Comparable long-term survival outcomes after endoscopic and gastrectomy treatment of pT1acN0M0 gastric adenocarcinoma in patients who met the expanded criteria.

BACKGROUND: Whether the Western pT1acN0M0 gastric cancer (GC) patients who met the Japanese expanded criteria could be the candidates for endoscopic treatment (ET) remains unclear because of unknown long-term survival outcomes. METHODS: A retrospective cohort study using data from the Surveillance, Epidemiology, and End Results (SEER) program was performed. The survival differences between pT1acN0M0 gastric adenocarcinoma patients who received ET or gastrectomy treatment (GT) were evaluated using multivariate survival analysis. RESULTS: A total of 314 pT1acN0M0 gastric adenocarcinoma patients who met the expanded criteria were included, 46 patients received ET and 268 patients received GT. pT1acN0M0 gastric adenocarcinoma patients met the expanded criteria underwent ET experienced a similar hazard of cancer-specific death compared with those underwent GT both in the multivariate Cox survival analysis (adjusted hazard ratio [HR]; 1.18, 95% confidence interval [CI] 0.40-3.49; P = 0.766) and the multivariate competing risk model (subdistribution HR [SHR], 1.12, 95% CI 0.38-3.29; P = 0.845). The result that pT1acN0M0 gastric adenocarcinoma patients met the expanded criteria underwent ET experienced comparable survival outcomes to those who underwent GT did not change even compared with those who underwent GT with > 15 lymph nodes examined (adjusted HR, 1.55, 95% CI 0.44-5.49; P = 0.499; SHR, 1.47, 95% CI 0.44-4.88; P = 0.532). CONCLUSIONS: The ET can be considered in Western pT1acN0M0 gastric adenocarcinoma patients who met the Japanese expanded criteria. However, a prospective study should be warranted.

Comparable long-term outcomes after endoscopic therapy and gastrectomy of early adenocarcinoma of esophagogastric junction: a population-based study.

BACKGROUND AND AIMS: Current guidelines recommend consideration of endoscopic therapy (ET) when treating selected early gastric cancers. However, clinical decision-making on ET versus gastrectomy for early adenocarcinoma of esophagogastric junction (AEGJ) remains challenging because of uncertain long-term outcomes. METHODS: We performed a retrospective cohort study using the Surveillance, Epidemiology, and End Results database from 2004 to 2017 of early AEGJ patients underwent ET or gastrectomy. Multivariate models were used to compare cancer-specific survival (CSS). RESULTS: Of 881 included early AEGJ patients, 227 (36.2%) patients underwent ET and 654 (63.8%) patients underwent gastrectomy. Early AEGJ patients who underwent ET experienced a similar hazard of cancer-specific death compared with those underwent gastrectomy in both multivariate Cox regression (HR [hazard ratio], 0.93; 95% CI [confidence interval], 0.55-1.56; P = 0.78) and the multivariate competing risk model (subdistribution HR [SHR], 0.86; 95% CI 0.50-1.45; P = 0.56). Propensity score matching was used, 210 patients underwent ET were matched with 210 patients underwent gastrectomy. Patients underwent ET experienced a similar hazard of cancer-specific death compared with those underwent gastrectomy in both multivariate Cox regression (HR, 0.97; 95% CI 0.53-1.77; P = 0.92) and the multivariate competing risk model (SHR, 0.96; 95% CI 0.52-1.77; P = 0.89). CONCLUSION: Early AEGJ patients who received ET or gastrectomy had comparable long-term outcomes, which lend support to the role of ET in the treatment of these patients.

Effects of different treatments on prognosis of triple-negative breast cancer / 国际肿瘤学杂志

Objective:To analyze the clinical features and the effects of different treatments on 5-year overall survival (OS) rate and 5-year disease free survival (DFS) rate of stage 0-Ⅲ triple-negative breast cancer (TNBC).Methods:The data of 209 patients diagnosed as stage 0-Ⅲ TNBC in Ward 2 of Department of General Surgery of the Fifth Medical Center of PLA General Hospital from January 2004 to December 2013 were selected. The relationships between the clinical features, treatments and 5-year OS rate, 5-year DFS rate were retrospectively analyzed. Kaplan-Meier method was used to draw survival curves, and Cox proportional risk model was used for multivariate analysis.Results:Univariate analysis found that clinical stage and methods of surgery were associated with 5-year OS rate ( χ2=52.615, P<0.001; χ2=17.329, P=0.001) and 5-year DFS rate ( χ2=55.112, P<0.001; χ2=18.816, P<0.001). Multivariate analysis showed that clinical stage was an independent prognostic factor of DFS ( HR=3.637, 95% CI: 2.146-6.164, P<0.001) and OS ( HR=3.545, 95% CI: 2.091-6.009, P<0.001). For the TNBC patients without axillary lymph node metastasis ( n=118), the 5-year OS rates of patients with breast conservation surgery + sentinel lymph node biopsy, total breast resection + sentinel lymph node biopsy, modified radical mastectomy and breast conserving surgery + axillary lymph node dissection were 97.6%, 97.7%, 91.4%, 100% respectively, the 5-year DFS rates were 97.3%, 94.3%, 85.8%, 100% respectively, and there were no significant differences among the four groups ( χ2=3.369, P=0.338; χ2=3.868, P=0.276). The 5-year OS rate (74.5% vs. 91.1%) and 5-year DFS rate (73.6% vs. 86.8%) were significantly different in patients receiving neoadjuvant chemotherapy ( n=106) compared with those receiving adjuvant chemotherapy ( n=80) ( χ2=4.504, P=0.034; χ2=4.683, P=0.030). The patients receiving neoadjuvant chemotherapy had later clinical stages than those receiving adjuvant chemotherapy ( χ2=35.314, P<0.001). There were no significant differences in 5-year OS rate and 5-year DFS rate between the patients receiving neoadjuvant chemotherapy and adjuvant chemotherapy with the same clinical stage (all P>0.05). The 5-year OS rates of patients with pathologic complete response (pCR), partial response (PR) and stable disease (SD) obtained by neoadjuvant chemotherapy were 100%, 75.8% and 57.1% respectively, and the 5-year DFS rates were 100%, 74.5% and 55.7% respectively, with statistically significant differences ( χ2=10.086, P=0.006; χ2=10.399, P=0.006). Between the pCR group and the PR group, the 5-year OS rate ( χ2=4.238, P=0.040) and 5-year DFS rate ( χ2=4.525, P=0.033) were significantly different. Between the pCR group and the SD group, the 5-year OS rate ( χ2=8.163, P=0.004) and 5-year DFS rate ( χ2=8.509, P=0.004) were significantly different. Between the PR group and the SD group, the 5-year OS rate ( χ2=3.931, P=0.047) and 5-year DFS rate ( χ2=3.896, P=0.048) were significantly different. Conclusion:For the patients with stage 0-Ⅲ TNBC, clinical stage is an independent prognostic factor. For the TNBC patients without axillary lymph node metastasis, breast conservation surgery + sentinel lymph node biopsy, total breast resection + sentinel lymph node biopsy, modified radical mastectomy and breast conserving surgery + axillary lymph node dissection have similar outcomes. There is no significant difference between neoadjuvant chemotherapy and adjuvant chemotherapy in the prognosis of patients with the same clinical stage, but patients with pCR or PR obtained by neoadjuvant chemotherapy can achieve better survival.

Impact of Lymph Nodes Examined on Survival in ypN0 Gastric Cancer Patients: a Population-Based Study.

BACKGROUND: Our aim was to evaluate the prognostic value of the number of lymph nodes examined (eLNs) on survival in ypN0 gastric cancer (GC) patients, and further to define the optimal number of lymph nodes needed to be examined during radical gastrectomy of ypN0 GC patients. METHODS: A total of 1127 ypN0 GC patients during 2004-2015 from the Surveillance, Epidemiology, and End Results (SEER) database were included. The number of eLNs cutoff points that determined the greatest actuarial survival difference was calculated by the X-tile program. Univariate and multivariate analyses were performed to assess the impact of eLNs on overall survival (OS). RESULTS: The optimal number of eLNs thresholds was determined to be 15 for ypN0 GC patients. Kaplan-Meier analysis revealed that ypN0 GC patients with ≥ 16 eLNs had a significantly better OS than those with ≤ 15 eLNs (5-year OS; 60.8 vs 45.4%, P < 0.001). Similarly, multivariate Cox analysis revealed that ypN0 GC patients with ≥ 16 eLNs experienced a significantly lower hazard of death than those with ≤ 15 eLNs (adjusted HR; 0.73, 95% CI, 0.60-0.90, P = 0.003). CONCLUSIONS: The number of eLNs was an independent predictor of survival for ypN0 GC patients. A minimum of 15 eLNs is recommended as the cutoff point for the evaluation of the quality of postoperative or prognostic stratification in ypN0 GC patients.

Influence of Tumor Location on Lymph Node Metastasis and Survival for Early Gastric Cancer: a Population-Based Study.

BACKGROUND: The question that whether the criteria for endoscopic resection of early gastric non-cardia cancer (GNCC) is appropriate for early gastric cardia cancer (GCC) remains unclear. Thus, our aim was to evaluate the influence of tumor location on lymph node metastasis (LNM) and overall survival (OS) for early gastric cancer (GC). METHODS: A total of 5440 early GC patients in the Surveillance, Epidemiology, and End Results (SEER) database were identified. Multivariable analysis was performed to evaluate the influence of tumor location on LNM and OS for early GC. RESULTS: The rate of LNM was 17.48% for early GCC patients (232/1327) and 18.62% for early GNCC patients (766/4113). The early GCC patients experienced no significantly different risk of LNM compared with the early GNCC patients (adjusted OR 0.92, 95% CI 0.76-1.12, P = 0.405). The early GC patients were further stratified by node status. Tumor location was not a predictor of OS for node-negative early GC patients (adjusted HR 1.07, 95% CI 0.96-1.21, P = 0.225) but a predictor of OS for node-positive early GC patients (adjusted HR 1.80, 95% CI 1.48-2.20, P < 0.001). CONCLUSIONS: Tumor location was not a predictor of LNM for early GC patients. Moreover, tumor location was not a predictor of OS for node-negative early GC patients. Thus, the criteria for endoscopic resection of early GNCC might be appropriate for the treatment of early GCC.

Progress of diagnosis and treatment of gastric cancer surgery / 国际外科学杂志

Gastric cancer is a common malignant tumor in China, which is a serious threat to national health. It is the common demand of doctors and patients to reduce the complication rate on the basis of improving the therapeutic effect. Based on this demand, in recent years, on the basis of traditional surgery and systemic chemotherapy, gastric cancer surgery has derived many new hot areas, including artificial intelligence diagnosis and treatment technology, minimally invasive surgery technology, enhanced recovery after surgery, multi-disciplinary team (MDT) diagnosis and treatment, precision medicine, and so on, which provide more choices for gastric cancer surgeons, but also bring more challenges.

Expression and significance of IL-10 and TGF-β1 in serum of patients with systemic lupus erythematosus / 军事医学

Objective To investigate the serum levels of IL-10 and TGF-β1 and their significance for patients with sys-temic lupus erythematosus( SLE) .Methods A total of 135 cases were available for the study including 63 cases in primary group(A), 40 cases in remission group(B) and 32 cases in healthy control group(C).ELISA method was used to deter-mine the concentrations of IL-10 and TGF-β1 in serum.Finally, the results of group A were analyzed on the basis of System-ic Lupus Erythematosus Disease Activity Index( SLEDAI) .Results The level of IL-10 in serum of group A was significant-ly higher than that of group B and group C.The level of IL-10 in serum of group B was significantly higher than that of group C(P0.05).The level of TGF-β1 in serum of group A had negative correlation with SLEDAI.The cases in group A were divided into three subgroups by SLEDAI:21 cases in mild activities subgroup, 30 cases in moderate activities sub-group,and 12 cases in severe activities subgroup, the levels of IL-10 and TGF-β1 in the three subgroups were significantly different(P<0.05).Conclusions IL-10 and TGF-β1 are involved in activity and severity of SLE.

Influence of different training methods in hand hygiene compliance of health care workers / 中国感染控制杂志

Objective To train health care workers (HCWs)by method of conventional training plus survey of hand contamination status,the influence of two kinds of methods in hand hygiene compliance of HCWs was evalua-ted.Methods From November 2013 to April 2014,all HCWs in a cardiovascular internal medicine department were as trained subjects,they were divided into two groups (trial group and control group).Hand hygiene compli-ance status was investigated 1 month before training.In the first month after training,conventional training method was adopted by both groups,from the second to fifth month,conventional training plus hand contamination survey was adopted by trial group,hand hygiene compliance between two groups were compared.Results Hand hygiene compliance rates of trial group and control group was 42.63% (107/251 )and 41 .80% (102/244)respectively be-fore training,there was no significant difference(P >0.05 ).In the first and second month after training,hand hygiene compliance rate of trial group was 55.70% (132/237)and 63.11 % (154/244)respectively,control group was 56.52% (130/230)and 62.61 % (149/238)respectively,compared with pre-training,the differences were sig-nificant (both P 0.05);From the third to fifth month,hand hygiene compliance rates of trial group was 60.73%(150/247),61 .44%(145/236),and 61 .22%(150/245)respectively,control group was 51 .68%(123/238),51 .02%(125/245 ),and 52.32% (124/237)respec-tively,there was significant difference between two groups(P <0.05).Conclusion Conventional training combined with survey of hand contamination status can promote hand hygiene compliance of HCWs.

Effects of blood purification in the treatment of patients with burn sepsis / 中华烧伤杂志

<p><b>OBJECTIVE</b>To observe the effects of blood purification in the treatment of burn sepsis, in order to provide evidence for its application.</p><p><b>METHODS</b>Twenty-seven patients with burn sepsis admitted to our burn ward from June 2012 to December 2013, conforming to the study criteria, were divided into conventional treatment group (CT, n = 15) and blood purification group (BP, n = 12) according to the random number table. After the diagnosis of sepsis was confirmed, patients in group CT received CT, while patients in group BP received both CT and continuous veno-venous hemodiafiltration for 48 hours. At the time of diagnosis of sepsis (before treatment) and post treatment hour (PTH) 24 and 48, levels of blood lactate and PaO2 were analyzed with blood gas analyzer, and the oxygenation index (OI) was calculated; blood sodium, blood glucose, blood urea nitrogen (BUN), creatinine, white blood cell count (WBC), procalcitonin (PCT) were determined; acute physiology and chronic health evaluation (APACHE) II score was estimated basing on the body temperature, respiratory rate, mean arterial pressure, PaO2, and blood pH values. The levels of TNF-α, IL-8, and IL-6 in serum were determined by ELISA. Data were processed with Fisher's exact test, t test, analysis of variance for repeated measurement, LSD- t test, and LSD test.</p><p><b>RESULTS</b>(1) The levels of blood lactate of patients in group BP were significantly lower than those of group CT at PTH 24 and 48 (with t values respectively 1.62 and 2.44, P values below 0.05). Compared with that detected before treatment, the level of blood lactate in group BP was significantly decreased at PTH 48 (P < 0.05). The OI values of patients in group BP at PTH 24 and 48 [(247 ± 30), (288 ± 41) mmHg, 1 mmHg = 0.133 kPa] were significantly higher than those of group CT [(211 ± 32), (212 ± 30) mmHg, with t values respectively 3.02 and 5.63, P values below 0.01]. Compared with that detected before treatment, the OI values of patients in group BP at PTH 24 and 48 were significantly higher (P values below 0.01). (2) Compared with those of group CT at PTH 24 and 48, the levels of blood sodium, BUN, and creatinine were significantly lower (with t values from 1.74 to 6.75, P < 0.05 or P < 0.01), while the level of blood glucose was approximately the same (with t values respectively -0.92, -0.38, P values above 0.05) in group BP. Compared with those detected before treatment, the levels of blood sodium, BUN, and creatinine of group BP at PTH 24 and 48 were significantly lower (P < 0.05 or P < 0.01). (3) The levels of WBC and PCT of patients in group BP at PTH 24 and 48 were significantly lower than those of group CT (with t values from 2.11 to 6.63, P < 0.05 or P < 0.01). Compared with those detected before treatment, the levels of WBC and PCT of patients in group BP at PTH 24 and 48 were significantly lower (P < 0.05 or P < 0.01). (4) The APACHE II scores of patients in group BP at PTH 24 and 48 [(18.7 ± 2.6) and (16.7 ± 3.0) scores] were significantly lower than those of group CT [(23.1 ± 1.6) and (25.5 ± 1.6) scores, with t values respectively 5.44 and 9.87, P values below 0.01]. Compared with those calculated before treatment, the APACHE II scores of patients in group CT were significantly increased (P < 0.05 or P < 0.01), while those in group BP were decreased at PTH 24 and 48 (P < 0.05 or P < 0.01). (5) The levels of TNF-α, IL-6, and IL-8 in serum of patients in group BP at PTH 24 and 48 were significantly lower than those of group CT (with t values from 6.12 to 19.78, P values below 0.01). Compared with those detected before treatment, the levels of TNF-α, IL-6, and IL-8 in serum of group BP at PTH 24 and 48 were significantly decreased (with P values below 0.01).</p><p><b>CONCLUSIONS</b>BP+CT is effective in improving organ function, correcting the disorder of internal environment, and controlling inflammation. Therefore, BP is an important method in the treatment of burn sepsis.</p>

Clinicopathological analysis of 3 cases of intraductal tubulopapillary neoplasm of the pancreas and literature review / 中华胰腺病杂志

Objective To analyze the clinical symptoms,pathological features and K-ras mutation alterations of intraductal tubulopapillary neoplasm (ITPN),and to better understand ITPN.Methods We collected the clinical data of 3 cases of ITPNs of Changhai Hospital and 16 cases in literature,and analyzed the morphology,K-ras mutation,immunophenotype of tumor cells by routine H&E staining,immonohistochemistry,and fluorescence PCR.Then it was compared with 81 cases of intraductal papillary mucinous tumor (IPMT).Results All the 3 patients of ITPN were male,with a median age of 43 years.Two lesions were located in pancreatic head and 1 case in pancreatic body and tail.ITPNs presented as intraductal solid masses,and consisted of cells with uniformly median-to-high grade nuclear atypia,and tumor cells were arranged as glandular and cribriform.One case was accompanied with invasive ductal adenocarcinoma and peripancreatic lymph node metastasis.All tumor cells of epithelial marker cytokeratin was positively expressed,and p53 was positively expressed in some tumor cells.However,CHR,NSE,MUC2 and MUC5AC were negatively expressed,and K-ras mutation was not detected.The tumor cells of IPMT were presented as papillary pattern and cribriform structure was observed.The majority of cells were mucous epithelium,or goblet cells (intestinal type),a few were eosinophilic epithelium (eosinophilic cells type) and cuboidal epithelium (pancreatic,biliary duct type),MUC2 and MUC5AC was positively expressed,and K-ras mutation rate was 50％.Conclusions As a new tumor entity of pancreas,ITPNs show distinctive features with IPMTs.

Detection of HSPB1 expression in pancreatic cancer and its clinical significance / 中华胰腺病杂志

Objective To investigate the expression of HSPB1 in pancreatic cancer and its relationship with clinicopathological characterization.Methods Pathological specimens from 47 cases of pancreatic cancers,13 cases of para-cancerous normal pancreatic tissues and 3 cases of chronic pancreatitis tissues were selected,and tissue microarray construction instrument was used to prepare tissue microarray,then the expression of HSPB1 was determined by immunohistochemistry SP method.The scores of the proportion of positive cells and staining intensity were multiplied to make the judgment.Results The expression of HSPB1 in malignant,para-cancerous and chronic pancreatitis tissues was 80.9％ (38/47),12.5％ (2/16),respectively; and the difference between the two groups was statistically significant (X2 =24.058,P =0.000).The expression of HSPB1 in pancreatic cancer tissue was not significantly related to sex,age,location,differentiation degree and nerve infiltration of tumor ( P ＞ 0.05 ).Conclusions The expression of HSPB1 is related to development and progression of pancreatic cancer,and may be an early molecular event.

Clinical characteristic of autoimmune pancreatitis: an analysis of 81 patients / 中华胰腺病杂志

Objective To analyze the clinical characteristic of Chinese autoimmune pancreatitis (AIP) patients.Methods All clinical data of 81 patients with a diagnosis of AIP in Shanghai Changhai Hospital from February 2005 to May 2012 were analyzed.Results The sex ratio was 7.1∶1 and the mean age was (57± 12) years old in 81 patients with AIP.Obstructive jaundice was the initial symptom in 51.9％ (42/81) patients.In patient receiving CT,focal and diffuse type accounted for 45 and 35 patients.respectively,and pseudocyst was the main manifestation in 1 patient,biliary tract was involved in 59(72.8％ ) patients,dilatation of main pancreatic duct was observed in 5 ( 11.1％ ) patients.In patients receiving PET-CT,diffuse increased Flourine-18 FDG uptake by the pancreas was found in 11 patients,focal increased uptake in 2patients,and significant extra-pancreatic uptake was found in 5 patients.The positive rate of serum IgG4,CA19-9,ss DNA,anti-nuclear antibody and ds-DNA antibody was 94.6％ (53/81),54.4％ (37/68),14.3％ (4/28),10.7％ (3/28),7.1％ (2/28),respectively.The pathological findings of H-E staining and IgG4 immunohistochemical analysis in 20 patients were consistent with lymphoplasmacytic sclerosing pancreatitis.Conclusions Type 1 AIP is the main subtype of AIP in China.Combining clinical symptoms,extra-pancreatic manifestations,imaging or nuclear medicine findings,serology,cytology or histology can effectively increase the correct diagnosis rate of AIP.

MicroRNA profiles in pancreatic ductal adenocarcinoma / 中华胰腺病杂志

Objective To study the differentially expressed microRNA (miRNA) between pancreatic ductal adenocarcinoma (PDAC) and para-cancerous tissues,and determine related target genes.Methods Nine fresh PDAC tumor tissues and 3 adjacent normal pancreatic tissues were collected,then Agilent miRNAmicroarray with 713 miRNA loci was used to identify the differentially expressed miRNA.Real-time PCR method was applied to verify the up-regulated miRNA.TargetScan 5.1 and miRandaV5 software were used to analyze the related target genes.Results miRNA microarray identified 11 PDAC related miRNAs,among them,the expressions of miR-194*,miR-192*,miR-602,miR-194 were up-regulated,while the expressions of miR-139-3p,miR-513a-5p,miR-630,miR-30c-1 *,miR-887,miR-508-5p,miR-516a-5p were down-regulated.The expressions of miR-192,miR-194 and their homolog were verified in 31 PDAC tumor tissues.After software analysis,it was found that target genes of miR-192 were ZEB2,CXCL-2,EEF1A1,ERCC3,and target genes of miR-192 * were DCC,SMAD4,FAS,and target genes of miR-194 included DACHI,IGSF11,PTPN2,RBBP4,while target genes of miR-194 * included CD40LG,CIDEB,FHL1.Conclusions Eleven differentially expressed miRNAs are present in PDC,and they may be involved in the occurrence and development of PDC.

Experience of problem-based learning of pathological experiments teaching in clinical medicine eight-year program / 中华医学教育探索杂志

Pathologic experiment teaching is special feature and stresses morphologic teaching,It is easy for stuents to learn passively.Problem-basedlearning ( PBL ) was introduced in pathologic experiment teaching in eight-year clinical medicine.program courses.In pathologic experiment class,questions was produced by analyzing various diseases,observing macroscopic and microscopic changes,discussed by clinical cases and solved by students themselves with bilingualistic teaching.In conclusion,PBL was significant in improving the quality of pathological experiment teaching,overcoming the shortage of morphologic learning,and making students more active in learning pathology.

Pathologic study on the perineural invasion in 513 cases of pancreatic cancer / 中华胰腺病杂志

Objectives To investigate the characteristics of neural invasion of pancreatic cancer as well as its relationship with other clinicopathological factors. Methods The neural invasion situation of 491 cases of ductal adenocarcinoma and other 22 pancreatic malignancies, 41 cases of benign tumor of pancreas and 21 cases of chronic pancreatitis was observed under light microscope, and its relationship with other clinicopathological factors was analyzed. Results The rate of neural invasion in ductal adenocarcinoma (74%) was much higher than in other types of pancreatic neoplasm (23% ,P ＜ 0.01). Pancreatic ductal adenocarcinoma cell often invaded through peripheral nerve membrane into inner nerve fiber bundle, sometimes even invaded the whole cross-sectional nerve fiber. But neural invasion was not associated with differentiation of the tumor. The occurrence of chronic inflammation in the para-tumoral pancreas (52%) was also higher than that in other types of malignant (14%) or benign lesions (15% ,P ＜0.01). Lymphocytes neural invasion rate in pancreatic ductal adenocarcinoma was 65%, which were significantly higher than those in other types of malignant (36%) or benign lesions (22%, P ＜ 0.01). Neural invasion rate in pancreatic ductal adenocarcinoma was associated with paratumoral chronic pancreatic inflammation and lymphocytes neural invasion, but not with lymph node metastasis. Conclusions Neural invasion was characteristic biological behavior in pancreatic ductal adenocarcinoma.

Chemotherapy of pancreatic cancers by drug sensitivity test in vitro / 中华胰腺病杂志

Objective To investigate the effect of cancer drug sensitivity on the selection of chemotherapy for pancreatic cancer. Methods The cells from the cancer tissues of 156 pancreatic cancer patients were cultured with 6 kinds of chemotherapy drugs in vitro including gemcitabine (GEM), 5 fluorouracil (5-FU), Mitomycin C (MMC), Oxaliplatin (L-OHP) and irrinotecan (CPT-11), according to the in vitro standard of solitary tumor. More than 70% of inhibitory rate was highly sensitive, 50% ～ 70% was moderately sensitive, ＜ 50% was insensitive. The inhibitory rate of chemotherapy drugs were determined by MTT colorimetric assay. Results The pathological findings of the 156 cases of pancreatic cancer were pancreatic duct cancer in 135 cases, adenosquamous carcinoma in 13 cases, mucinous carcinoma in 8 cases.Pancreatic duct cancer was sensitive to all the 6 drugs; adenosquamous carcinoma and mucinous carcinoma was sensitive to all the drugs except for L-OHP and CPT-11, respectively. The inhibitory rate of GEM was higher than that of MMC, L-OHP and CPT-11 (P ＜ 0.05 ) , but there was no difference with 5-FU and DDP ( P ＞0.05 ). There was no difference among the other 5 drugs (P ＞ 0.05 ). However, the cells from different types of pancreatic cancers and the cells from different patients of the same type of pancreatic cancer have different sequence of sensitivity to the 6 kinds of chemotherapy drugs. For pancreatic duct cancer, the sequence of sensitivity was GEM ＞ DDP ＞ 5-FU ＞ CPT-11 ＞ MMC ＞ L-OHP; adenosquamous carcinoma was GEM, CPT-11 ＞ DDP, 5-FU, MMC ＞ L-OHP; mucinous carcinoma was L-OHP ＞ GEM ＞5-FU, MMC ＞ DDP ＞ CPT-11.Conclusions Cancer drug sensitivity test may help to select the fight chemotherapy and be of clinical value.

Research on influence of repair with tissue engineered tendon of vitreous cryopreservation on ultrastructure of Achilles tendon defect / 生物医学工程学杂志

By observations of the features of ultrastructure changes in the tissue engineered artificial tendon of vitreous cryopreservation, we investigated the repairing effect of tendon after an in-vivo implantation and hence we provided an important theoretical and experimental basis for the vitreous cryopreservation and application of tissue engineered artificial tendon. After vitreous cryopreservation, the implantation materials of tissue engineered artificial tendon dynamically constructed in vitro were implanted in rats for reparation of the tendon defect. A scanning electron microscope was used. At the 2nd week, the materials presented a reticular formation and there were juvenile tendon cells among materials. At the 6th week, materials were already degraded and absorbed, and then were substituted by neonatal tendon cells and collagen fibers. At the 8th week, dense tendon tissues containing uniform tendon cells and collagen fibers were found already formed; the density of collagen fibers significantly increased with time. Using a transmission electron microscope at the 2nd week, we found active proliferation of tendon cells; most of them were immature cells with a complete nuclear membrane, clear nucleolus and little collagen fibers. At the 6th week, tendon cells were more mature with a little-sized, deep-stained nucleolus surrounded by plenty of collagen fibers with complete fiber structure and clear cross striation. There was no significant difference between the two groups. Using an electron microscope, we found a very good agreement in observation of the tissue engineered artificial tendon after the in-vivo implantation in two groups. Neonatal tendon cells and collagen fiber tissues grew well and are in a similar form and order when compared versus normal tendon tissues. This proved that vitreous cryopreservation has no significant influence on the function of tendon cells. The neonatal tissue-engineered tendon exerts good function of growth and repair.

Early detection and evaluation of waste through sensorized containers for a collection monitoring application.

The present study describes a novel application for use in the monitoring of municipal solid waste, based on distributed sensor technology and geographical information systems. Original field testing and evaluation of the application were carried out in Pudong, Shanghai (PR China). The local waste management system in Pudong features particular requirements related to the rapidly increasing rate of waste production. In view of the fact that collected waste is currently deployed to landfills or to incineration plants within the context investigated, the key aspects to be taken into account in waste collection procedures include monitoring of the overall amount of waste produced, quantitative measurement of the waste present at each collection point and identification of classes of material present in the collected waste. The case study described herein focuses particularly on the above mentioned aspects, proposing the implementation of a network of sensorized waste containers linked to a data management system. Containers used were equipped with a set of sensors mounted onto standard waste bins. The design, implementation and validation procedures applied are subsequently described. The main aim to be achieved by data collection and evaluation was to provide for feasibility analysis of the final device. Data pertaining to the content of waste containers, sampled and processed by means of devices validated on two purpose-designed prototypes, were therefore uploaded to a central monitoring server using GPRS connection. The data monitoring and management modules are integrated into an existing application used by local municipal authorities. A field test campaign was performed in the Pudong area. The system was evaluated in terms of real data flow from the network nodes (containers) as well as in terms of optimization functions, such as collection vehicle routing and scheduling. The most important outcomes obtained were related to calculations of waste weight and volume. The latter data were subsequently used as parameters for the routing optimization of collection trucks and material density evaluation.

Municipal solid waste management in Pudong New Area, China.

The increase in population, the rapid economic growth and the rise in community living standards accelerate municipal solid waste (MSW) generation in developing cities. This problem is especially serious in Pudong New Area, Shanghai, China. The daily amount of MSW generated in Pudong was about 1.11 kg per person in 2006. According to the current population growth trend, the solid waste quantity generated will continue to increase with the city's development. In this paper, we describe a waste generation and composition analysis and provide a comprehensive review of municipal solid waste management (MSWM) in Pudong. Some of the important aspects of waste management, such as the current status of waste collection, transport and disposal in Pudong, will be illustrated. Also, the current situation will be evaluated, and its problems will be identified.

Expression of P33ING1 in stomach cancer and its clinical significance / 第二军医大学学报

Objective:To discuss the pathological relationship between P33ING1 and stomach cancer and its clinical significance. Methods: In 71 cases of stomach cancer specimen, twelve cases of gas tric mu cous membrane atypical hyperplasia tissues and 18 cases of normal gastric mucous membrane tissue（as control）,the expression of P33ING1 were detected b y EnVision immunohistochemical method,while the expression of P53 and Bcl -2 in stomach cancer were also detected. Results: P33IN G1 expression in mucous membrane atypical hyperplasia group and control group was positive, the expression in stomach cancer group was extremely low(62.0%，44 /71), significantly different from the other 2 groups(P<0.01).P33ING1 expression in stomach cancer was related to the tumor growth, lymph node meta s tasis and tumor polarization (P<0.01), P53 expression was related to tumor s ize, growth and lymph node metastasis (P<0.01). Bcl-2 expression was relate d to lymph node metatasis and tumor polarization.The expression of P33ING1 was related to that of P53 in stomach cancer(P<0.05),while had no relation with that of Bcl-2.Conclusion:P33ING1 may play an importa nt role in the occurrance and development of stomach cancer.It's very important to detect the expression of P33ING1 and P53 simultaneously.