Objective: To study the cause and treatment of postoperative chylothorax in esophageal cancer patients.Methods: The operative procedure and postoperative thoracic drainage volume(PTDV) of the patients with postoperative chylothoreax were analyzed.The cause and treatment of postoperative chylothorax were reviewed.Results: Postlateral thoractomy was performed in all 13 cases.Esophageal gastric layer by layer anastomoses were performed in all cases.The sites of anastomoses were above the aorta arch in 12 cases,and below the arch in 1 case respectively.Post-operative pathology showed squamous carcinoma in 13 cases.TNM: T1 2 cases,T2 3 cases,T3 8case;N0 8 cases,N1 5 cases,M0 13 cases.PTDV was 320~1530 ml/d(mean:560ml/day).Albumin: 30~210g.The volume of plasma was 1000~8000ml.The length of time of surgical intervention from esphageal surgery was 9~21 days.Ligation of the thoracic duct was used in 9 cases.The treatmenrt was conservative in 4 cases.All patents were discharged without recurrent chylothorax.Conclusions: It is easy to damage the thoracic duct in the sites of invading,post and above aorta arch.It could partly avoid the thoracic duct damage by good exposure.PTDV is more than 500ml/day,and if the symptom lasts over one week,surgical intervention should be considered.

In order to study the significance of FasL expression in immune escape of breast cancer, FasL protein expression and the number of tumor-infiltrating lymphocytes (TILs) in 40 specimens of breast cancer were detected by immunohistochemitry. The expression of FasL mRNA was measured by in situ hybridization in the consecutive tissue slices of 40 breast cancers respectively. By using terminal deoxynucleotidyl transferase-mediaed dUTP nick end labeling (TUNEL), apoptotic cells were detected in 40 specimens of breast cancer. The expression of FasL was detected in all 40 specimens to varying degrees. In the consecutive tissue slices, the location of expression of FasL protein corresponded with that of FasL mRNA. In those with FasL extensive expression, the number of TILs was less (P<0.05), the apoptotic index (AI) of TILs was higher and the AI of tumor cells was lower (P<0.01) than those with FasL weak expression respectively. The AI of TILs was correlated with that of tumor cells (r= -0.629, P<0.01). In conclusion, breast cancer cells can induce the apoptosis of TILs through the expression of FasL, which can counterattack the immune system. This may be a mechanism of immune evasion in breast cancer.

Objective To observe the effects of camellia oil on the development of allergic contact dermatitis in mice. Methods Mice models of allergic contact dermatitis were established with dinitrofluo-robene (DNFB). Then, certain concentrations of camellia oil and halcinonide were used topically on the ears of mouse models twice daily for 6 days. Skin specimens were obtained from the treated ears and subjected to histology examination and pathological analysis. RT-PCR was performed to detect the mRNA expressions of interleukin 2 (IL-2) and interferon γ (IFN-γ) in the skin tissues. Results Allergic contact dermatitis was successfully induced by DNFB in mice with a marked increase in the mRNA expression of IL-2 and IFN-7. There was a slight decrease in the ear swelling degree, inflammatory reaction intensity, number of infiltrating inflammatory cells, and pathological severity in camellia oil-treated mice and halcinonide-treated mice compared with glycerinetreated mice. Camellia oil and halcinonide also induced different degrees of reduction in the mRNA expression of IL-2 and IFN-γ in inflammatory tissues. Conclusion Camellia oil can alleviate the pathological damage and down-regulate the expression of IL-2 and IFN-7 in mice with DNFB-induced allergic contact dermatitis.

Objective To evaluate the prognostic factors for survival in patients with renal pel-vic and ureteral carcinoma. Methods The clinical data of 220 patients with renal pelvic and/or ure-teral carcinoma were retrospectively analyzed. One hundred and forty-six cases were males and 74 ca-ses were females. Age ranged from 38 to 84 years. One hundred and three cases were renal pelvic car-cinoma, 84 cases were carcinoma of ureter, 13 cases were renal pelvic carcinoma with carcinoma of u-reter, 5 cases were renal pelvic carcinoma with bladder cancer, 11 cases were carcinoma of ureter withbladder carcinoma, and 4 cases were renal pelvic carcinoma with carcinoma of ureter and bladder carci-noma. For TNM stage, there were 2 cases in T., 116 cases in T1, 48 cases in T2,37 cases in Ta and 17 cases in T,. For WHO grade, there were 5 cases with grade Ⅰ tumor, 87 cases with grade Ⅱ tumor and 128 cases with grade Ⅲ. Multivariate analyses were done using logistic analysis and Cox proportional hazards regression model with Kaplan-Meier method, Log-rank test and Gehan test, re-spectively. Results The 5-year survival rates of Ta--T1,T2,T3,T4cases were 80.5%(95/118), 70.8%(34/48), 45.9%(17/37) and 17.6%(3/17), respectively. Survival rates were significantly different in patients with tumor stage Ta-T1,T2and patients with tumor stage T3-T4 (u=9.429, P=0.002). There was no significant difference between survival o{ ureterorenoscopic surgery group and other operation group(x2=0.217,P=0.641). The factors affected survival were age (RR= 1.639,P=0.027), time of initial symptoms to operation (RR=1.279, P=0.019) and clinical stage of the tumor (RR=1.373,P=0.011). Logistic regression analysis showed that the factors influencing the recurrence of bladder carcinoma ineluded multi-site growth(RR=11.292,P=0.003)and coexisting bladder careinoma (RR=8.780,P=0.001). Conclusions Age, time of initial symptoms to opera-tion and the stage of the tumor are the important predictors affecting the prognosis of the renal pelvic and ureteral carcinoma. Multi-site growth and coexisting bladder carcinoma are important risk factors having impact on the recurrence of bladder carcinoma.

Objective To investigate the changes of molecular markers in cultured skin stem cells exposed to UVB in vitro. Methods Skin stem cells were isolated and cultured according to their adherasion ability,and identified by immunohistochemistry using anti-K15 and anti-β-integrin antibodies. Then, a part of the skin stem cells were irradiated with UVB at 10 mJ/cm2 for 2 times. After 24-hour additional culture, the expressions of CD34, beta-catenin and p53 were detected with immunohistochemistry. Results Skin stem cells showed a high density in culture free of irradiation, which were round or polygon with a clear shape, well-distributed cytoplasm, high N/C ratio; mitotic cells could be seen. In unirradiated skin stem cells, beta-catenin was expressed predominantly in cell membrane and cytoplasm, with a positive expression rate of 64.74% and 8.4%in membrane and cytoplasm respectively; p53 was expressed mainly in cell cytoplasm and nuclei, with a positive expression rate of 6.9% in cell nuclei. After exposure to UVB, skin stem cells decreased in cell density and N/C ratios with a deformed and anomalous shape, vacuoles were present in cytoplasm, and some cells experienced karyopyknosis or apoptosis. Additionally, in irradiated cells, beta-catenin was expressed predominantly in cytoplasm with a positive expression rate of 64.74% and 0 in cytoplasm and nuclei, respectively; p53 was expressed mainly in nuclei with a positive expression rate of 100%. CD34 was detected in neither unirradiated nor irradiated skin stem cells. Conclusion UVB can promote beta-eatenin to accumulate in cytoplasm as well as beta-catenin and p53 to migrate from cytoplasm to nuclei.

Objective To observe the effect of early enteral nutrition on the recovery and stress reaction after the operation of colon carcinoma.Methods 93 patients with colon carcinoma were divided into enteral nutrition group and parenteral nutrition group.Patients of EN group were given nutrition preparation through the jejunal nutrient canal beginning in the first day after operation and reduced the venous support gradually.Those of PN group were given parenteral nutritional supports from the the first day after operation until oral feeding.Results There were no significant differences between the EN group and PN group in the nutritional status.Both the first postoperative anoretum exhaust time and defecation time(52.9 ± 17.6;67.2 ± 9.3) h in group EN were less than that(71.4 ± 13.8;83.6 ± 10.1) h in group PN,there were significant differences between two groups(t = 2.58,3.56,all P＜0.05).The CRP in EN group after operation was obviously lower than preoperation(P＜0.05).Conclusion The early enteral nutrition could lower the stress reaction and promote the recovery of gastrointestinal tract function.

Objective:To observe the clinical efficacy of tuina on infantile diarrhea.Method:Sixty-two cases were classified into five subtypes:diarrhea due to food injury,wind-cold,damp-heat,spleen deficiency and yang deficiency of the spleen and kidney.The manipulations including separating hand yin-yang,kneading the general tendon,pushing spleen-earth,transporting external Bagua,rubbing the abdomen,pressing Zusanli (ST 36),kneading Guiwei and pinching the spine were applied once a day.Result:After the treatments of 3 to 30,35 cases got recovery,21 got marked effect,and 6 got improvement.Conclusion:The infantile tuina treatment is effective for infantile diarrhea.

The bulge of hair follicles contains a mixed population of stem cells,including epidermal stem cells,neural crest stem cells,as well as another type of stem cells which can be induced into melanocytes.Bulge stem cells have the ability to divide,proliferate and are pluripotent as other adult stem cells.The neural crest stem cells can differentiate in vitro into neurons,glia and melanocytes under proper induction.Meanwhile,it was proved that implanting these cells into the gap region of damaged nerves could greatly enhance the regeneration rate of nerve and restoration of nerve function.In this review,distribution of the stated stem cells in hair follicle bulge and their characteristics of differentiating into neurons were discussed,as well as their possible application in regenerative medicine.

Objective To analyze the biochemical effect of cryosugery on residual bronchial tissue and the adjacent organs in dogs. Methods Bronchial stumps of 18 dogs after lobectomy and the adjacent tissues and organs(including 4 samples of esophagi, 3 diaphragms, 3 stomachs, 2 livers, 7 tracheae and 3 superior saphenous vein sinuses) of 22 dogs after thoracectomy were frozen. The observation from 1～212 d was conducted after surgery. Results Cryonecrosis and fibrosis were found in all 18 samples of the frozen bronchial stumps, but no fistula of bronchial stump was found. Three cryodamaged esophagi in 4 dogs developed fine sheet of fibrous membrane like scars in the situs of cryosurgery. Perforation was found in 2 dogs, one in the esophagus, another in stomach. No perforation was found in dogs with diaphragm cryosurgery. Cartilaginous ring disappeared in 7 dogs by cryosurgery of the trachea and a membrane like scar developed in the inner wall of trachea. There were yellow scars on the liver after cryosurgery. Conclusion Exfoliation of the necrotic tissues is slow due to the slowly developed cryonecrosis and good tolerance to cryosurgery of the fibrotic tissues. The original construction disappears but fibrosis develops. At the edge of cryo necrotic area, proliferation of capillary can be found.

Arytenoid Cartilage ; pathology ; Humans ; Laryngeal Neoplasms ; diagnosis ; pathology ; Neoplasm Invasiveness ; diagnosis ; Neoplasm Staging