Influence of traditional Chinese medicine constitution type on the susceptibility of hypertensive cases to intracerebral haemorrhage / 中国结合医学杂志

<p><b>OBJECTIVE</b>To explore the influence of Chinese medicine constitution type on the susceptibility of hypertensive patients to intracerebral haemorrhage.</p><p><b>METHODS</b>Primary hypertensive patients were studied and divided into the hypertension and the hypertensive intracerebral haemorrhage groups, depending on whether or not the patients had intracerebral haemorrhage. The demographic characteristics, physiological characteristics, living habits, biochemical tests, other chronic diseases, Chinese medicine constitution type, etc. were collected and compared between the two groups. The neurological deficit in the hypertensive intracerebral haemorrhage group was also compared among the different constitution types.</p><p><b>RESULTS</b>A total of 304 patients participated in this investigation, including 213 cases in the hypertension group and 91 cases in the hypertensive intracerebral haemorrhage group. The percentages of dampness-heat and qi-depression types in the intracerebral haemorrhage group were greater than those with the same types in the hypertension group (20.9% vs 6.1%, 22.0% vs 8.0%; P<0.05). The percentages of each constitution type were different between genders in both groups. In addition, there were more male cases (14/20) with qi-depression type and more female cases (7/8) with phlegm-dampness type in the hypertensive intracerebral haemorrhage group than those with the same types (3/17 and 9/34, respectively) in the hypertension group (P<0.05). The cases with phlegm-dampness and qi-depression types had greater levels of blood lipids in the intracerebral haemorrhage group than those with the same types in the hypertension group (P<0.05). Furthermore, the cases with the qi-deficiency type presented with a more severe neurological deficit than those with the other types (P<0.05).</p><p><b>CONCLUSIONS</b>Chinese medicine constitution type might have an impact on the susceptibility of hypertensive patients to have an intracerebral haemorrhage. The heat-dampness and qi-depression types might lead to greater susceptibility than the other types. In addition, the patient's gender and blood lipids might also influence the susceptibility along with the constitution type.</p>

Study on the distribution of Chinese medical constitutions of hypertension complicated diabetes patients / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the distribution features of Chinese medical constitutions in hypertension complicated diabetes patients.</p><p><b>METHODS</b>Recruited were 251 primary hypertension inpatients at the Department of Neurology and the Department of Cardiology, Mindong Hospital of Ningde City from October 2010 to March 2011. They were assigned to two groups according to whether they were complicated with diabetes, i.e., the primary hypertension complicated diabetes (as the case group, 78 cases) and the primary hypertension without complicated diabetes (as the control group, 173 cases). The constitution types were investigated by questionnaire. The constitution type distribution was compared between the two groups. The data including gender, age, and the distribution of the constitution type were compared between the two groups. The levels of TG, TC, LDL-C, Hb, FPG, and ALB were detected on the 2nd day after admission. The levels of TG, TC, LDL-C, Hb, and ALB were compared be- tween the two groups in patients of yin deficiency constitution, phlegm dampness constitution, and qi deficiency constitution.</p><p><b>RESULTS</b>There was no statistical difference in the hypertension grading, the disease course, and chronic disease complications between the two groups (P > 0.05). The main constitution types were yin deficiency (accounting for 26.0%), phlegm dampness (accounting for 19.1%), and qi deficiency (accounting for 19.1%) in the control group. The main constitution types were yin deficiency (accounting for 32.1%), phlegm dampness (accounting for 30.8%), and qi deficiency (accounting for 17.9%) in the case group. The ratio of phlegm dampness type in the case group was higher than that in the control group with statistical difference (P = 0.041). There was no statistical difference in the constitution distribution in the same gender between the two groups (P > 0.05). There was no statistical difference in the constitution distribution in those younger than 80 years between the two groups (P > 0.05). Compared with those older than 80 years in the control group, the ratio of phlegm dampness was higher, and the ratios of yang deficiency, yin deficiency, qi deficiency, and dampness heat were lower in the case group with statistical difference (P = 0.020). There was no statistical difference in the constitution distribution among different age stages in the case group (P > 0. 05). But there was statistical difference in the constitution distribution among different age stages in the control group (P < 0.05). The yin deficiency and qi deficiency constitutions were dominated in thinner patients of the control group, while yin deficiency constitution was dominated in thinner patients of the case group, showing no statistical difference between the two groups (P > 0.05). There was no statistical difference in the distribution of constitution type in overweight patients between the two groups (P = 0.458). Compared with those of gentle type constitution in the same group, the levels of TC and LDL-C increased in those of phlegm dampness constitution in the two groups (P < 0.05). The level of TC increased in those of qi deficiency constitution in the case group. The level of Hb decreased in those of qi deficiency constitution in the control group (P < 0.05). Compared with those of qi deficiency constitution in the same group, the levels of TC and Hb obviously increased in those of phlegm dampness constitution in the control group (P < 0.05). The level of ALB increased in those of yin deficiency constitution in the case group (P < 0. 05). Compared with the control group, the level of FPG of those of each constitution increased in the case group (P < 0.05) ,.and the level of TC increased in those of qi deficiency constitution (P = 0.007).</p><p><b>CONCLUSIONS</b>The main constitution types of hypertension complicated diabetes patients were yin deficiency, phlegm dampness, and qi deficiency. The ratio of phlegm dampness was higher in hypertension complicated diabetes patients than hypertension without complicated diabetes patients. The levels of TC and LDL-C were higher in those of phlegm dampness constitution type. The level of TC was higher in hypertension complicated diabetes patients of qi deficiency constitution.</p>

Simultaneous pancreas-kidney transplantation in a single center: 10-year retrospective analysis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Simultaneous pancreas-kidney transplantation (SPKT) is the best treatment option for diabetic patients with advanced chronic renal failure. The current study aimed to analyze the surgical indications, treatments and prognosis of SPKT.</p><p><b>METHODS</b>We retrospectively analyzed 40 cases of SPKT performed between December 1999 and January 2010 in our center, including the survival rate, complications and the reasons of reoperation.</p><p><b>RESULTS</b>Of all the 40 SPKT cases, the one-year survival rates of the recipients, kidney and pancreas transplant graft were 97.6%, 97.6% and 92.7%, while 97.6%, 91.1%, 92.7% at 3 years and 83.6%, 78.0%, 79.4% at 5 years, respectively. After SPKT, 10 patients need reoperation because of surgical complications (14 operations). The reoperation rate was 25%, including 2 patients (4 operations) with hematuria, 4 patients with abdominal hemorrhage, 2 patients (3 operations) with abdominal infection, 1 patient with pancreatic venous thrombosis, 1 patient with anastomotic leakage, and 1 patient with fistula.</p><p><b>CONCLUSION</b>Although SPKT provides a successful and effective treatment for diabetics with end-stage renal disease, how to reduce the complications of this treatment still need further effort.</p>

Study on type I interferon and phospho-IRF3 in murine liver dendritic cells after intervened by HBV / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To detect the secretions of type I interferon and the expressions of phospho-IRF3 in murine liver dendritic cells intervened by HBV.</p><p><b>METHODS</b>The murine liver dendritic cells were isolated via anti-CD11c microbeads and were incubated in the presence of GM-CSF and IL-4 to induce the DC generation and proliferation in 24-well cell culture plates. HBV virions were isolated via ultracentrifugation and were detected by quantitative Realtime-PCR. The DCs were divided into two groups: one group was cultured with HBV virions for 24 hours, the other group was cultured without HBV as control group. The cells were harvested at Oh, 1h, 2h, 6h and 24h after being stimulated with poly I:C and the expressions of p-IRF3 and the concentration of IFN beta in supernatants were detected with western blot and ELISA respectively.</p><p><b>RESULTS</b>The IFN beta concentrations at 0 h, 6 h and 24 h in the supernatants of the HBV group and the control group were (12.38 +/- 3.71) pg/ml, (88.67 +/- 9.01) pg/ml and (69.89 +/- 5.80) pg/ml vs (10.83 +/- 4.11) pg/ml, (137.68 +/- 12.28) pg/ml and (72.25 +/- 8.61) pg/ml, respectively. No statistical differences found at 0 h (t = 0.8398, P > 0.05) and 24 h (t = 0.6820, P > 0.05) between the two groups except that at 6 h (t = 9.653, P < 0.01). The expressions of phospho-IRF3 in HBV group were lower than that in control group.</p><p><b>CONCLUSIONS</b>The type I interferon secretion and the phospho-IRF3 expression were decreased in murine liver dendritic cells when intervened by HBV.</p>

Mechanism of the reduction of cerebral ischemic-reperfusion injury through inhibiting the activity of NF-kappaB by propyl gallate / 药学学报

The probable mechanism of the reduction of rat cerebral ischemic-reperfusion injury by propyl gallate was studied. Intraluminal suture middle cerebral artery occlusion model of rat was employed. Propyl gallate was injected immediately after the ischemia was happened. The activity of NF-kappaB, and the expression of COX-2 and HSP70 on the peripheral ischemia were determined by Western blotting. The expression of TNF-alpha was determined by ELISA assay. RT-PCR and immunofluorescence staining were employed to detect the transcription and expression of TLR-4. Results showed that propyl gallate could inhibit the activity of NF-kappaB in the peripheral ischemia, and reduce the expression of COX-2 and TNF-alpha. As the upstream of NF-kappaB, the transcription and expression of TLR-4 decreased, as well as HSP70, the endogenic ligand of TLR-4. As an antioxidant, propyl gallate could reduce the cerebral ischemic-reperfusion injury through inhibiting the activity of NF-kappaB and decreasing the COX-2 and TNF-alpha in the peripheral ischemia. It also could influence HSP70 and TLR-4.

Detection of epidermal growth factor receptor gene mutations and its clinical significance in non-small cell lung cancers / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the detection technology and its clinical significance of the EGFR gene mutation in non-small cell lung cancer.</p><p><b>METHODS</b>DNA direct sequencing methods by PCR amplification were used to detect EGFR gene exons 18-21 mutation and to analyze its clinical pathological significance in 192 patients with non-small cell lung cancer.</p><p><b>RESULTS</b>64 of the 192 cases presented with EGFR gene tyrosine kinase binding domain mutation (64/192, 33.3%), of which exon 19 deletion mutation rate was 60.9% (39/64), exon 21 alternative mutation rate was 39.1% (25/64), but exons 18 and 20 mutation was not found in this group of patients. EGFR gene mutation rate was 58.5%(24/41) in lung adenocarcinoma associated with bronchioloalveolar carcinoma differentiation, which was significantly higher than that of ordinary adenocarcinoma (37.9%, 33/87), squamous cell carcinoma (7.5%, 4/53), large cell carcinoma (1/5) and adenosquamous carcinoma (2/6, P<0.05). EGFR gene mutation rates in male patients (20.9%, 24/115), were significantly higher than in the females (51.9%, 40/77; P<0.01); non-smokers (50.0%, 57/114), significantly higher than that of smokers (9.0%, 7/78; P<0.01).</p><p><b>CONCLUSIONS</b>DNA direct sequencing method by PCR amplification is stable and reliable in detection of EGFR gene mutation in non-small cell lung cancer. It might provide a scientific basis for targeted therapy.</p>

Could tumor characteristics identified by colonoscopy predict the locally advanced rectal carcinoma? / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Neoadjuvant chemoradiation is now considered the standard care for locally advanced rectal carcinoma (T3-4 or/and N1-2 lesions), but the accuracy of staging examinations including endorectal ultrasonography (ERUS) and MRI is far from excellent. In addition, the above staging equipment or professionals who perform the examinations may not be available in some hospitals, while preoperative colonoscopy and biopsy are usually obtainable in most hospitals. The objective of the present study was to investigate the clinical and pathological characteristics of locally advanced rectal carcinoma and identify candidates for neoadjuvant chemoradiation.</p><p><b>METHODS</b>This was a retrospective study. Patients who were treated for rectal cancer at Changhai Hospital from January 1999 to July 2008 were identified from our prospectively collected database. Statistical analysis was performed using SPSS Software System (version 15.0). The Mann-Whitney test, chi-square test and multivariate Logistic regression analysis were performed.</p><p><b>RESULTS</b>A total of 1005 cases were included in this research, of which 761 cases were identified as locally advanced rectal carcinoma depending on postoperative TNM staging. The results of multivariate Logistic regression analysis indicated seven independent risk factors that could be used to predict a locally advanced rectal carcinoma independently: a high grade (including poor differentiation and undifferentiation) (OR: 3.856; 95% CI: 2.064 to 7.204; P = 0.000); large tumor size (OR: 2.455; 95% CI: 1.755 to 3.436; P = 0.000); elevated preoperative serum CEA level (OR: 1.823; 95% CI: 1.309 to 2.537; P = 0.000); non-polypoid tumor type (OR: 1.758; 95% CI: 1.273 to 2.427; P = 0.001); the absence of synchronous polyps (OR: 1.602; 95% CI: 1.103 to 2.327; P = 0.013); the absence of blood in stool (OR: 1.659; 95% CI: 1.049 to 2.624; P = 0.030); and a greater circumferential tumor extent (OR: 1.813; 95% CI: 1.055 to 3.113; P = 0.031). Based on these findings, a Logistic equation was established, the accuracy of which was 64% according to the information of the additional 50 cases.</p><p><b>CONCLUSIONS</b>Some independent risk factors related with locally advanced rectal carcinoma were identified, based on which it is possible to establish a Logistic equation as a tool to predict candidates of neoadjuvant chemoradiation. Further research about optimization of the equation is warranted.</p>

Expression of nuclear factor-κB and its regulated cytokines in dendritic cells in patients with chronic severe hepatitis B and its clinical significance / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the correlation of nuclear factor-κB (NF-κB) level and its regulated cytokines in monocyte-derived dendritic cells (MoDC) with illness severity and prognosis in patients with chronic severe hepatitis B (CSHB).</p><p><b>METHODS</b>Peripheral blood mononuclear cells (PBMC) were isolated by Ficoll density gradient separation from 37 patients with CSHB, 20 chronically HBV-infected patients, and 20 normal controls. Monocytes were acquired using immunomagnetic anti-CD14-beads. Next, monocytes were induced into immature DC (iDC) in vitro. On day six, polyI:C was added to induce DC maturation. Then mature DCs (mDCs) were collected at 48 h after polyI:C treatment to test the expression of NF-κB p50 by real time PCR. The supernatants were also collected respectively. The expression of TNFα and IL-6 in the supernatants were measured by ELISA.</p><p><b>RESULTS</b>The expression of NF-κB p50 in mDCs of patients with CSHB was the highest in three groups (F=19.01, P<0.01). The secretion of TNFα and IL-6 in mDCs from group CSHB was extremely high when compared with the other two groups, the secretions of TNFα in groups CSHB, CHB and NC were(15317.69+/-4124.90) pg/ml, (9670.29+/-3654.68) pg/ml and (6547.43+/-1027.20) pg/ml (F=45.77, P<0.01) respectively, and the productions of IL-6 in groups CSHB, CHB and NC were (1423.78+/-375.14) pg/ml, (862.68+/-93.68) pg/ml and (567.26+/-167.04) pg/ml (F = 67.60, P is less than 0.01), respectively. NF-κB p50 showed significant correlations with TNFα(r=0.52, P<0.01) and IL-6 (r=0.65, P<0.01) in mDCs. Furthermore, the secretions of TNFα and IL-6 in mDCs from group CSHB were negatively associated with PTA (r=-0.41, P=0.01; r=-0.40, P=0.01), but not with ALT, TBil and virus loads (r=-0.03, P=0.85, r=0.01, P=0.93, r=0.01, P=0.95; r=-0.09, P=0.58, r=0.16, P=0.34, r=0.09, P=0.59). No significant difference found in the expression of TNFα and IL-6 between the survival subgroup and the death subgroup in group CSHB (t=0.42, P=0.67; t=0.76, P=0.45).</p><p><b>CONCLUSIONS</b>The expression levels of NF-κB and its regulated cytokines in monocyte-derived DCs in patients with chronic severe hepatitis B were up-regulated and perhaps associated positively with the illness severity.</p>

Accuracy comparison of preoperative histological assessment in differentiation and grading of rectal adenocarcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare the accuracy of preoperative assessment in differentiation and grading of rectal adenocarcinoma.</p><p><b>METHODS</b>One hundred consecutive patients diagnosed as invasive rectal cancer by colonoscopy biopsy and undergone operation in the Changhai Hospital from March 2006 to May 2008 were studied retrospectively. Patient characteristics, examination records, operative and pathologic reports were reviewed. The slides of preoperative biopsy and postoperative pathologic specimen were reviewed to identify the differentiation by a single pathologist. The results of preoperative biopsy were compared to those of postoperative specimen which was considered as final diagnosis. The accuracy of preoperative assessment of differentiation was calculated. Patients were then divided into two groups based on the preoperative differentiation:the low-grade tumor including well and moderately differentiated tumors, and the high-grade tumor consisting of poorly differentiated and undifferentiated tumors. The accuracy of grading was also calculated.</p><p><b>RESULTS</b>The accuracy of preoperative assessment of differentiation was 72%, with 20% overgrading and 8% undergrading, while the accuracy of preoperative grading was 91%, with 4% overgrading and 5% undergrading. The accuracy of grading was significantly higher than that of specific differentiation(P<0.01).</p><p><b>CONCLUSION</b>The grading of preoperative biopsy has high accuracy rate and should be considered in clinical practice.</p>

99Tcm-ciprofloxacin imaging in detecting the secondary infection of severe acute pancreatitis / 中华核医学杂志

Objective To evaluate the characteristics of 99Tcm-ciprofloxacin and explore its feasibility in early detection of secondary infectious foci of severe acute pancreatitis (SAP).Methods Ciprofloxacin was labeled with 99Tcm.The labeling efficiency and radiochemical purity of 99Tcm-ciprofloxacin were calculated and its biodistribution in normal pigs was measured.The recruited baby pigs were divided into three groups:normal control group (6), non-infected group (6) and infected group (16).370-400 MBq of 99Tcm-ciprofloxacin was injected into each pig intravenously.SPECT scanning was performed at 0.5, 1,2, 3, 4 and 6 h after administration.The differences of 99Tcm-ciprofloxacin uptake among groups were calculated and the tracer activity ratio of lesion-to-background was recorded at each time point.The diagnostic value of 99Tcm-ciprofloxacin SPECT imaging for the dectection of secondary infection of SAP was assessed using histopathological results as the gold standard.Variance analysis and least significant difference test were used to analyze the data.Results Both the labehing efficiency and radiochemical purity of 99Tcm-ciprofloxacin were over 90% within 6 h.Organs with rich blood supply, such as kidney, liver and spleen were the target organs for the accumulation of 99Tcm-ciprofloxacin; while no significant uptake was found in gastrointestinal tract or normal pancreas tissue of SAP.Rapid plasma clearance and renal excretion were observed.In the infected group, the lesion was visualized at 1 h after administration.The highest radioactivity ratio of lesion-to-background (3.36 ± 0.33) was at 3 h after administration, which was significantly higher than that of the other time point ( F =99.570, P ＜0.001 ).The sensitivity, specificity, positive and negative predictive values, Youden's index (YI) and Kappa value of 99Tc%ciprofloxacin imaging were 88.2% (15/17), 83.3% (5/6), 93.8% ( 15/16), 71.4% (5/7), 0.715 and 0.667 respectively.Conclusions The biodistribution of99Tcm-ciprofloxacin is suitable for imaging infectious focus of SAP.The optimal imaging time for the detection of secondary infection of SAP is 3 h after administration, with high sensitivity and specificity.

Endoscopic retrograde cholangiopancreatography-guided brush cytology diagnosis of pancreatobiliary tumors / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the cytologic features of pancreatobiliary tumors in endoscopic retrograde cholangiopancreatography (ERCP)-guided brushing preparations and to evaluate the usefulness of cytology in the diagnosis of pancreatobiliary malignancy.</p><p><b>METHODS</b>A retrospective analysis of 212 cases of ERCP-guided brush cytology smears performed during the period from January, 2004 to December, 2006. The cytologic diagnosis was confirmed either by the histologic diagnosis or the strict clinical criteria.</p><p><b>RESULTS</b>Two of the cases studied were unsatisfactory for diagnosis, with no epithelial cells identified. One hundred and thirty-seven smears were diagnosed as "negative", 45 of which subsequently confirmed to be malignant (negative predictive value = 60.2%). Six of the 11 cases with "low-grade atypia" were proven to be malignant (positive predictive value = 54.5%), as compared to 19 of 23 cases of "high-grade atypia" (positive predictive value = 86.4%). All of the 41 cases with cytologic diagnosis of "malignancy" were confirmed to be malignant (positive predictive value = 100%). The cytologic features of malignancy in ERCP-guided brushing preparations included overlapping nuclei, anisonucleosis, coarse chromatin pattern, poor cellular cohesion, tumor diathesis, prominent nucleoli and atypical mitotic figures.</p><p><b>CONCLUSIONS</b>The accuracy of ERCP-guided brush cytology relies on good specimen preparation and application of morphologic criteria. Grading of cytologic atypia is of clinical significance. A "negative" or "low-grade atypia" cytologic diagnosis requires further diagnostic workup to rule out the possibility of underlying malignancy, while a "high-grade atypia" or "malignant" diagnosis is relatively specific in guiding subsequent management of suspected pancreatobiliary malignancy.</p>

Early complications after simultaneous pancreas-kidney transplantation / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the early complications after simultaneous pancreas-kidney transplantation (SPK).</p><p><b>METHODS</b>The clinical data of 20 patients who underwent SPK in our center from September 2002 to September 2007 were retrospectively analyzed.</p><p><b>RESULTS</b>The complications after SPK included hematuria (n = 4), abdominal bleeding (n = 4), abdominal infections (n = 6), lung infections (n = 5), urinary infection (n = 1), poor wound healing (n = 3), abdominal distension (n = 1), and acute cardial infarction (n = 1).</p><p><b>CONCLUSIONS</b>Infection and bleeding are the most common early complications after SPK. Urinary infection and metabolic acidosis are common in BD mode.</p>

The effect of the different immunosuppression therapy on CD4(+)Foxp3(+) Treg cells in kidney recipients / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of the different immunosuppression therapy on CD4(+)Foxp3(+)regulatory T cells (CD4(+)Foxp3(+)Treg cells) in the peripheral blood monocytes of kidney transplantation recipients.</p><p><b>METHODS</b>A Closed Cohort study was conducted in 50 primary living kidney transplant recipients between January 2006 and January 2008, who had been followed up for 1 year. The recipients divided into calcineurin inhibitors group (CNI + MMF + Pred) (19 recipients, including cyclosporin group 10 recipients and tacrolimus group 9 recipients), rapamycin group (RAPA + MMF + Pred) (31 recipients). Twenty end-stage renal disease patients were in control group. The frequency of CD4(+)Foxp3(+)Treg cells in total CD4(+)T cells was analyzed by flow cytometry in peripheral blood from three groups, results were compared.</p><p><b>RESULTS</b>The clinical variables of recipients such as age, sex, cold ischemia time, human leucocyte antigen mismatch, panel reaction antibody, rejection episode were no significant difference. The percentage of CD4(+)Foxp3(+)Treg cells in total CD4(+) cells was significantly higher in rapamycin group and end-stage renal disease group than calcineurin inhibitors group (P < 0.01). The level of CD4(+)Foxp3(+)Treg cells between cyclosporin group and tacrolimus group was no significant difference (P > 0.05).</p><p><b>CONCLUSION</b>The level of CD4(+)Foxp3(+)Treg was significantly higher in patients receiving RAPA + MMF + Pred than the patients receiving CNI + MMF + Pred, which suggested that RAPA may be play a more important role in immune tolerance induction.</p>

Impact of meticulousness of pathologists on lymph node harvest after radical resection of invasive rectal carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To analyze the impact of meticulousness of pathologists on the lymph node harvest after radical resection of invasive rectal carcinoma.</p><p><b>METHODS</b>From January 2008 to May 2009, the clinical data of rectal cancer patients undergone operation were reviewed retrospectively. After multidisciplinary cooperation on rectal cancer, a new rule was applied to request the pathologists to find no less than 15 nodes in single colorectal specimen from January 2009. Patients were divided into two groups (2008 group and 2009 group) and the node harvest numbers were compared. Excluded criteria were recurrent colorectal tumor, Tis tumor, R(1) or R(2) resection, tumor resection transanally or endoscopically, the cases enrolled in other prospective research, synchronous diseases affecting the surgical procedure for the rectal cancer (familial adenomatous polyposis, synchronous colorectal carcinoma) and rectal cancer receiving neoadjuvant chemoradiation. Statistical analysis was performed using One-Sample Kolmogorov- Smirnov test, Mann-Whitney test, Independent-Samples T test and Chi-Square test(SPSS 15.0).</p><p><b>RESULTS</b>A total of 232 patients were identified, including 76 cases in the 2009 group and 156 cases in 2008 group. The lymph node retrieval in the 2009 group was significantly more than that in 2008 group (16.0+/-0.3 vs 11.4+/-0.3, P<0.01). A significantly higher percentage of patients was found in 2009 group with a lymph node harvest equal to or more than 12 nodes (72/76 vs 71/156, P<0.01). There were no significant differences in gender (46/76 vs 86/156, P=0.436), age (58.1+/-1.3 vs 59.2+/-1.1, P=0.527), distance from tumor to anal verge (7.4+/-0.4 vs 7.1+/-0.3, P=0.761), proportion of sphincter-sparing surgery (67/76 vs 140/156, P=0.715), ratio of well and moderate differentiated tumors (68/76 vs 125/156, P=0.074) and overall TNM stage (P=0.167) between the two groups.</p><p><b>CONCLUSIONS</b>The lymph node harvest in 2009 group is significantly more than that in 2008 group. The good performance of pathologists could produce adequate number of lymph nodes for rectal cancer without neoadjuvant chemoradiation.</p>

Expression of proteins in p53 (p14ARF-mdm2-p53-p21WAF/CIP1) pathway and their significance in exocrine pancreatic carcinoma / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the expression of p14(ARF), p53, mdm2 and p21(WAF/CIP1) proteins and their relationship in exocrine pancreatic carcinoma.</p><p><b>METHODS</b>Specimens of pancreatic carcinoma, adjacent non-neoplastic pancreatic tissue and pancreatic benign lesions were examined for p14(ARF), p53, mdm2 and p21(WAF/CIP1) protein expression by tissue microarray technique and immunohistochemistry.</p><p><b>RESULTS</b>The expression of p14(ARF), p53, mdm2 and p21(WAF/CIP1) proteins in pancreatic carcinoma were 35.3% (59/167), 57.5% (96/101), 64.1% (107/167) and 39.5% (66/167) respectively. The expression of p53 proteins was increased in pancreatic carcinoma (P < 0.01), while the expression of p14(ARF) and p21(WAF/CIP1) proteins was reduced (P < 0.05), as compared with that in non-neoplastic pancreatic tissue. p21(WAF/CIP1) protein expression in pancreatic carcinoma significantly correlated with the age of patients and perineural invasion (P < 0.05). p53 protein expression correlated significantly with tumor differentiation, lymph node metastasis and perineural invasion (P < 0.05). Mdm2 protein expression correlated significantly with tumor differentiation (P < 0.05), while p14(ARF) protein expression correlated significantly with the age of patients and metastasis (P < 0.05). There was also statistic correlation between the expression of these four genes (P < 0.05).</p><p><b>CONCLUSIONS</b>Overexpression of p53 and mdm2 and loss of p14(ARF) and p21(WAF/CIP1) expression may contribute to the pathogenesis of pancreatic carcinoma. These proteins play a critical role in cell cycle arrest and apoptosis after DNA damage through p14(ARF)-mdm2-p53-p21(WAF/CIP1) pathway. Detection of p53 and Mdm2 protein overexpression may be useful in evaluation of the aggressiveness of pancreatic carcinoma.</p>

Analysis of relationship between P27, P53 and PCNA expression and its clinical significance / 第二军医大学学报

Objective: To investigate the relationship between P27，P53 and PCNA expression in human gastric carcinoma tissues and clinicopathological parameters. Methods: The expression of P27，P53 and PCNA in 62 human gastric carcinoma tissues was examined with immunohistochemistry SP method. Results: Positive rates of P27，P53 and PCNA expression were 37.1％, 40.4%，83.9％. P27 expression was related with Bormann type, infiltrative depth, lymph node and distant metastasis and clinical stage. P53 expression was related with sex of patients, distant metastasis and clinical stage. PCNA expression was related with age of patients and infiltrative depth of tumor. P27 positive expression group was higher than negative group as to 5-year survival. P27 expression was in reverse relation with PCNA expression. Conclusion: The expression of P27, P53 and PCNA may be regarded as an important marker in judging malignant degree of gastric carcinoma,distant metastasis and prognosis.

Analysis of relationship between P27, P53 and PCNA expression and its clinical significance / 第二军医大学学报

Objective: To investigate the relationship between P27，P53 and PCNA expression in human gastric carcinoma tissues and clinicopathological parameters. Methods: The expression of P27，P53 and PCNA in 62 human gastric carcinoma tissues was examined with immunohistochemistry SP method. Results: Positive rates of P27，P53 and PCNA expression were 37.1％, 40.4%，83.9％. P27 expression was related with Bormann type, infiltrative depth, lymph node and distant metastasis and clinical stage. P53 expression was related with sex of patients, distant metastasis and clinical stage. PCNA expression was related with age of patients and infiltrative depth of tumor. P27 positive expression group was higher than negative group as to 5-year survival. P27 expression was in reverse relation with PCNA expression. Conclusion: The expression of P27, P53 and PCNA may be regarded as an important marker in judging malignant degree of gastric carcinoma,distant metastasis and prognosis.

A combined-staining method for neural cholinesterase and elastic and collagen fibers in rat pancreatic tissues / 第二军医大学学报

Objective:To investigate the distribution of neural cholinesterase and elastic and collagen fibers in rat pancreatic tissues.Methods:Rats were decapitated and the pancreatic tissues were harvested,frozen and made into 8?m serial sections.A combined-staining method(K-R-VB-P-PA method,a combination of Karnovsky-Roots and Victoria blue-Ponceau-Picric acid) was used for staining and the distribution of neural cholinesterase and elastic and collagen fibers was observed.Results:The results showed that the neural cholinesterase was brown.the elastic fibers were cyan.the collagen fibers were light red.and the smooth muscle was yellow in the pancreatic acinar,islet of Langerhans and blood vessels.Conclusion:K-R-VB-P-PA combined staining method can demonstrate the distribution of neural cholinesterase,elastic and collagen fibers and smooth muscle fibers in the pancreatic tissues synchronously.