Value of Intraplaque Neovascularization on Contrast-Enhanced Ultrasonography in Predicting Ischemic Stroke Recurrence in Patients With Carotid Atherosclerotic Plaque

Objective@#Patients with a history of ischemic stroke are at risk for a second ischemic stroke. This study aimed to investigate the relationship between carotid plaque enhancement on perfluorobutane microbubble contrast-enhanced ultrasonography (CEUS) and future recurrent stroke, and to determine whether plaque enhancement can contribute to risk assessment for recurrent stroke compared with the Essen Stroke Risk Score (ESRS). @*Materials and Methods@#This prospective study screened 151 patients with recent ischemic stroke and carotid atherosclerotic plaques at our hospital between August 2020 and December 2020. A total of 149 eligible patients underwent carotid CEUS, and 130 patients who were followed up for 15–27 months or until stroke recurrence were analyzed. Plaque enhancement on CEUS was investigated as a possible risk factor for stroke recurrence and as a possible adjunct to ESRS. @*Results@#During follow-up, 25 patients (19.2%) experienced recurrent stroke. Patients with plaque enhancement on CEUS had an increased risk of stroke recurrence events (22/73, 30.1%) compared to those without plaque enhancement (3/57, 5.3%), with an adjusted hazard ratio (HR) of 38.264 (95% confidence interval [CI]:14.975–97.767; P < 0.001) according to a multivariable Cox proportional hazards model analysis, indicating that the presence of carotid plaque enhancement was a significant independent predictor of recurrent stroke. When plaque enhancement was added to the ESRS, the HR for stroke recurrence in the high-risk group compared to that in the low-risk group (2.188; 95% CI, 0.025–3.388) was greater than that of the ESRS alone (1.706; 95% CI, 0.810–9.014). A net of 32.0% of the recurrence group was reclassified upward appropriately by the addition of plaque enhancement to the ESRS. @*Conclusion@#Carotid plaque enhancement was a significant and independent predictor of stroke recurrence in patients with ischemic stroke. Furthermore, the addition of plaque enhancement improved the risk stratification capability of the ESRS.

Pathological features and clinicopathological significance of TERT promoter mutation in breast fibroepithelial tumors without definite diagnosis / 中华病理学杂志

Objective: To investigate the pathological features and the clinicopathological significance of TERT detection in those tumors that were difficult to diagnosis. Methods: A total of 93 cases of fibroepithelial tumors without definite diagnosis were collected from the Affiliated Hospital of Qigndao University between 2013 and 2021. The clinical details such as patients' age and tumor size were collected. All slides were re-reviewed and the pathologic parameters, including stromal cellularity, stromal cell atypia, stromal cell mitoses, and stromal overgrowth were re-interpreted. Sanger sequencing was used to detect TERT promoter status, and immunohistochemistry was performed to detect TERT protein expression. The relationship between TERT promoter mutation as well as protein expression levels and the clinicopathological parameters were also analyzed. Results: The patients' ages ranged from 30 to 71 years (mean of 46 years); the tumor size ranged from 1.2 to 8.0 cm (mean 3.8 cm). These tumors showed the following morphologic features: leafy structures in the background of fibroadenoma, or moderately to severely abundant stromal cells. The interpretations of tumor border status were ambiguous in some cases. The incidence of TERT promoter mutation was high in patients of age≥50 years, tumor size≥4 cm, and stromal overgrowth at ×4 or ×10 objective, and these clinicopathologic features were in favor of diagnosis of phyllodes tumors. TERT protein expression levels was not associated with the above clinicopathologic parameters and its promoter mutation status. Conclusions: The diagnostic difficulty for the breast fibroepithelial tumors is due to the difficulty in recognition of the leafy structures or in those cases with abundant stromal cells. A comprehensive evaluation combined with morphologic characteristics and molecular parameters such as TERT promoter may be helpful for the correct diagnosis and better evaluating recurrence risk.

Photothermal therapy against breast cancer 4T1 cells using PEGylated gold triangular nanoparticles / 医学研究生学报

Objective To observe the photothermal therapeutic effect of PEGylated gold triangular nanoparticles (PEG-GTN) to breast cancer 4T1 cells upon 606-nm laser irradiation. Methods The obtain gold triangular nanoparticles were functionalized with SH-PEG and incubated with 4T1 cells. The cellular toxicity and photothermal therapeutic effect of PEG-GTN to 4T1 cells were measured by MTT assays. Results After incubated with 5, 10. 20 and 40 µg/mL PEG-GTN for 24 h, the cellular viability were (96.2±4.4)%,(95.9±4.4)%,(95.2±4.8)% and (96.6±4.7)%. There were no statistical differences between PEG-GTN treated groups and control group. With the irradiation of 660-nm laser irradiation, the cellular viability of 4T1 cells were (92.2±6.2)%,(51.6±6.8)%,(25.7±4.5)% and (4.8±2.5)%. The cells treated with PEG-GTN with concentrations equal or higher than 10 µg/mL showed significant lowered cell viability. Conclusion PEG-GTN has low cytotoxicity and concentration-dependent photothermal effect.

Analysis of two outbreaks of respiratory infection caused by adenovirus / 中华实验和临床病毒学杂志

Objective@#To investigate the epidemiological characteristics and the causes of two outbreaks of upper respiratory tract infection in our city.@*Methods@#The epidemiological investigation was carried out on the outbreaks and the pharyngeal swabs were collected to do the pathophysiologic examination by using real-time PCR. Hexon gene of adenovirus was amplified by PCR. Then the positive products were sequenced and BLAST searching was done in GenBank.@*Results@#The clinical symptoms of the two cases were high fever, sore throat and cough, etc, while the main signs were pharyngeal congestion and tonsil swelling; 32 students of a class in Yunxing primary school had respiratory infection related symptoms, of which the incidence rate was 55%; while 12 of 38 students in a class of Fangcun primary school were infected. All these students were on school in the same class, and the incidence was aggregate without proliferation. The duration of the disease was about 5 days and the prognosis was good, no death occurred. The positive result of real-time PCR showed adenovirus. BLAST search analysis on hexon gene showed AdV14.@*Conclusions@#According to epidemiological investigation and laboratory test results, the cause of these two outbreaks of upper respiratory tract infection was adenovirus type 14.

Determination of 16 Kinds of Polycyclic Aromatic Hydrocarbons in Atmospheric Fine Particles by Accelerated Solvent Extraction Coupled with High Performance Liquid Chromatography / 分析化学

A method for determination of 16 kinds of polycyclic aromatic hydrocarbons ( PAHs ) in atmospheric fine particles ( PM2. 5) was developed based on accelerated solvent extraction-direct injection coupled with high performance liquid chromatography (HPLC). PM2. 5 was collected by glass fiber membrane filter and pretreated with acetonitrile by accelerated solvent extraction. The extract was separated by ZORBAX Eclipse PAH column with acetonitrile and water as mobile phase, and detected by ultraviolet and fluorescence detectors. The result showed that the 16 kinds of PAHs were well separated and there were good linear relationships ( r≥0. 9998) in the concentration range of 0. 025 -5. 00 μg / mL. The recoveries were from 78. 3% to 113. 2% . The relative standard deviations ranged from 0. 5% to 9. 5% . The detection limits were 0. 007 - 0. 062 ng / m3 . The method was simple, rapid, accurate and sensitive, and suitable for the simultaneous determination of 16 kinds of PAHS in PM2. 5.

Analysis of Distribution and Drug Resistance of Bacteria in Elderly Patients with Vaginal Infection / 中国药房

OBJECTIVE:To provide reference for the formulation of clinical therapy plan for elderly patients with vaginal in-fection. METHODS:From Jun. 2014 to Oct. 2016,200 elderly patients with vaginal infection were selected from Wuhan Wuchang Hospital (called our hospital for short). Leucorrhea routine examination,bacterial culture,identification and drug sensitivity test were all performed for the secretions of vaginal side wall. The occurrence of vaginal infection was compared among different age groups. The distribution of bacteria,distribution of cleanliness and drug resistance were observed. RESULTS:The types of vaginal infectious diseases in 200 patients included Candida vaginitis,Trichomonas vaginitis,bacterial vaginitis,nonspecific vaginitis. The incidence of vaginal infection in 66-70 age group was significantly higher than 60-65 age group and 71-80 age group,the incidence of vaginal infection in 60-65 age group was significantly higher than 71-80 age group,with statistical significance(P<0.05). A to-tal of 205 strains of bacteria were detected,most of which were Gram-positive bacteria,except for Escherichia coli. Streptococcus was the most common pathogen,with a total of 76 strains(37.07％),followed by Staphylococci(48 strains,23.41％). The vagi-nal secretion cleanliness was grade Ⅰ,Ⅱ,Ⅲ and Ⅳ respectively in 10,70,90,30 cases. The amount of bacteria increased with the increase of vaginal secretion cleanliness,and Streptococcus and Staphylococcus infection were the most common in patients with Ⅲ to Ⅳ degree. Resistance rate of bacteria to penicillin,gentamicin and erythromycin were relatively higher while most of them to teicoplanin and linezolid were relatively lower;they were all sensitive to vancomycin (resistance rate of 0). CONCLU-SIONS:There are many types of vaginal infectious diseases in our hospital,and most of them are 66-70 years old. The majority of bacteria were Gram-positive bacteria,most of them were Streptococcus. The drugs which are sensitive to pathogen include vancomy-cin,teicoplanin and linezolid. Antibiotics should be rationally selected according to drug sensitivity test.

Aiyu Capsules or Fufang Banmao Capsules combined with icotinib hydrochloride in the treatment of advanced NSCLC / 中成药

AIM To explore the curative effects,adverse events,effects on immunity function and cost-effectiveness of Aiyu Capsules (Cremastrae pseudobulbus,Solanum lyratum,Angelicae sinensis Radix,etc.) or Fufang Banmao Capsules (Mylabris,Ginseng Radix et Rhizoma,Astragali Radix,etc.) combined with icotinib hydrochloride in the treatment of advanced non-small cell lung carcinoma (NSCLC).METHODS One hundred and sixty patients with advanced NSCLC were randomly divided into three groups.The patients in icotinib hydrochloride group (n =80) took icotinib hydrochloride,125 mg each time,three times a day;the patients in Aiyu Capsules + icotinib hydrochloride group or Fufang Banmao Capsules + icotinib hydrochloride group were treated with Aiyu Capsules (40 cases,three pills each time,three times a day) or Fufang Banmao Capsules (40 cases,one pill each time,three times a day) combined with icotinib hydrochloride (125 mg each time,three times a day),respectively.Curative effects,adverse events,serum tumor markers,dendritic cell subsets and cost-effectiveness among the three groups were compared.RESULTS Eight weeks after the treatment,effective rates in the Aiyu Capsules + icotinib hydrochloride group (82.50％) and Fufang Banmao Capsules + icotinib hydrochloride group (97.5％) were significantly higher than that in the icotinib hydrochloride group (73.5％) (P ＜ 0.05).Six-month survival rates in the icotinib hydrochloride group,Aiyu Capsules + icotinib hydrochloride group and Fufang Banmao Capsules + icotinib hydrochloride group were 93.7％,97.5％ and 97.5％,respectively;one-year survival rates in the three groups were 53.7％,72.5％ and 75.0％,respectively;two-year survival rates in the three groups were 20.0％,37.5％ and 40.0％,respectively.One-year,two-year survival rates in the Aiyu Capsules + icotinib hydrochloride group and Fufang Banmao Capsules + icotinib hydrochloride group were significantly higher than those in the icotinib hydrochloride group (P ＜ 0.05).Myeloid dendritic cell (mDC) subsets' increases (d8week-d1) in the Aiyu Capsules + icotinib hydrochloride group and Fufang Banmao Capsules + icotinib hydrochloride group were significantly higher than that in the icotinib hydrochloride group (P ＜ 0.05).There was no statistical significance in plasmacytoid dendritic cell (pDC) subsets' change among the three groups (P ＞ 0.05).Changes of carcinoembryonic antigen (CEA),cytokeratin-19-fragment (CYFRA21-1),neuron-specific enolase (NSE) in the Aiyu Capsules + icotinib hydrochloride group and Fufang Banmao Capsules + icotinib hydrochloride group were higher than those in the icotinib hydrochloride group (P ＜ 0.05).Treatment costs in the Aiyu Capsules + icotinib hydrochloride group and Fufang Banmao Capsules + icotinib hydrochloride group were significantly lower than that in the icotinib hydrochloride group (P ＜ 0.05).No obvious statistical difference in adverse events was found among the three groups (P ＞ 0.05).CONCLUSION The curative effects and cost-effectiveness of Aiyu Capsules or Fufang Banmao Capsules combined with icotinib hydrochloride are better than those of icotinib hydrochloride alone in the treatment of advanced NSCLC.

Regional characteristic analysis of alkaloids and chlorogenic acid in wild Phellodendri Amurensis Cortex / 中国中药杂志

In the present research, 674 wild medicinal material samples of Phellodendri amurensis Cortex were collected from 31 sampling sites in the whole distribution of its original plant Phellodendron amurense. The samples were collected under the premise that the stem diameter of sampling plant, sampling position and time were controlled. And the sampling sites were set at the interval of a latitude. The content of 6 kinds of active ingredients, palmatine chloride, berberine hydrochloride, phellodendrine chloride, jatrorrhizine hydrochloride, magnoflorine, chlorogenic acid, etc in the medicinal material samples were determined, and the results showed that the content of most active ingredients in the medicinal materials showed significant differences due to the difference of sampling sites. Among them, the medicinal materials from Liaoning region had the highest content of active ingredients, followed by Beijing and Jilin regions, and that from Heilongjiang region had the lowest content. The study has important directive significance to the exploration of environmental factors for the formation of active constituent and artificial planting regionalization of high quality Phellodendri amurensis Cortex.

Evaluation of myocardial strain and aortic elasticity in patients with bicuspid aortic valve / 华中科技大学学报（医学）（英德文版）

This study evaluated the myocardial strain and aortic elasticity in patients with bicuspid aortic valve (BAV) and then investigated the relation between them. Thirty-nine patients (30 males; mean age 44±19 years; range 6 to 75 years) with BAV were recruited as BAV group, and 29 age- and sex-matched healthy controls (21 males; mean age 42±11 years; range 20 to 71 years) served as control group. Aortic strain, distensibility and stiffness index were derived using M-mode echocardiography. Left ventricular global myocardial strain was acquired with speckle-tracking echocardiography. Correlation between aortic elasticity and myocardial strain was also analyzed. The results showed that aortic stiffness was higher (17.5±14.0 vs. 5.3±2.7, P<0.001), and aortic strain (4.9±4.7 vs. 11.0±4.1, P<0.001) and distensibility (1.8±2.1 vs. 3.7±1.6, P<0.001) were lower significantly in BAV group than in control group. Global circumferential strain (-19.1±4.2 vs.-22.5±3.7, P<0.001), radial stain (29.8±14.9 vs. 38.0±8.8, P<0.001) and longitudinal stain (-18.4±3.4 vs.-20.8±3.5, P<0.001) were significantly lower in BAV group than in control group. There was weak association between aortic elasticity and myocardial strain. These findings indicated BAV patients manifest reduced myocardial strain which had weak relationship with aortic elastic lesion.

Simultaneous determination of seven alkaloids in Cuyanhusuo Granule by RP-HPLC / 中草药

Objective: To establish HPLC method for the simultaneous determination of protopine, palmatine hydrochloride, berberine hydrochloride, dehydrocorydaline, tetrahydropalmatine, tetrahydroberberine, and corydaline in Cuyanhusuo Granule. Methods: The analysis was performed on Ultimate AQ-C18 column (250 mm×4.6 mm, 5 μm) by gradient elution of acetonitrile-0.1% phosphoric acid (adjust to pH 6.0 with triethylamine) (10:90). The UV detection wavelength was set at 280 nm and the flow rate was 1.0 mL/min. Results: The linear ranges of protopine, palmatine hydrochloride, berberine hydrochloride, dehydrocorydaline, tetrahydropalmatine, tetrahydroberberine, and corydaline were 6.8-119.0 (r=0.9999), 24.38-426.65 (r=0.9999), 8.88-155.40 (r=0.9999), 77.66-1359.05 (r=0.9999), 41.4-724.5 (r=0.9999), 6.70-117.25 (r=0.9999), and 25.50-446.25 ng (r=0.9999). The average recoveries (n=6) were 98.2% (RSD=2.0%), 99.6% (RSD=2.8%), 100.2% (RSD=1.3%), 99.0% (RSD=2.2%), 100.8% (RSD=2.6%), 98.7% (RSD=2.5%), and 97.7% (RSD=2.2%), respectively. Conclusion: This method is simple and rapid, and can be used for the quality control of Cuyanhusuo Granule with satisfactory separation and repeatability.

Application of near infrared spectroscopy to identify authenticity of Polygonum multiflorum / 中国中药杂志

<p><b>OBJECTIVE</b>To establish a near-infrared qualitative analysis model to identify the authenticity of Polygonum multiflo- rum and distinguish processed products Polygoni Multiflori Radix.</p><p><b>METHOD</b>The NIR spectra were peformed on over 30 batches of P. multiflorum and Polygoni Multiflori Radix samples and the adulterants Cynanchum bungei, Pteroxygonum giraldii, Polygonum cillinerve to establish the qualitative discriminant model and the conformity test model of Polygonum multifiorum , and cluster analysis was used to analyze the samples from different origins.</p><p><b>RESULT</b>The model is able to identify correctly P. multiflorum with its counterfeit, and distinguish between P. multiflorum and Polygoni multiflori Radix.</p><p><b>CONCLUSION</b>Near-infrared spectroscopy can be applied in the identification of P. multiflorum, which could be used to screen Chinese herbal medicine preliminarily.</p>

Vitrectomy combined with internal limiting membrane peeling for treating foveoschisis in high myopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the efficacy and safety of vitrectomy combined with internal limiting membrane ( ILM) peeling for treating foveoschisis in high myopia. METHODS:Thirty high-myopia patients (30 eyes) with foveoschisis from March 2011 to March 2013 were divided two groups: the treatment group ( 16 eyes ) was treated with vitrectomy combined with ILM peeling, and the control group (14 eyes) was treated only with vitrectomy. The foveoschisis reattachment and and best spectacle-correction were measured preoperatively and 2mo after surgery. RESULTS: The improvement of foveoschisis reattachment and best spectacle - correction in the treatment group was significantly better than those in the control group (P CONCLUSION: Vitrectomy combined with ILM peeling is a safe and effective treatment for foveoschisis in high myopia.

Relationship between carotid plaque neovascularization and coronary heart disease by using contrast-enhanced ultrasound / 中华医学超声杂志（电子版）

Objective To evaluate the relationship between carotid plaque neovascularization and coronary heart disease using contrast-enhanced ultrasound. Methods We studied carotid plaques in 312 patients with coronary artery disease by contrast-enhanced ultrasound [51 patients with acute coronary syndrome (ACS) and 261 patients with stable coronary artery disease (sCAD) ]. We analyzed sonographic features of each plaque, including the enhancement intensity of plaque (A value), the ratio of plaque to carotid artery lumen in enhancement intensity (Ratio), plaque thickness and plaque echo (soft plaque, hard plaque, mixed plaque, calcified plaque). Results The average thickness of plaque in patients with ACS and in patients with sCAD had no significant difference in statistics [(2.6±0.4) mm vs (2.9±0.8) mm, t=-1.903, P=0.058) ]. The group with ACS:soft plaque 43 (84.3%, 43/51), mixed plaque 8 (15.7%,8/51), no hard plaque and calcified plaque. And the group with sCAD:soft plaque 174 (66.7%,174/261), hard plaque 19 (7.3%,19/261), mixed plaques 16 (6.1%,16/261), calcified plaque 52 (19.9%,52/261). The percentage of soft plaque in the acute coronary syndrome group was significantly higher than that in stable coronary artery disease group (χ2=6.274,P=0.012). The A value and Ratio in patients with ACS were prominently larger than those in patients with sCAD [ (11.3±3.2) vs (8.9±3.3) dB, t=7.150,P<0.01;0.6±0.2 vs 0.4±0.2, t=7.419,P<0.01].Conclusion Carotid artery plaque neovascularization density was significantly higher in patients with ACS than that in patients with sCAD by using contrast-enhanced ultrasound, revealing that the neovascularization density is closely related to clinical symptoms of patients with coronary heart disease.

The value of myocardial contrast echocardiography combined with dobutamine stress echocardiography in early diagnosis of coronary artery disease / 中华医学超声杂志（电子版）

Objective To investigate the value of myocardial contrast echocardiography(MCE)combined with high-dose dobutamine stress echocardiography(DSE)in the early diagnosis of coronary artery disease(CAD).Methods The dobutamine stress MCE and SonoVue contrast infusion were performed before an elective percutaneous coronary intervention in 38 patients with suspected CAD.The total and regional perfusion were scored as normal or abnormal and attributed to the three main epicardial coronary arteries using a 16-segment left ventricular model.Results An intermediate stress level was obtained in 22(58%)patients,and 9(24%)patients were obtained with peak stress.Twenty seven of 38 patients were diagnosed as CAD by quantitative coronary angiography.A perfusion defect was detected in 89% of the patients at peak stress,compared to 37% at baseline,there was significant difference(χ2=15.565,P<0.01).ConclusionsThe MCE combined with DSE can increase the sensitivity of myocardial ischemia detection.As a new non-invasive method,MCE combined with DSE could be used in the early diagnosis of CAD.

A simplified method for reconstituting active E. coli DNA polymerase III

Genome duplication in E. coli is carried out by DNA polymerase III, an enzyme complex consisting of ten subunits. Investigations of the biochemical and structural properties of DNA polymerase III require the expression and purification of subunits including α, ge, θ, γ, δ', δ, and β separately followed by in vitro reconstitution of the pol III core and clamp loader. Here we propose a new method for expressing and purifying DNA polymerase III components by utilizing a protein co-expression strategy. Our results show that the subunits of the pol III core and those of the clamp loader can be coexpressed and purified based on inherent interactions between the subunits. The resulting pol III core, clamp loader and sliding clamp can be reconstituted effectively to perform DNA polymerization. Our strategy considerably simplifies the expression and purification of DNA polymerase III and provides a feasible and convenient method for exploring other multi-subunit systems.

Value of high-dose dobutamine stress echocardiography combined with two-dimensional strain imaging in early diagnosis of coronary artery disease / 中华超声影像学杂志

Objective To investigate the value of high-dose dobutamine stress echocardiography combined with two-dimensional strain imaging in early diagnosis of coronary artery disease. Methods Highdose dobutamine stress echocardiography was performed to 28 patients with suspected coronary artery disease. All wall movements were observed during resting condition and at all stress levels,respectively;the peak systolic longitudinal strain in each endomyocardial segment of left ventricular was measured; the sensitivity and specificity between visual method and two-dimensional strain imaging in diagnosing myocardial ischemia with high-dose dobutamine stress echocardiography were compared. The average peak systolic longitudinal strain was calculated against control group, coronary artery disease group during ischemia segments and non-ischemia segments, and a comparison was made inside each group as well as against the other groups. The area under receiver operating characteristic curve of the peak systolic longitudinal strain was used to predict the sensitivity and the specificity of myocardial ischemia. Results With dobutamine dose of 40 μg·kg-1 · min-1 ,wall motion abnormalities were diagnosed in 6 patients (20 segments) through visual method, myocardial ischemia was found in 15 patients (148 segments) through computing the peak systolic longitudinal strain. Inside the coronary artery disease group during ischemic　segments,the majority of peak systolic longitudinal strain was significantly reduced ( P＜0.05) compared to the non-ischemic segments and the control group. In diagnosing myocardial ischemia in high-dose dobutamine stress echocardiography, the sensitivity of visual method and two-dimensional strain imaging were 35.3％ and 88.2％(P＜0.01), specificity 100％ and 100％(P＞0.05), and accuracy 60.7％ and 92.8％ (P＜0.01). The cutoff value of the peak systolic longitudinal strain was less than or equal to 14.9％, its sensitivity and specificity in predicting myocardial ischemia were 83.3％ and 91.7％,respectively. Conclusions High-dose dobutamine stress echocardiography combined with two-dimensional strain imaging can increase the sensitivity of detecting myocardial ischemia and detect concealed myocardial ischemia. High-dose dobutamine stress echocardiography combined with two-dimensional strain imaging can be used in early diagnosis of coronary artery disease.

Association between the number of retrieved lymph nodes in stage II( colorectal cancer radical resection and its prognosis / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the association between the number of retrieved lymph nodes and the prognosis of stage II colorectal cancer.</p><p><b>METHODS</b>Clinical data of 380 patients with stage II colorectal cancer were analyzed retrospectively. SPSS 13.0 was used for data processing. Survival rate was calculated by Kaplan-Meier method, and risk factors related to prognosis of stage II colorectal cancer were analyzed by Logistic regression analysis. Recurrence rate and survival rate were assessed with Chi-squared test.</p><p><b>RESULTS</b>The average number of lymph nodes retrieved from 56 patients who developed recurrence or metastasis in 5 year after surgery was 9.5, and 16.3 from patients who had no recurrence or no metastasis(P<0.01). The number retrieved from 97 patients who died in 5 years after surgery was 11.1, and 16.7 from survivors. Patients were divided into 2 groups:>or=12 group and <12 group. The 5-year survival rate was 83.9% in >or= 12 group and 62.0% in < 12 group, respectively(P<0.01), the recurrence rate was 6.4% in >or=12 group and 25.7% in < 12 group (P<0.01). The univariable analysis showed that the number of retrieved lymph nodes was significantly associated with the survival and recurrence in patients with stage II colorectal cancer (P<0.05).</p><p><b>CONCLUSIONS</b>The number of retrieved lymph nodes is associated with the prognosis of stage II colorectal cancer. Patients with more retrieved lymph nodes have a higher survival rate.</p>

Prognostic factors of resectable pulmonary metastases from colorectal cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the prognostic factors for patients who underwent curative resection of pulmonary metastases from colorectal cancer.</p><p><b>METHODS</b>The clinicopathological data of 60 patients with pulmonary metastases from colorectal carcinoma who underwent a radical pulmonary metastasectomy between February 1985 and December 2004 at the Cancer Hospital of Chinese Academy of Medical Sciences were retrospectively reviewed and analyzed.</p><p><b>RESULTS</b>The overall 5-year survival rate was 43.7% after pulmonary excision and 74.0% after colorectal resection. Three factors were identified as significant by univariate log-rank test for overall survival after pulmonary resection, they were preoperative carcinoembryonic antigen, number of pulmonary metastases (solitary vs. multiple), and hilar and/or mediastinal lymph node metastases (P < 0.05). Multivariate analysis showed that number of pulmonary metastases (solitary vs. multiple) and hilar and/or mediastinal lymph node metastasis were independent prognostic factors. However, shorter disease-free interval and more number of pulmonary metastases predicted poor prognosis after primary colorectal resection.</p><p><b>CONCLUSION</b>Pulmonary resection for metastases from colorectal cancer is safe and patients may get long-term survival in selected cases, especially in patients with a solitary pulmonary metastasis and without hilar and/or mediastinal lymph node metastasis.</p>

Wide local excision could be considered as the initial treatment of primary anorectal malignant melanoma / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Anorectal malignant melanoma was a rare disease with extremely poor prognosis. The aim of this study was to explore the clinical characteristic, diagnosis and treatment strategies of anorectal malignant melanoma.</p><p><b>METHODS</b>The data of 57 patients with anorectal malignant melanoma was collected and retrospectively analyzed.</p><p><b>RESULTS</b>Rectal bleeding and anal mass were found to be common symptoms of anorectal malignant melanoma. The preoperative diagnosis rate of anorectal malignant melanoma was 48.6%. The overall 3-year and 5-year survival rate was 38.0% and 21.3% respectively. The 3-year survival rates of stage I and II patients were 63.0% and 16.7% respectively (P = 0.000), and the 5-year survival rates were 33.3% and 11.1% (P = 0.001), which both had significant statistic differences. The 3-year survival rate of patients undergone abdmoninoperineal resection and patients undergone wide local excision were 36.7% and 53.0% respectively (P = 0.280), while the 5-year survival rate were 24.1% and 23.1% (P = 0.642), which both had no significant statistic differences.</p><p><b>CONCLUSIONS</b>This study identified no survival advantage to abdominoperineal resection in treatment of anorectal malignant melanoma, and we propose that wide local excision could be considered as the initial treatment of choice.</p>

Correlation between serum bone metabolism biomarkers and bone mineral density in chronic kidney disease patients with different stages / 中华肾脏病杂志

Objective To investigate the correlation between serum bone metabolism biomarkers and bone mineral density (BMD) in chronic kidney disease (CKD) patients with different stages. Methods Seventy-eight CKD patients were enrolled in this study and were assigned to different groups according to their ereatinine clearance (Cer). Patients with Cer ≥ 15 ml/min were divided into 4 groups based on clinical CKD 1-4 stage standard, and those with Ccr<15 ml/min were divided into two groups of hemodialysis (HD) and non-HD. Their levels of serum calcium, phosphorus, alkalinity phosphatase (ALP), urea, Ser, osteocalein (gla-protein, OC), calcitonin (CT), intact parathyroid hormone (iPTH), osteoprotegerin (OPG) and BMD were detected respectively. Results (1) The serum levels of OPG, iPTH and phosphorus increased significantly in stage 3, 4, 5, respectively (P<0.01), and serum OPG level was elevated to (5.1±1.34) ng/L after HD, which was significantly higher than (3.35±0.76) ng/L before HD (P<0.05). The levels of serum OC, CT, calcium, ALP were not significantly different among patients with different CKD stages, while the level of OC was elevated in HD patients (P<0.05). The femoral WARDS triangle BMD of CKD stage 4 patients decreased to 0.77±0.09, which was less than the value of CKD stage 1 patients (P<0.01), with litde influence from hemodialysis treatment. (2) The level of serum OPG was positively correlated with the levels of serum phosphorus, iPTH, OC (r = 0.51, 0.39, 0.36,all P<0.01), and it was negatively correlated with the level of Ccr (r =-0.70, P<0.01). The femoral WARDS triangle BMD was negatively correlated with the levels of iPTH, OC, phosphorus and OPG (r =-0.59,-0.51,-0.45,-0.48, all P<0.05). Conclusions Most of serum bone metabolism biomarkers change according to the declined level of Cer. Compared with serum phosphorus, the levels of iPTH, BGP and femoral WARDS triangle BMD, serum OPG may be early diagnosticmarkers of renal osteodystrophy in CKD patients.