcinoma (P<0.05), although significant difference was not observed from that of metastatic Krukenberg tumor (P>0.05). Napsin A expressed in 97.4% (37/38) of ovarian clear cell carcinoma, 6.7% (2/30) of high-grade serous carcinoma, 22.7% (5/22) of endometrioid adenocarcinoma. Napsin A expression in clear cell carcinoma was higher than those in high-grade serous carcinoma and endometrioid adenocarcinoma (P<0.01), and no expression of Napsin A was seen in metastatic Krukenberg tumor (P>0.05). The sensitivity and specificity of HNF-1β in the diagnosis of ovarian clear cell carcinoma were 100% and 52.9%, those of Napsin A were 97.4% and 91.2%, those of both HNF-1β and Napsin A were 97.4% and 91.2%, respectively. The sensitivity and specificity of HNF-1β or Napsin A in the diagnosis of ovarian clear cell carcinoma were 100% and 52.9%, respectively.</p><p><b>CONCLUSIONS</b>HNF-1β is a more sensitive marker for the diagnosis of ovarian clear cell carcinoma, whereas Napsin A is a more specific marker. The combined detection of HNF-1β and Napsin A may be helpful for the diagnosis of clear cell carcinoma of the ovary.</p>

Research progress of ovarian tissue vitrification / 中国比较医学杂志

Vitrification provides a rapid cooling to induce glass-like solidification inside cells and protect cell membrane and cytoskeleton system free of injury by ice crystals.The main factors that can influence the effect of vitrification are the size of ovarian tissue, the kind of cryoprotectants, the method of permeation, carrier system and so on. Ovarian tissue structure is very complex, and there is no uniform standardized protocol of vitrification yet.This paper presents also the current problems of ovarian tissue vitrification.

Negative expression of RECK indicates unfavorable clinical outcome for breast cancer / 实用肿瘤学杂志

Objecive To explore the significance of RECK expression in breast cancer .Methods Im-munohistochemical staining was used to analyze RECK expression levels in patients with breast cancer .We com-pared these data with the clinicopathological features of these patients .Rseults Breast cancer patients with nega-tive RECK expression had significantly lower DFS and 5-year survival rates than patients with positive RECK expression.In addition,for node-negative breast cancer ,negative RECK expression indicated markedly unfavor -able survival rate than positive arm .Multivariate analysis further confirmed that RECK expression was an inde -pendent prognostic factor for patients with breast cancer .Conclusion The loss of RECK expression indicates un-favorable survival rate for patients with breast cancer .RECK expression is a new ,important risk factor for recur-rence in breast cancer .

Epigenetic regulation of estrogen receptor-αin breast cancer / 实用肿瘤学杂志

Recently,in the management of estrogen receptor(ER)positive breast canner,endocrine thera-py is the main treatment method;and estrogen receptor -α( ER-α) has obtained popularity as one of the most common targets .There are many known risk factors for ER function in breast canner such as ER gene mutation ;unbalanced microenvironment;signal transduction pathway disorders .While more and more attention is paid to the changes in ER expression and function induced by epigenetic aberrations .ER gene promoter methylation induces down regulation and deletion in ER expression ,which has not only a most highly incidence in epigenetic aberra-tions,but also a widen degree of research .Histone modification could influence ER -αexpression and function , either.However,the special mirco RNAs(miRNAs)are also implicated in the regulation of ER -α,and affect the therapy of tamoxifen in breast tumor .

Clinical significance and changes of serum sex hormone levels in patients with hepatocellular carcinoma / 中国基层医药

Objective To explore the changes and clinical significance of sex hormone levels in patients with hepatocellular carcinoma.Methods The serum levels of estrodiol,testosterone,prolactin and E2/T ratio in normal control group(n =28),liver cirrhosis patients (n =28) and hepatocellular carcinoma patients (n =28) were determined by using chemiluminescente microparticle immunoassay method.All the data collected were calculated by the statistic software SPSS13.0 and ANOVA.Results In hepatocellalar carcinoma patients,the serum E2 (221.93 ±11.78) pmol/L,PRL (1.48 ± 0.02) nmol/L and E2/T ratio (3 889.37 ± 14.28) were significantly higher than those of normal control:E2(117.64 ±5.18)pmol/L,PRL (0.78 ±0.17) nmol/L,E2/T (558.23 ±11.19),while serum T level (0.06 ±0.08)nmol/L in hepatocellular carcinoma patients was significantly lower than that of normal control group (0.21 ± 0.07) nmol/L (t =17.52,10.73,1 1.12,14.69,all P ＜ 0.05).The comparison of sex hormone levels and E2/T ratio between metastasis patients and those without metastasis in hepatocellular carcinoma patients had no statistically significant difference (P ＞ 0.05).Conclusion Sex hormones levels were related with the hepatocellular carcinoma development.The higher level of serum E2/T ratio would indicate poor prognosis.