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ObjectiveTo survey the status of Helicobacter pylori (HP)infection in cholangiocarcinoma,and its relation to clinical and pathological parameters and prognosis. MethodsHP infection in 80 cholangiocarcinoma samples and 30 controls was detected by PCR,in those with positive results the expression of Cag A and its subtypes of Vac A sla,m1 and m2 was further tested by PCR.ResultsChi-square test showed that the detection rate of in HP ( + ) in cholangiocarcinoma group is 71％,higher than 20％ in control group.The positive cases of CagA and VacA sla,m1,m2 in cholangiocarcinoma group was respectively 30,40,5 and 43 cases.HP infection in cholangiocarcinoma was correlated with the location of the tumor(x2 =27.580,P ＜ 0.05 ). MultivariateLogisticanalysisshowedthat cholangiocarcinoma is over 10 times more likely in HP ( + ) patients than HP ( - ) ( OR =10.531 ).Cox regression analyses showed that the infection of HP(HR =8.105,P =0.032),the staging of TNM( Ⅱ/ⅢHR=9.141,P=0.040,Ⅳ HR =29.071,P=0.040) and surgery (HR=9.531,P =0.015) are all independent prognostic factors of cholangiocarcinoma. Life table analyses showed HP infection negatively affects the survival time of cholangiocarcinoma after a surgery ( u =10.074,P =0.002),and the median survival time is 7.25 months shorter than HP( - ) patients. ConclusionsIt is common that HP infection complicating cholangiocarcinoma,usually with the genotype of VacA sla/m2,HP infection is a risk factor for cholangiocarcinoma,and negatively affects oatients survival after surgery.
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Trastuzumab is a monoclonal antibody directed against the human epidermal growth factor receptor-2( HER-2). Recent studies found that Trastuzumab in combination with chemotherapy could improve the survival of patients with HER-2 positive advanced gastric. However, the use of techniques like immunohistochemistry, fluorescence in situ hybridization (FISH) in assessing HER-2 status of gastric cancer has many disadvantages, a new technique silver-enhanced in situ hybridization (SISH) is likely to be the reference standard for assessing HER-2 status of gastric cancer. This paper reviews the advance of the detection and clinical studies of HER-2 in gastric cancer.
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With the aim of further understanding of the nerve supply of the Iumbodorsal region,and its relation to the pathogenesis of lumbago and lumbocrural pain,the superior chnial nerves of lilty adult Chinese cadavers were dissected. In the present study,it was shown that the superior clunial nerve consists of lateral branches of the posterior rami of spinal nerves rarying from T_(12)L_(1～5)and S_1 segments. The contribution of these branches to this nerve is as follows,T_(12):40 cases,L_1 and L_2: 100 cases each,L_3:96 cases,L_4:48 cases,L_5:11 cases,and S_1:4 cases.Our observation revealed the fact that the posterior rami of L_(4,s)spinal nerves consist of a lot of lateral cutaneous branches,which is not in accordance with embroyological descriptions cited in literature which deny their existence. Basing on our data,we classify the superior clunial nerve into 4 types,Viz:one- branched:1 case;two-branched:15 cases;three-branched:66 cases;and four-branched:18 cases. More than one half of the medial and the most medial branches of the superior clunial nerves perforate through the deep surface of the attachment of the posterior layer of the lumbodorsal fascia on to the iliac crest,and enter the superficial fascia of the buttock.During acute wriggle of the loin,the firm fixation and tight stretching of the perforating branches by this attachment may cause partly the injury of the branches. The crossing point of the lateral margin of the sacrospinalis muscle and iliac crest or the area slightly medial to this point is the site where the perforating superior clun- ial nerve could be localized supeficialiy.