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Objective To evaluate the accuracy of double contrast-enhanced ultrasonography (DCUS) and endoscopic ultrasonography (EUS) in the preoperative N staging of gastric cancer.Methods Between June 2015 and September 2016,a total of 65 consecutive patients who were diagnosed with histologically confirmed gastric carcinoma and underwent surgery in the 2nd Affiliated Hospital of Wenzhou Medical University were enrolled into this study.DCUS and EUS were performed in all patients to estimate lymph node metastasis (N stage) within 5 days before surgery.The findings of the histopathologic examination of resected specimens were considered as gold standard and were retrospectively compared with the results of DCUS and EUS.The sensitivity,specificity and Youden index of DCUS and EUS were calculated.The difference of diagnostic performance between DCUS and EUS was assessed by chi-square test.Results There were 25 N-patients and 40 N + patients confirmed by pathology.Of all 25 N-cases,18 cases were diagnosed correctly by DCUS and 20 cases were diagnosed correctly by EUS;Of all 40 N + cases,32 cases were diagnosed correctly by DCUS and 31 cases were diagnosed correctly by EUS.The sensitivity,specificity and Youden index of DCUS were 80.0％,72.0％ and 0.52 respectively.The sensitivity,specificity and Youden index of EUS were 77.5％,80.0％ and 0.58 respectively.The overall accuracy of DCUS and EUS in N-staging were 76.9％ (50/65) and 78.5％ (51/65).There was no significant difference between two methods (x2=0.044,P=0.833).Conclusions There was no significant difference between DCUS and EUS in overall N-staging of gastric cancers.Either of these two methods had its advantages and disadvantages.When the two methods were combined,the accuracy of preoperative N-staging of gastric cancers could be improved and this improvement may influence treatment algorithms.
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ObjectiveTo explore the value of virtual touch tissue quantification (VTQ) in evaluating Lauren classification of advanced gastric carcinoma.MethodsForty-one patients with gastric cancer proved by endoscopic biopsy performed preoperative VTQ examination,and the findings were compared with postoperative pathologic results via hematoxylin -eosin and Alcian Blue-Periodic Acid Schiff (AB-PAS) staining.ResultsIn 41 patients,26 cases were diagnosed as diffuse type and 15 cases as intestinal type by pathology after operation.The shear wave velocity(SWV) of diffuse type was higher than that of intestinal type [(1.72± 0.83)m/s vs (1.05± 0.66)m/s,t =2.819,P=0.008] measured by virtual touch tissue quantification (VTQ).According to the area under the ROC curve,the cut- off value of SWV in gastric cancer tissues for assessing the diffuse type was 1.045 m/s with a sensitivity of 80.8％ and specificity of 73.3 ％ respectively.ConclusionsVTQ could be considered as a promising method to distinguish the Lauren classification in patients with advanced gastric carcinoma.
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Objective To evaluate the accuracy of double contrast-enhanced ultrasonography(DCUS) and endoscopic ultrasonography (EUS) in the preoperative T staging of gastric cancer.Methods A total of 136 consecutive patients with histologically confirmed gastric carcinoma were enrolled into this study.DCUS and EUS were performed in all patients to estimate depth of invasionin (T stage) before surgery.All patients underwent surgery.The findings of the histopathologic examination of resected specimens were considered as gold standard and were retrospectively compared with the results of DCUS and EUS.Results The accuracy of DCUS and EUS in determining the T stage of gastric cancer were 80.1％ ( T165.5 ％,T2 79.5％,T386.5％,T487.5％) and 81.60％ ( T182.8％,T276.9％,T382.7％,T487.5％) respectively.There was no significant difference between two methods ( P ＞0.05) except T1 staging.Conclusions There is no significant difference between DCUS and EUS in overall T-staging of gastric cancers,but there is a significant difference between two methods in T1 staging.Either of these two methods has its advantages and disadvantages.If two methods are carried out simultaneously to make up for each other,the accuracy of preoperative T-staging of gastric cancers can be improved and this improvement can influence treatment algorithms.
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Objective To find the possible pathogenesis of enteric nervous system, gut hormone and gastric Cajal interstitial cell ( ICC ) in gastritis related gastrointestinal ( GI ) motor disorders on the changes of protein gene product 9. 5 in neurons , mucosal expression of C-kit, gastrin and somatostatin from the gastric wall of gastritis rat. Methods 45 rats were divided into 3 groups which included gastritis group A, gastritis group B and control group. Rats in gastritis group A were fed with Hp Sydney Strain 1, the mixture of 2% aspirin and 0. 6N hydrochloric acid was fed in gastritis group B. The control group only received saline. All of the rats were killed and mucosal tissue was obtained from antrum and greater curvature of the gastric body. Pathological and Hp examination were performed in the tissue slides, and then it was stained to check PGP 9. 5, gastric body's mucosal expression of C-kit, antrium's mucosal expression of gastrin and somatostatin. The cell body, the maximum diameter (Dmax, μm), mean area( μm2) and optical density (nm), integral optical density of the gastrin and somatostatin in the C-kit expression positive neurons from the gastric wall were compared among the groups. Result The mean area and optical density of PGP 9. 5 expression in neurons from the gastric wall of rat in group A or B were obviously lower than that of the control group ( P ＜0. 01 ), while there was no difference between gastric group A and B ( P ＞0. 05). Gastric group A had higher GAS expression than control group, while SS expression was lower than control group( P＜0. 05). There was no difference between group B and the control group in the two variances( P ＞0. 05).By linear correlation analysis, it showed that SS was negatively correlated with GAS ( r = - 0. 333, P ＜0. 01 ). The distributive area and diameter of cells with C-kit expression in both group A and B were significantly smaller than that in the control group ( P ＜ 0. 05 ), while there was no obvious difference between group A and B ( P ＞ 0. 05 ). There was no difference of integral optical density of the C-kit expression positive neurons among the three groups. Conclusions Hp infection and NSAIDs might cause gastritis and had influence on the structural changes of neurons from gastric wall and ICC. Hp infection could obviously inhibit SS excretion from antrum mucosa while increase Gastrin excretion. NSAIDs induced gastritis had little influence on GAS and SS.
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Objective To evaluate clinical value of double contrast-enhanced ultrasonography(DCUS)in diagnosing gastric stromal tumors(GST). Methods The medical records of 26 patients with a histological diagnosis of GST were retrospectively reviewed. The correlation between DCUS features and pathological findings of the lesions was compared. Results Total 26 cases of GST were divided into low risk group( 16 cases) and high risk group (10 cases). The size,contour,liquefactive necrosis and enhancement distribution of lesions were markedly correlated with the pathobiologic behaviour of the tumor ( P ＜0.05). There was no significant difference in border and metastasis of lesions between two groups( P ＞0.05). It was shown that DCUS supplied statistically significant improvement in the localization diagnosis and detection of liquefactive necrosis versus oral contrast-enhanced ultrasonography ( P ＜ 0.05 ). Conclusions DCUS is considered as a valuable tool in diagnosing location as well as pathobiological behaviour of GST. It can provide the guidance and reference comments for treatment algorithms.
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Objective To evaluate the change of elasticity of rabbit liver following portal inflow vessels occlusion using acoustic radiation force impulse (ARFI). Methods Twelve Japanese white big ear rabbits were used to establish total hepatic vascular exclusion animal models by occluding the portal inflow vessels. The elasticity of rabbits' right liver was detected during the stages of baseline(T0), 5 min(T1),20min(T2) ,30min (T3)after occluding the portal inflow vessels using ARFI respectively. The elasticity of rabbit liver, levels of serum's aspartate aminotransferase (AST), alanine aminotransferase (ALT) and historical results of hepatic tissue during different stage were compared. Results Shear wave velocity(Vs)of rabbits' right livers in T2 was significantly higher than that in T0 ( P ＜0.05) and Vs of rabbits' right livers in T3 was significantly higher than that in T2 ( P ＜0.05). No significant differences of serum's AST,ALT levels between T2 and T0 were found,while the Vs of rabbit live in T2 was slightly higher than that in T0 (P＞0.05), serum's AST, ALT levels in T3 were significantly higher than that in T2 ( P ＜0.05).Historical changes of liver ischemia and injury were observed in T2 and T3 with light microscopy. Conclusions The liver ischemia and injury severity can be accurately and objectively evaluated using ARFI.
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usions DCUS could initial estimate the pathological typing of advanced gastric caner before operation.
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Objective To investigate the clinical value of double contrast-enhanced ultrasonography (DCUS)in Borrmann classification of advanced gastric carcinoma preoperatively. Methods A total of 69 patients with advanced gastric carcinoma were examined by ultrasound after taking oral contrast agent and bolus injection of SonoVue preoperatively.A comparison with final pathologic results was made after surgery. Results The accuracy of oral contrast-enhanced ultrasonography and DCUS in Borrmann classification of advanced gastric cancer were 78.3%and 91.3%,respectively.There was a significant difference between two methods(X2=4.087,P＜0.05).In addition,Kappa value of two methods were 0.73 and 0.90,respectively.Conclusions DCUS is a new valuable method for Borrmann classification with its high accuracy preoperatively.
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Objective To investigate the clinical value of double contrast-enhanced ultrasonography (DCUS)in diagnosing Lauren classification of advanced gastric carcinoma.Methods Fifty-eight patients with gastric cancer proved by endoscopic biopsy underwent preoperative DCUS examination,and the findings were compared with postoperative pathologic results via hematoxylin-eosin and alcian blue-periodic acid schiff(AB-PAS)staining.Results In 58 patients,34 cases were diagnosed as intestinal type and 24 cases as diffuse type by pathology after operation.In intestinal type,30 cases were enhanced as global homogeneous intensity by using DCUS.another 2 cases as"lamellar"model and the other 2 cases as heterogeneous intensity.However,in diffuse type,22 cases were enhanced heterogeneously with"barrier"signs in 5 cases,"map"signs in 9 cases and"lamellar"signs in 8 cases.the remaining 2 cases of diffuse type enhanced as homogeneous model.The sensitivity and specificity of heterogeneous enhancement in diagnosing diffuse type of advanced gastric cancer was 91.7%and 88.2%respectively,and the Youden's index was 0.8.Conclusions DCUS could be considered as a new valuable method to distinguish the Lauren classification and evaluate the invasiveness,metastasis and prognosis in patients with gastric carcinoma.
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Objective To observe the expression of cell proliferation and apoptosis in congenital pulmonary cyst and to investigate their effect in the development of aspergillus.Methods Immunohistochemical method was used to detect the expression of KI-67、BCL-2 and BAX in normal lung tissue from 10 adult(control group 1,CG1),relative normal lung tissue around the aspergillus from 20 aspergillus cases(control group 2,CG2)and abnormal lung tissue from 20 aspergillus cases.Results The expressions of KI-67,BAX and the ratio of BAX/BCL-2 in the bronchial epithelium of aspergillus were significantly higher than those in two control groups(P
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OBJECTIVE:To facilitate the evolvement of Chinese ADR monitoring.METHODS:Approaches concerning prescription-event monitoring in England and its progresses were investigated.RESULTS:Early warning signals that of precaution effect were available through prescription-event monitoring on primary safeguarded newly marketed drugs.CON?CLUSION:Voluntary ADR reporting system is now prevalent in China,the prescription-event monitoring system assumed by England set a good example for us to follow.
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AIM: To investigate the molecular mechanisms of antianxiety drugs on the rats with restraint stress. METHODS: The rat stress model was made by restraint stress. The behaviors of rats were tested in open field conditions, and the expression of c fos positive cells was detected by S P immunohistochemical assay in hypothalamus. RESULTS: The crossing scores, the rearing scores and the expression of c fos positive cells increased more significantly in the other groups than that in the control group, but decreased in the paroxetine group. The paroxetine inhibited the behaviors and the expression of c fos positive cells in the hypothalamic paraventricular nucleus (PVN) of rats after immobilization stress. CONCLUSION: The effects of paroxetine on the anxiety disorders in rats may be related to the downregulation of the expression of the c fos in the hypothalamic paraventricular nucleus (PVN).
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<p><b>OBJECTIVE</b>To improve the clinician's awareness of angiostrongyliasis.</p><p><b>METHODS</b>The clinical and laboratory data as well as the epidemiological information concerning 18 patients with eosinophilic meningoencephalitis caused by Angiostrongylus cantonensis were analyzed.</p><p><b>RESULTS</b>All patients had a history of eating raw fresh water snail (Ampularium canaliculatus) before the onset of the disease. Incubation period ranged from 1 to 25 days. The major symptoms of the patients had severe headache and pain in the trunk and limbs. Increased eosinophlic count in peripheral blood and cerebrospinal fluid was noted. Tested by enzyme-linked immunoadsorbent assay (ELISA), sera were specifically IgG-antibody positive against Angiostrougylus cantonensis antigen, but were negative against other parasitic antigens such as Paragonimus westermani, Cysticerus, Cellulosae hominis, Echinococcus granulosus and Trichinella spiralis. Abnormal spotty signals were found in 2 cases with brain magnetic resonance imaging. Electroencephalogram (EEG) showed slow alpha rhythm. All the patients were effectively treated with combined administration of albendazole and dexamethazone.</p><p><b>CONCLUSIONS</b>Angiostrongyliasis is one of the common causes leading to eosinophilic meningoencephalitis. To our knowledge, Wenzhou is the first small outbreak site of angiostrongyliasis discovered in Chinese mainland.</p>
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Adult , Animals , Female , Humans , Male , Middle Aged , Albendazole , Angiostrongylus cantonensis , Dexamethasone , Eosinophilia , Meningoencephalitis , Prognosis , Strongylida Infections , Drug TherapyABSTRACT
To explore the relationship between pathological findings and clinical manifestation, pathological and clinical data were collected and analyzed in 22 cases died from infantial pneumonia, and inference study were undertaken based on the theory of airway hydrokinetics (AHK).The results showed that all 22 cases suffered from airway obstruction. 2 of 5 cases with aspiration pneumonia were confirmed to have inhaled meconium, other 3 cases were probably correlated to gastro-esophageal reflux (GER).Among 17 cases with primary pneumonia, myocardial damage was observed in 14 cases, cerebral neural degeneration in 10,hepatic damage in 13 and renal damage in 9, respectively. Pathological changes were significantly correlated with the results of X-rays and blood-gas analysis.It is concluded that big changes of AHK can be induced by pneumonia, and should be pay attention to the features of the laminar flow and the eddy flow in the airway during the clinical treatment of infantial pneumonia.
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AIM: To study the effects of paroxetine on the psychological stress induced by c-fos gene expression in the rat hypothalamus paraventricular nucleus(PVN) and to explore the molecular mechanism of effects of paroxetine on the stress related anxiety disorders. METHODS: The rat psychological stress model was made by restraint stress. The cortisol was analyzed by radioimmnoassay, and expression of c-fos positive cells was detected by S-P immunohistochemical assay in the rat PVN. RESULTS: The level of cortisol and the expression of c-fos positive cells increased more significantly in the other groups than that in the control group, but decreased in the paroxetine group. The paroxetine reduced the level of cortisol and inhibited the expression of c-fos positive cells in the PVN after psychological stress. CONCLUSION: The paroxetine can regulate the nerve centre by alleviating the expression of the c-fos in the hypothalamus paraventricular nucleus(PVN)and the activation of HPA pathway.
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AIM:To study the relationship between apoptosis, proliferation and expression,mutation of related genes in breast cancer. METHODS: Methods of TUNEL, immunohistochemical S-P and PCR-SSCP were used respectively to study apoptotic index (AI), mitotic index(MI), expression of Bcl-2,p53,c-erbB-2,PCNA,Ki67,TopoⅡ and mutation of p53 in 54 cases of breast cancer. RESULTS: AI and MI were 9.40?3 78 and 5 96?2 36, respectively. There was a significant direct correlation between them( r= 0 46 P
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Objective To study the relationships between cell kinetics, apoptosis and expression, mutation of related genes in breast cancer. Methods Flow cytometry, immunohistochemical SP and PCR SSCP were used respectively to study DNA index(DI), S phase fraction(SPF), proliferation index(PI), apoptosis index(AI), expression of c erbB 2, Bcl 2, p53, PCNA, Ki67, TopoⅡ and mutation of p53 in 54 cases of breast cancer. Results High DI, aneuploidy rate, SPF, PI and AI were coincided with high expression of c erbB 2, p53, PCNA, Ki167 and TopoⅡ. Low DI, SPF, PI and AI were coincided with high expression of Bcl 2. High DI, SPF, PI and AI were coincided with high mutation of p53. High AI was related to a type of p53 mutation——loss of heterozygosity(LOH). Conclusion Abnormal cell kinetics and apoptosis were related with abnormal expression, mutation of related genes in breast cancer. [