Value of postoperative radiotherapy and analysis of prognostic factors in early-stage neuroendocrine carcinoma of cervix / 中华妇产科杂志

Objective: To evaluate the effect of postoperative radiotherapy and high-risk pathological factors on the prognosis of early-stage neuroendocrine carcinoma of cervix (NECC). Methods: A single-center retrospective cohort study of early-stage NECC in Peking Union Medical College Hospital from January 2011 to April 2022 were enrolled. The patients were treated with radical hysterectomy±adjuvant treatment. They were divided into postoperative non-radiation group and postoperative radiation group. The possible postoperative recurrence risk factors identified by univariate analysis were assessed using multivariate logistic regression. The Kaplan-Meier method was used to analyze the progression free survival (PFS), overall survival (OS), recurrence rate, and mortality rate. Results: (1) Sixty-two cases were included in the study, including 33 cases in postoperative non-radiation group and 29 cases in postoperative radiation group. (2) The median follow-up time was 37 months (ranged 12-116 months), with 23 cases (37%) experienced recurrences. There were 7 cases (11%) pelvic recurrences and 20 cases (32%) distant recurrences, in which including 4 cases (6%) both pelvic and distant recurrences. Compared with postoperative non-radiation group, the postoperative radiation group had a lower pelvic recurrence rate (18% vs 3%; P=0.074) but without statistic difference, a slightly elevated distant recurrence rate (24% vs 41%; P=0.150) and overall recurrence rate (33% vs 41%; P=0.513) without statistically significances. Univariate analysis showed that lymph-vascular space invasion and the depth of cervical stromal invasion≥1/2 were risk factors for postoperative recurrence (all P<0.05). Multivariate analysis showed lymph-vascular space invasion was an independent predictor for postoperative recurrence (OR=23.03, 95%CI: 3.55-149.39, P=0.001). (3) During the follow-up period, 18 cases (29%, 18/62) died with tumor, with 10 cases (30%, 10/33) in postoperative non-radiation group and 8 cases (28%, 8/29) in postoperative radiation group, without significant difference (P=0.814). The postoperative 3-year and 5-year survival rate was 79.2%, 60.8%. The depth of cervical stromal invasion≥1/2 was more common in postoperative radiation group (27% vs 64%; P=0.011), and postoperative radiation in such patients showed an extended trend in PFS (32.3 vs 53.9 months) and OS (39.4 vs 73.4 months) but without statistic differences (P=0.704, P=0.371). Compared with postoperative non-radiation group, the postoperative radiation did not improve PFS (54.5 vs 37.3 months; P=0.860) and OS (56.2 vs 62.4 months; P=0.550) in patients with lymph-vascular space invasion. Conclusions: Postoperative radiation in early-stage NECC patients has a trend to reduce pelvic recurrence but not appear to decrease distant recurrence and overall recurrence, and has not improved mortality. For patients with the depth of cervical stromal invasion≥1/2, postoperative radiation has a trend of prolonging OS and PFS but without statistic difference. Lymph-vascular space invasion is an independent predictor for postoperative recurrence, but postoperative radiation in such patients does not seem to have any survival benefits.

Prognostic comparison of active surveillance and adjuvant chemotherapy in the treatment of patients with stage Ⅰ ovarian immature teratoma after fertility-sparing surgery / 中华妇产科杂志

Objective: To compare the survival outcomes between surveillance and adjuvant chemotherapy in patients with stage Ⅰ ovarian immature teratoma (IMT) underwent fertility-sparing surgery. Methods: Clinical and pathological records of patients with stage Ⅰ ovarian IMT between Jan. 2011 to Feb. 2023 were collected from Peking Union Medical College Hospital, except stage Ⅰa grade 1. The consultation of risks and benefits regarding adjuvant chemotherapy was conducted by gynecologic oncologists. A shared decision about surveillance or chemotherapy was made by physician and patients or their guardians. Patients who finally decided to undergo surveillance were included in the surveillance group (n=40), the others were included in the adjuvant chemotherapy group (n=63). Clinical characteristics, treatment and survival outcomes were analyzed and compared between two groups. Results: A total of 103 patients were included. The median age of initial diagnosis was 20 years old (range: 3-39 years old), and the median follow-up time was 31 months (range: 1-254 months). The age, International Federation of Gynecology and Obstetrics (FIGO) stage, pathological grade, surgical method, and preoperative and postoperative alpha-fetoprotein levels in the surveillance group and the adjuvant chemotherapy group were similar (all P>0.05). The surgical approach and maximum tumor diameter between two groups were significantly different (all P<0.05). Forty patients of the surveillance group were identified, only one patient with stage Ⅰa grade 2 IMT who underwent cystectomy had malignant recurrence on the same ovary. Another 63 patients received adjuvant chemotherapy after surgery, five patients had malignant recurrence, and two of them died of disease progression after relapsed. There were no significant differences in disease-free survival (DFS;20 vs 36 months) and overall survival (OS; 23 vs 39 months) between the surveillance group and the adjuvant chemotherapy group (follow-up time censored at 72 months; DFS: P=0.325, OS: P=0.278). Conclusions: There are no differences in survival outcomes between patients with stage Ⅰ ovarian IMT underwent adjuvant chemotherapy or not. Active surveillance might be safe and preferable in stage Ⅰ IMT patients underwent complete resection of tumor.

Study on determination of 2-thioxothiazolidine-4-carboxylic Acid in urine by high performance liquid chromatography / 中华劳动卫生职业病杂志

Objective: To establish a high performance liquid chromatography method for the determination of 2-thioxothiazolidine-4-carboxylic acid (TTCA) in urine. Methods: After acidification with hydrochloric acid, TTCA in urine was first extracted by ethyl acetate with excessive sodium chloride, then gradient separated by a symmetry C18 column and then detected by a diode array detector. The quantification was based on a working curve of external standard method. Results: The linear relationship of TTCA in urine was good in the range of 0.03-10.00 mg/L, and the correlation coefficient was 0.9999. The detection limit and minimum quantitative concentration of TTCA in urine were 0.008 mg/L and 0.027 mg/L. The intra-assay precision of the method was 0.9%-1.4%, the inter-assay precision was 1.3%-3.5%, and the average recovery was 85.0%-92.7% while the concentrations of TTCA in urine was 0.8, 2.0 and 8.0 mg/L, respectively (n=6) . Conclusion: The gradient elution high performance liquid chromatography method has simple operation and high sensitivity, and it is suitable for the determination of TTCA on a low level in urine for occupational workers exposure to carbon disulfide.

Anatomical Study of the Accessory Tendon of the Extensor Hallucis Longus Muscle and Its Clinical Application

Background@#The accessory tendon of the extensor hallucis longus (ATEHL) muscle is a common abnormal structure, and its clinical significance remains debatable. In this study, we provide the incidence of the ATEHL and characterize its morphological types in Asian cadavers and investigate its clinical applications. @*Methods@#The tendons from 50 adult cadaveric feet, fixed in 10% formalin, were analyzed. We measured the length and width of both the ATEHL and the extensor hallucis brevis (EHB). @*Results@#All dissected specimens had an ATEHL. The first metatarsophalangeal joint was surrounded by an accessory tendon that inserted onto the joint capsule and the dorsal base of the proximal phalanx. We classified the ATEHL into 3 types based on their directions. Differences in ATEHL type based on sex were not statistically significant. @*Conclusions@#We found an ATEHL in all cadaveric specimens in this study. We surmise that the ATEHL acts as an antagonist with the EHB when the toe is extending, which might help prevent the occurrence of hallux valgus deformity.

Anatomical Study of the Accessory Tendon of the Extensor Hallucis Longus Muscle and Its Clinical Application

Background@#The accessory tendon of the extensor hallucis longus (ATEHL) muscle is a common abnormal structure, and its clinical significance remains debatable. In this study, we provide the incidence of the ATEHL and characterize its morphological types in Asian cadavers and investigate its clinical applications. @*Methods@#The tendons from 50 adult cadaveric feet, fixed in 10% formalin, were analyzed. We measured the length and width of both the ATEHL and the extensor hallucis brevis (EHB). @*Results@#All dissected specimens had an ATEHL. The first metatarsophalangeal joint was surrounded by an accessory tendon that inserted onto the joint capsule and the dorsal base of the proximal phalanx. We classified the ATEHL into 3 types based on their directions. Differences in ATEHL type based on sex were not statistically significant. @*Conclusions@#We found an ATEHL in all cadaveric specimens in this study. We surmise that the ATEHL acts as an antagonist with the EHB when the toe is extending, which might help prevent the occurrence of hallux valgus deformity.

p53 and its isoforms in DNA double-stranded break repair / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

DNA double-stranded break (DSB) is one of the most catastrophic damages of genotoxic insult. Inappropriate repair of DNA DSBs results in the loss of genetic information, mutation, and the generation of harmful genomic rearrangements, which predisposes an organism to immunodeficiency, neurological damage, and cancer. The tumor repressor p53 plays a key role in DNA damage response, and has been found to be mutated in 50% of human cancer. p53, p63, and p73 are three members of the p53 gene family. Recent discoveries have shown that human p53 gene encodes at least 12 isoforms. Different p53 members and isoforms play various roles in orchestrating DNA damage response to maintain genomic integrity. This review briefly explores the functions of p53 and its isoforms in DNA DSB repair.

Efficacy analysis of radical intensity-modulated radiotherapy combined with concurrent chemotherapy for treatment of metastatic nasopharyngeal carcinoma / 肿瘤研究与临床

Objective To investigate the clinical effects of radical intensity-modulated radiotherapy (IMRT) combined with concurrent chemotherapy in the treatment of metastatic nasopharyngeal carcinoma. Methods Ninety patients with metastatic nasopharyngeal carcinoma in the First Affiliated Hospital of Hainan Medical University from August 2010 to April 2015 were selected as the research objects. All the patients were randomly divided into the observation group (45 cases) and the control group (45 cases) according to the random lottery envelope. The control group was treated with conventional chemotherapy treatment, and the observation group was treated with radical IMRT based on the treatment of the control group. The efficacy of the patients in both groups was evaluated after the treatment for 4 periods. Results The effective rate in the observation group was higher than that in the control group [66.7 % (30/45) vs. 33.3 % (15/45); χ2= 4.552, P＜ 0.05]. In the observation group, there were 3 cases of radiation esophageal injury and 3 cases of lung injury, and the incidence rate was 13.3 % (6/45), bringing the better treatment outcome. The incidence of side effects such as hair loss, nausea and vomiting, liver and kidney damage, bone marrow suppression in the observation group was 71.1 % (32/45), which was higher than that in the control group [66.7 % (30/45)] and there was no significant difference (χ 2= 0.331, P＞ 0.05). All the patients were followed up. 1 yeas and 2 year survival rates in the observation group were 95.6 % (43/45) and 86.7 % (39/45) respectively, while the control group were respectively 75.6 % (34/45) and 64.4 % (29/45) (χ2values were 6.393 and 5.309, both P＜0.05). Conclusion Radical IMRT combined with concurrent chemotherapy for metastatic nasopharyngeal carcinoma can improve the therapeutic effect and show good safety, and the radiation damage would not affect the treatment process.

Effects of Chinese herbal compound "Jisuikang" on phagocytosis of microglia and regeneration of injured neurons in co-culture system / 中国免疫学杂志

Objective:To observe the effects of Chinese herbal compound'Jisuikang'on the phagocytosis of microglia and the regeneration of injured neurons in co-culture system.Methods: Prepared drug serum of 'Jisuikang′ and isolated and identified the primary neuron and microglia.The neuron cells were induced apoptosis by glutamic acid and the microglia cells were predisposed by drug serum of'Jisuikang'.Then,the co-culture system of injured neurons and microglia cells was established.24 h and 96 h after co-culture,engulfment of neuron debris by microglia cells and regeneration of injured neurons were observed by immunofluorescence double labeling method.Results: 24 h after co-culture,middle and high dose of'Jisuikang' showed greater phagocytic percentage and phagocytic index than that of control.In comparison of LPS,high dose of'Jisuikang' showed no significant difference.96 h after co-culture,first grade of neuritis of middle and high dose of'Jisuikang' were more than that of control,and there were no significant difference in comparison of LPS.Neuritis' mean length per cell of middle and high dose of'Jisuikang' were larger than that of con-trol.Neuritis' mean length per cell of high dose of'Jisuikang' showed significant difference in comparison of LPS.Conclusion:Traditional Chinese medicine compound'Jisuikang'may enhance engulfment of neuron debris by microglia to improve local microenvi-ronment,which promote the repair and regeneration of injured neurons.

Research advance on Toxoplasma gondii vaccine / 中国人兽共患病学报

Toxoplasma gondii is a serious foodborne zoonosis,which can not only affect the development of animal husbandry and the safety of meat products,but also cause great harm to public health.Therefore,the prevention of toxoplasmosis is crucial.Toxoplasma gondii vaccine which is regarded as an important measure to prevent toxoplasmosis has significant value to both public health and economics.This paper mainly summarizes advances in the study of Toxoplasma gondii vaccine in order to provide references for the further development of it,so as to control the toxoplasmosis more effectively.

Hepatic vein occlusion with Satinsky clamp in hepatectomy for complicated liver tumor / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the application of an improved method of hepatic vein occlusion with Satinsky clamp when resecting the liver tumor involving second hepatic portal.</p><p><b>METHODS</b>From January 2003 to December 2010, there were totally 330 patients with liver tumor admitted, who underwent liver resection with Pringle maneuver plus hepatic vein occlusion with Satinsky clamp. Data regarding the intra-operative and post-operative course of the patients were analyzed. There were 245 male and 85 female patients, with a mean age of (50 ± 11) years. The diameter of tumor was (9 ± 6) cm. Among the 330 patients, there were 271 patients with viral hepatitis B, 215 patients with liver cirrhosis; 321 patients were in Child class A of liver function and 9 in class B. Pringle maneuver plus hepatic vein occlusion with Satinsky clamp was used to occlude the blood flow in the liver resection. The liver transection was performed with clamp-crushing technique.</p><p><b>RESULTS</b>Hepatic vein occlusion with Satinsky clamp was successful in all 330 patients. The operation time was (132 ± 29) minutes, while (7 ± 3) minutes for dissecting hepatic vein and (22 ± 7) minutes for inflow blood occlusion. The blood loss in operation was (480 ± 265) ml, with 20% of patients receiving blood transfusion. No patient had large hemorrhage and air embolism due to hepatic vein laceration. No patient died in the perioperative period. The complications included 31 patients of pleural effusion, 14 patients of seroperitoneum, 10 patients of biliary fistula, 2 patients of massive blood loss during liver resection and 2 patients of re-bleeding after operation.</p><p><b>CONCLUSION</b>The method of hepatic vein occlusion with Satinsky clamp was safe and effective.</p>

Identification of low-risk indicators of early stage cervical cancer / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the low-risk indicators of early cervical cancer.</p><p><b>METHODS</b>The medical records of 201 patients undergoing radical surgery between March 2000 and April 2011 for staging Ia2,Ib1 (tumor diameter≤2cm) cervix cancer were retrospectively reviewed, with particular focus on the pathological findings [parametrial involvement, positive margin, positive pelvic lymph node, and lymph vascular space invasion (LVSI)], treatment, and outcomes.</p><p><b>RESULTS</b>The operation duration ranged 75-330min (mean:188.87 min) and the intra-operative blood loss was approximately 100-2500 ml (mean: 583.33 ml). Pathology showed the rate of parametrial spread, positive margins, lymph node metastasis, LVSI was 0, 6.97%, 12.44%, and 17.41%. Based on the pathologic findings, the patients were classified as two groups: group A had 147 patients(73.13%) with no neoplasm or tumor diameter ≤2 cm,while group B had 54 patients (26.87%) with tumor diameter > 2 cm. The incidence of ≥ 1/2 cervical stromal invasion, LVSI, positive lymph node, underlying section of uterus involvement, and low tumor differentiation in group A and B were 20.14% vs. 85.19% (p = 0.000), 13.61% vs. 27.78%(p = 0.019), 9.52% vs. 20.37% (p=0.039), 4.82% vs. 14.81% (p=0.008), and 35.37% vs. 44.44% (p=0.025), respectively, with significant differences. Among the 163 patients who were followed up for more than 3 months, 10(6.13%) developed recurrence whereas no patient died.</p><p><b>CONCLUSIONS</b>Pathologic parametrial involvement in clinical stage 1a2 and 1b1 cervical cancer is uncommon. Tumor size and cervical stromal invasion can be used to identify low-risk population that are worthy of consideration for studies of less radical surgery performed in conjunction with pelvic lymphadenectomy.</p>

Expression of galectin-1 in carcinogenesis of oral mucosal epithelium / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the expression of galectin-1 in oral squamous cell carcinoma(OSCC) and its clinical significance.</p><p><b>METHODS</b>Detection of the mRNA and protein expression of galectin-1 in the in vitro cellular carcinogenesis model of OSCC, OSCC cell lines and tissue specimens from 30 primary OSCC patients were performed using real-time polymerase chain reaction (PCR), Western blotting and immunohistochemistry, respectively.</p><p><b>RESULTS</b>The value of galectin-1 mRNA and protein level in human immortalized oral epithelia cell (HIOEC) cell was 0.071 ± 0.023, 0.118 ± 0.046, Compared with the HIOEC, galectin-1 mRNA level and protein expression were increased significantly in all the cell lines (0.141 ± 0.049, 0.504 ± 0.33) (P < 0.01). The levels of mRNA and protein expression of galectin-1 were significantly higher in the cancerous tissue (0.059 ± 0.034, 1.5 ± 0.68) than in the normal adjacent tissues (0.029 ± 0.012, 0.4 ± 0.56) (P < 0.01).</p><p><b>CONCLUSIONS</b>The expression of galectin-1 gene up-regulated in carcinogenesis process of OSCC significantly may be related to the tumorigenesis and development of OSCC, which illustrates its potential clinical application as tumor marker for early diagnosis.</p>

Primary sarcoma of the ovary: clinicopathological characteristics, prognostic factors and evaluation of therapy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The primary ovarian sarcoma is a very rare malignancy. The objective of this study was to further investigate the clinicopathologic features and outcome in patients with primary sarcoma of the ovary.</p><p><b>METHODS</b>Between 1988 and 2007, 24 patients with primary ovarian sarcoma who underwent treatment at Peking Union Medical Hospital were reviewed retrospectively. Response to treatment, progression and overall survival were analyzed.</p><p><b>RESULTS</b>Patients with ovarian sarcoma had a mean age of (54.3 ± 10.3) years, and 16 of them were postmenopausal. The most common symptom was abdominal pain, present in 14 patients. Of the 24 patients, 16 patients were pathologically diagnosed as carcinosarcoma (known as malignant mixed mesodermal tumor (MMMT)), 2 as ovarian leiomyosarcoma (LS) and 6 patients as ovarian endometrial stromal sarcoma (ESS). The patients in optimal debulking group had a median survival period of 28 months and 1-year survival rate of 71%. The patients in suboptimal debulking group had a significantly lower median survival of 6 months (P = 0.02) and 1-year survival rate of 29%. Among the patients, 23 patients received chemotherapy and most of regimens were based on platinum, 3 patients received chemoradiation. The mean number of courses of combined chemotherapy was 6.6 ± 5.0, and the response was unsatisfactory. The median survival for the entire group was 18.7 months. The one-year survival rate was 58%, and two-year survival rate only 29%.</p><p><b>CONCLUSIONS</b>Ovarian primary sarcoma has a poor overall prognosis. Optimal debulking surgery appears to be of prognostic significance. There is a clear need for further study to explore the role and the regimen of platinum-based chemotherapy in primary ovarian sarcoma.</p>

Mullerian adenosarcoma of the uterus: A clinicopathologic analysis of 9 cases / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathologic features, diagnosis, treatment and prognosis of uterine mullerian adenosarcoma.</p><p><b>METHODS</b>The clinicopathological data of 9 cases of uterine mullerian adenosarcoma in PUMC hospital from January 2003 to February 2009 were retrospectively analyzed.</p><p><b>RESULTS</b>There were 6 uterine endometrial adenosarcomas and 3 cervical adenosarcomas. The main clinical manifestations were abnormal vaginal bleeding and pelvic pain. Physical examination showed cervical/vaginal mass, enlarged uterus or pelvic mass. The adenosarcoma was characterized by benign or atypical-appearing neoplastic glands within a sarcomatous stroma. This stroma could appear as periglandular cuffs or intraglandular polypoid projections of increased cellular structure. The primary diagnostic rate was 66.7% and the most common clinical stage was stage I (7/9). All patients received surgical treatment and seven had postoperative chemotherapy, radiotherapy or hormone therapy. Conservation of unilateral ovary or bilateral ovaries was performed in 5 cases. Three patients underwent local excision, which resulted in the preservation of reproductive function. During the follow-up, 2 cases of uterine endometrial adenosarcoma recurred. One patient of clinical stage III containing sarcomatous overgrowth died from recurrence 13 months after surgery. The other one recurred 2 years after local excision of the tumor in the uterine cavity and she remained healthy since hysterectomy.</p><p><b>CONCLUSION</b>Uterine mullerian adenosarcoma is a rare tumor without specific clinical symptoms and signs. The diagnosis depends on pathomorphologic examination. The tumors show low malignant potential and the vast majority are at early stage. Surgical excision is the main treatment strategy with a good prognosis in the early stage disease with complete removal of tumors. The prognosis is poor in advanced adenosarcoma with sarcomatous overgrowth. Due to the relatively high rate of recurrence, long-term follow-up is recommended.</p>

Mechanism of glutamine downregulates the cytokine expression in lipopolysaccharide-stimulated human peripheral blood mononuclear cells / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the mechanism that glutamine (Gln) downregulates the cytokine expression in lipopolysaccharide (LPS)-stimulated human peripheral blood mononuclear cells (PMBCs).</p><p><b>METHODS</b>PMBCs were extracted from healthy volunteer by density gradient centrifugation, the cells were divided into two parts. The first part of PMBCs was pretreated with Gln of the concentration of 0, 8, 15 mmol/L for 0.5 h and 2.0 h respectively, then stimulated by LPS for 4.0 h. Cells and supernatants were collected. The second part of PBMCs was divided into group A, B and C. Group A and B were pretreated with HSP70 blocker (Quercetin) for 1.0 h, then were stimulated by LPS for 4.0 h. Cells and supernatants were also collected. The release of TNF-alpha and IL-10 was analyzed via enzyme-linked immunosorbent assay (ELISA) and HSP70 via Western Blot. In this experiment, the effect of Quercetin on TNF-alpha, IL-10 and HSP70 expression in human PBMCs was assessed.</p><p><b>RESULTS</b>Gln led to an increase in HSP70 expression, and decreased TNF-alpha, IL-10 release at 4.0 h after LPS stimulation when 8 mmol/L glutamine pretreated for 0.5 h and 2.0 h, 15 mmol/L glutamine pretreated for 0.5 h (P < 0.05). The expression level of HSP70 was significantly decreased, however, the expression of TNF-alpha and IL-10 was enhanced in Quercetin group (P < 0.05).</p><p><b>CONCLUSION</b>The effect of glutamine attenuating cytokine release in PBMCs is related to the enhancement of HSP70 expression.</p>

Clinical application of hepatic venous occlusion for hepatectomy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Most liver resections require clamping of the hepatic pedicle (Pringle maneuver) to avoid excessive blood loss. But Pringle maneuver can not control backflow bleeding of hepatic vein. Resection of liver tumors involving hepatic veins may cause massive hemorrhage or air embolism from the injuries of the hepatic veins. Although total hepatic vascular exclusion can prevent bleeding of the hepatic veins effectively, it also may result in systemic hemodynamic disturbance because of the inferior vena cava being clamped. Hepatic venous occlusion, a new technique, can control the inflow and outflow of the liver without clamping the vena cava.</p><p><b>METHODS</b>A total of 71 cases of liver tumors underwent resection with occlusion of more than one of the main hepatic veins. All tumors involved the second porta hepatis and at least one main hepatic vein. Ligation or occlusion with serrefines, tourniquets and auricular clamps were used in hepatic venous occlusion.</p><p><b>RESULTS</b>Of the 71 patients, ligation of the hepatic veins was used in 28 cases, occlusion with a tourniquet in 26, and occlusion with a serrefine in 17. Right hepatic veins were occluded in 38 cases, both right and middle hepatic veins in 2, the common trunk of the left and middle hepatic veins in 24, branches of the left and middle hepatic veins in 2, and all three hepatic veins in 5. Thirty-five cases underwent hemihepatic vascular occlusion, 4 alternate hemihepatic vascular occlusion, 23 portal triad clamping plus selective hepatic vein occlusion, and 9 portal triad clamping plus total hepatic vein occlusion. The third porta hepatis was isolated in 26 cases. The amount of intraoperative blood loss averaged (540 +/- 283) (range 100 to 1000) ml in the group of total hemihepatic vascular occlusion and in the group of alternate hemihepatic vascular occlusion, (620 +/- 317) (range 200 - 6000) ml in the group of portal triad clamping plus selective or total hepatic vein occlusion. All tumors were completely removed.</p><p><b>CONCLUSIONS</b>Hepatic venous occlusion applied in hepatectomy can prevent bleeding and air embolism, and is safe and effective with stable hemodynamics.</p>

Seven cases of epithelial ovarian carcinoma with brain metastasis / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To summarize the clinical characteristics, treatment, and prognosis of brain metastasis in patients with epithelial ovarian carcinoma.</p><p><b>METHODS</b>Retrospective analysis was conducted in 7 cases of brain metastases of epithelial ovarian carcinoma from January 1986 to March 2007 in Peking Union Medical College Hospital for summarizing therapy results and prognosis-affecting factors.</p><p><b>RESULTS</b>Incidence of brain metastases of epithelial ovarian carcinoma was about 0.66% (7/1055). Serous adenocarcinoma was the predominant pathological type in 4 cases and the subsequent was adenocarcinoma in 3 cases. All the patients were diagnosed at late stage, 6 cases with the International Federation of Gynecology and Obstetrics (FIGO) stage IIIc and 1 with FIGO stage IV. The mean duration from diagnosis of ovarian carcinoma to brain metastasis was 32.7 +/- 20.0 months (range, 23-73 months). Single metastasis focus occurred in 43% of cases and multiple metastases in 57% of cases. Fifty-seven percent of patients presented extracranial metastasis. Serum CA125 played a role in monitoring reoccurrence and brain metastases. The average survival time was about 12 months. Better treatment with prolonged survival could be achieved by combination of operation and chemotherapy or combination of radiotherapy with chemotherapy.</p><p><b>CONCLUSIONS</b>As a rare condition, brain metastasis of epithelial ovarian carcinoma is rising in incidence with improved treatment of ovarian carcinoma and prolonged survival. However, brain metastasis indicates bad prognosis which can be improved by combined therapy.</p>

Studies on isolation and identification of flavonoids in herbs of Agrimonia pilosa / 中国中药杂志

<p><b>OBJECTIVE</b>To study the chemical constituents in Agrimonia pilosa.</p><p><b>METHOD</b>The compounds were isolated and purified by various column chromatographic methods and elucidated on the basis of chemical and spectroscopic evidences.</p><p><b>RESULT</b>Nine flavonoids were obtained and identified as tiliroside (1), kaempferol 3-O-alpha-L-rhampyranoside (2), quercetin 3-O-alpha-L-rhampyranoside (3), quercetin 3-O-beta-D-glucopyranoside (4), kaempferol 3-O-beta-D-glucopyranoside (5), kaempferol (6), apigenin (7), luteolin (8), quercetin (9).</p><p><b>CONCLUSION</b>Compounds 1-3, 5, 6 and 8 were isolated from this plant for the first time.</p>

Benzo (a) pyrene induced tumorigenesity of human immortalized oral epithelial cells: transcription profiling / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The present study was designed to examine and analyze the global gene expression changes during the tumorigenesis of a human immortalized oral epithelial cell line, and search for the possible genes that may play a role in the carcinogenesis of oral cancer associated with benzo (a) pyrene.</p><p><b>METHODS</b>The human immortalized oral epithelial cells, which have been established through transfection of E6/E7 genes of human papillomavirus type 16 and proved to be non-tumorigenic in nude mice, were treated with benzo (a) pyrene. Tumorigenicity of the treated cells were examined through nude mice subcutaneous injection. The global gene expression profiles of immortalized cells and the tumorigenic cells were acquired through hybridization of a microarray of Affymetrix U133 plus 2.0. The data were analyzed using Spring 7.0 software and treated statistically using one-way analysis of variance (ANOVA). The differentially expressed genes were classified using a Venn diagram and annotated with gene ontology. Several highlighted genes were validated in cells using a real-time polymerase chain reaction.</p><p><b>RESULTS</b>There were 883 differentially expressed genes during the tumorigenesis and most of them changed expression in the early stage of tumorigenesis. These genes mainly involved in macromolecule metabolism and signal transduction, possessed the molecular function of transition metal ion binding, nucleotide binding and kinase activity; their protein products were mainly integral to membranes or localized in the nucleus and cytoskeleton. The expression patterns of IGFBP3, S100A8, MAP2K, KRT6B, GDF15, MET were validated in cells using a real-time polymerase chain reaction; the expression of IGFBP3 was further validated in clinical oral cancer specimens.</p><p><b>CONCLUSIONS</b>This study provides the global transcription profiling associated with the tumorigenesis of oral epithelial cells exposed to benzo (a) pyrene; IGFBP3 may play a potential role in the initiation of oral cancer related to benzo (a) pyrene exposure.</p>

Phase II study of gemcitabine combined with platinum chemotherapy for recurrent epithelial ovarian cancer / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the anti-tumor effect and toxicity of gemcitabine combined with platinum chemotherapy on recurrent epithelial ovarian cancer.</p><p><b>METHODS</b>Phase II study of gemcitabine combined with platinum chemotherapy was carried out in 22 patients with recurrent epithelial ovarian cancer. Median age of patients was 50.5 years old. Seven patients were platinum-sensitive and 15 patients were platinum-resistant or -refractory. All patients received gemcitabine combined with carboplatin or oxaliplatin chemotherapy. Patients' response rate (RR) and toxicity of gemcitabine combined with platinum chemotherapy were evaluated.</p><p><b>RESULTS</b>A total of 98 gemcitabine-based chemotherapy cycles were performed. Total RR was 36.4%, RR of platinum-sensitive patients was 4/7 and platinum-resistant and -refractory patients was 4/15. The estimated median survival time was 10.0 months (95% CI: 7.0-13.0) after initiation of gemcitabine combined with platinum chemotherapy. There was no significant difference in survival time between platinum-resistant/refractory group and platinum-sensitive group (P = 0.061). Side effects of gemcitabine combined with platinum chemotherapy were observed in 81.8% of patients. Grade II/III anemia (54.5%) and grade III/IV neutropenia (54.5%) were most common toxicities. Ten (45.5%) patients had to delay their chemotherapy cycles or reduce the dose of chemotherapeutic drugs because of the severe side effects. Fourteen (63.6%) patients received granulocyte colony-stimulating factor to relieve neutropenia, and 8 (36.4%) patients received component blood transfusion to treat anemia or thrombocytopenia. There was no treat-ment-associated death.</p><p><b>CONCLUSION</b>Gemcitabine combined with platinum chemotherapy appears to be an effective and well-tolerant treatment for recurrent epithelial ovarian cancer, including platinum-resistant or -refractory diseases.</p>