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Objective To analyze the clinic pathologic factors and survival rate by performing a retro-spective study on the early gastric carcinoma (EGC)with signet ring cell underwent curative gastrostomy (SRC) percentage less than 50%after operation .Methods A total of 424 patients was diagnosed as EGC from January 2008 to January 2010 in Changhai Hospital .The patients were divided into three groups according to the different percentage of SRC within tumor cells , SRC group ( with percentage of SCR more than 50%) , Mixed SRC group (with percentage of SRC less than 50%),and Non-SRC group(Classic adenocarcinoma without SRC ).Then we evaluated the clinic pathologic indicators and prognoses , and study on the relationship with histologic types . Results In ECG,the mixed-SRC group was similar to the SRC group on the phases of onset age and sex .On the other phases,the mixed-SRC group was more associated with mucosa -confined,lower lymph node metasta-sis(LNM),and 5-year survival rate was better than adenocarcinoma group (P<0.05).However,the mixed-SRC group showed more submucosal invasion ,and higher LNM than other groups ( P<0 .05 ) .The mixed-SRC component was one of the independent risk factors of LNM .Conclusion In EGC,mixed-SRC had a more favor-able risk factor of LNM ,showed more aggressive behavior than other groups and displayed poor prognosis .
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Kaposiform hemangioendothelioma ( KHE ) is a vascular tumor characterized by intermediate malignancy.Retrospective analysis and literature review on the clinical pathologic,immunohistochemical and clini-cal data of a patient with mesentery KHE.The cardinal symptom of this patient is alimentary track hemorrhage, imageological diagnosed as a huge soft tissue mass of mesentery and invaded ileum.Clinical feature is without Ka-sabach-Merritt phenomenon,observing under the light microscope.The tumor is with cavernous vascular structure, and lymphocyte infiltration inside of stroma.The nodules are composed of disposed and lots of short spindle cell tumor;the tumor cells inside of the nodules are vertical and horizontal staggered and form tendon like or fissuring vessels.Immunohistochemistry:CD31(+),CD34(+),D2-40(+),C-Kit(-),SMA(-),Ki-67(1%).
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Objective To analyze the methods and strategy of treatment for multiple injuries in the use of damage control operation, and improve the treatment level and cure rate for multiple injuries.Method From March 2005 to March 2009, 21 patients with multiple injuries were treated by damage control strategy and performed the determinacy operation after the resuscitation in ICU. Results In 21 patients, 16 cases (76.2%) were cured and 5 cases (23.8%) were dead. The injury severity score of 5 dead cases were exceeded 35 points. Conclusions In the strategy of damage control operation, the surgical operation is considered to be a part of the total resuscitative procedure, not the ending of treatment. To those multiple injuries patients, it is safe and effective to perform the damage control operation. It has practical value in clinical treatment.
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Objective To investigate the relation of the peripheral blood C-reactive protein (CRP)and procalcitonin (PCT) and multiple organ dysfunction syndrome( MODS ) for patients with multiple trauma.Methods A total of 136 patients with multiple trauma were divided into MODS group (49 cases) and non MODS group (87 cases),and 50 healthy volunteers were chosen as control group. Peripheral blood CRP and PCT concentration were detected at different times. Results The highest concentration of peripheral blood CRP in MODS group was appeared on 48 h [(38.7 ± 2.7) mg/L], CRP concentrations in MODS group were significantly different with non MODS group and control group (P ＜0.05). The highest concentration of peripheral blood PCT in MODS group was appeared on 24 h [(20.3 ± 1.7)μ g/L], PCT concentrations in MODS group were significantly different with non MODS group and control group (P＜ 0.05). Conclusions CRP and PCT are relevant to the occurrence of MODS in trauma acute stage. The observation of peripheral blood CRP and PCT concentrations can predict the occurrence of MODS.
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Objective To analyze the etiology of duodenal trauma and improve the result of its diagnosis and treatment. Methods The data of 28 cases with duodenal trauma during March 1968 to September 2007 was analyzed retrospectively. Results Twenty-two (78.6%) patients had blunt injuries. The rate of duodenal trauma and associated injuries was 21.4%(6/28)and 89.3% (25/28) respectively. The easiest injury part on the deseending part constituting was 46.4% (13/28) ,the secondary on the horizontal part constituting was 21.4% (6/28).The postoperative complication rate was 28.6% (8/28), the mortality rate was 3.6% (1/28), and the cure rate was 96.4% (27/28). Conclusions The incidence of blunt injuries is high compared with other kinds of duodenal trauma in China. It suggests that the early diagnosis, exploration proper surgical management,and intensive postoperative care are emphasized to reduce the mortality and complication rate.
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Objective To investigate the mechanism of the fluorouracil(FU)drug resistance and to prove deeply the role of serum dihydropyrimidine dehydrogenase(DPD)activity in patients with gastric cancer resistance to FU with the level of cell culture. Methods The peripheral blood was collected from 45 patients with advanced gastric cancer before chemotherapy to detect the activity of DPD by high performance liquid chromatography(HPLC).The patients were divided into two groups(high activity group and low activity group)according to the results. The FU drug inhibitory rate of gastric cancer cell cultured in vitro were tested with MTT to compare the effects of the two groups. Result The FU drug inhibitory rate of gastric cancer cell cultured in vitro was obviously lower in high activity group than that in low activity group,(47.6±±4.0)%,(53.7±8.0)%respectively. Conclusion The activity of serum DPD may be simple and convenient indicators in predicting the resistance to FU.
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The regulation of a target gene expression is very important in gene therapy. However, constitutive or inappropriate expression of the genes with traditional expression system may interfere with the effect of the gene therapy, even may lead to lethal side effect. We constructed an RU486 inducible eukaryotic vector carrying DsRed protein and evaluated its regulatable effect in vitro. The single vector named PDC-RURED was constructed with molecular biological methods, which contained DsRed gene, promoter and RU486-inducible system. To minimize any potential interference, we spaced the two transcriptional elements with a 1.6 kb insulator. The vector was identified by different enzyme restrictions, sequencing analysis and PCR assay. We demonstrated the regulatable expression of this vector after transfection in HEK293 cells by fluorescence microscopy and flow cytometry. In the absence of RU486, no significant DsRed protein activation was observed, whereas in the presence of RU486 up to 40 fold activation of the DsRed protein was observed in cultured cells. The data show that the novel eukaryotic expression plasmid vector can be used to regulate the expression level of genes of interest in appropriate time under the control of RU486. This inducible expression vector provides a powerful tool for the research of gene regulation and gene therapy.
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Humans , Cell Line , Fluorescent Dyes , Metabolism , Genetic Therapy , Methods , Genetic Vectors , Genetics , Kidney , Cell Biology , Luminescent Proteins , Genetics , Mifepristone , Pharmacology , Promoter Regions, Genetic , Genetics , TransfectionABSTRACT
Eight-year program of clinical medicine is an important way to develop high-talented students for medical education. According to the educational characteristics of general surgery,and based on the teaching achievement both in domestic and overseas schools,this article probes into the general surgery clinical practice for the military eight-year medical students.
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Adenovirus as gene transfer vector is characterized by high transfection efficiency,high titer,good stability in target cells and low pathogenicity,and has been widely used in gene therapy.Compared to first-and second-generation adenovirus vectors,the third-generation adenovirus vectors have unique advantages for gene therapy because of their low immunogenicity and high capacity.However,the clinical application of the third-generation adenovirus vectors is hampered by the existance of helper contamination and difficulties in their large-scale production.
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0.05).There was significant difference in lymph node metastatic rate between poorly-differentiated and undifferentiated adenocarcinoma(17.83%) compared with well-differentiated and middle-differentiated adenocarcinoma(1.58%)(P