The.progress in diagnosis and surgical treatment of gastric cancer contributes to the raised diagnosis rate and 5-year survival rate of gastric cancer patients in Japan. According to the clinical data of 273 142 Japanese gastric cancer patients from 1962 to 1991, the proportion of patients with stage I gastric cancer was increased from 22.5% to 58.1%, and the accumulative 5-year survival rate from 37.5% to 68.8%. The improvement of the accumulative 5-year survival rate was remarkable for patients with stage Ⅱ gastric cancer (from 47.7% to 70.3%) and stage Ⅲ gastric cancer (from 26.4% to 45.0%).

Objective To explore the value of diagnosis and treatment of conization of cervix to cervical intraepithelial neoplasia(CIN)Ⅱ-Ⅲ grade.Methods The data of 76 patients diagnosed as CIN Ⅱ-Ⅲ grade through pre-operative multiple-punch biopsies from July 1st 2006 to June 30th 2007 was retrospectively analyzed.Compared the pathohistology and treatment methods before and after conization of cervix.Results Accordance rate of diagnosis in pre-operative cervical biopsies under vaginoscopy was 48.68%,pathological up-grade were 24 cases(31.58%),among invasive carcinomas were 8 cases(10.53%),pathological down-grade were 15 cases(19.74%).Conclusion Diagnostic cervical conization could enhance the rate of diagnosis,and prevent the omission of invasive carcinomas for the patients with CIN Ⅱ-Ⅲ grade.

Objective To study the application of percutaneous dilatational tracheostomy in the critical pa- tient. Methods Twenty eight critical patients performed percutaneous dilatational tracheostomy have been followed up in our hospital during 1996 - 2000, and the operating time, the perioperative complications and the following - up results were reviewed. Results all of the 28 patients were operated on successfully,no complication occurred dur- ing the operation , and little bleeding was observed, most of the patients have been followed up, the longest following - up period was 18 months, and the cosmetic effect was good. Conclusions The percutaneous dilatational tracheo- somy is a good less invasive surgical technique. It can meet the needs of the clinical tasks and worth to apply to some critical area.

Objective To observe the long-term effect of combined intestine/auxiliary liver transplantation in rat.Methods Male Lewis rats were used. Total small bowel and 60 % liver were transplanted en bloc with an aortic segment that contained the celiac axis and superior mesenteric artery ensuring the blood supply to the graft. The end-to-side anastomosis was made between donor infrahepatic vena cava (IHVC) and recipient IHVC. The recipient small bowel was resected and the intestine continuity was restored. Sham control (laporotomy only) and transplantation groups were included. Ten rats in each group were followed-up for 18 months and then sacrificed. Liver function tests, terminal deoxynuleotidyl transferase-mediated 2'-deoxyuridine 5'-triphosphate (dUTP) nick end labeling (TUNEL) staining and proliferating cell nuclear antigen (PCNA) staining of liver tissue were evaluated.Results Sixteen rats survived over the operation. There were no significant differences in liver function tests between the sham control group and transplantation group. The grafted liver was hypertrophic and native liver did not regenerate 18 months following transplantation with an increased liver/body weight ratio. TUNEL-staining showed no significant differences among grafted liver, native liver of the recipient rat in transplantation group and the liver of the rat in control group. PCNA-staining revealed that the native liver in transplantation group had a lower proportion of TUNEL-positive hepatocytes. Conclusion This experimental study confirmed the long-term consequences of combined intestine-auxiliary liver transplantation, and the results suggest that liver/body weight ratio can be increased.

Objective To investigate the level of serological interleukin 35 (IL-35) in breast cancer patients and its clinical significance.Methods From Jan 2015 to July 2016,serum of 55 patients with breast cancer were collected from a tertiary hospital of Nanjing.Their pathological stages were also analyzed,including 12 cases of stage Ⅰ,15 cases of stage Ⅱ,12 cases of stage Ⅲ,and 15 cases of stage Ⅳ.Meanwhile,serum from 54 healthy individuals also selected.The level of serological IL-35 was determined by ELISA,and the IL-35 level,pathological stage and tumor metastasis were analyzed by correlation a nalysis.Results The serum IL-35 in patients with breast cancer was significantly elevated than health individuals.With the increase in pathological stage,IL-35 level in breast cancer patients with stage Ⅲ and Ⅳ was significantly higher compared to patients with stage Ⅰ breast cancer (P＜0.05).Further,patients with breast cancer metastasis had increased level of IL-35,compared to breast cancer patients without tumor metastasis (P＜ 0.05).Finally,Spearman correlation analysis indicated that the serum level of IL-35 in patients with breast cancer was positlvely correlated with the pathological stages (r=0.390,P=0.004) and tumor metastasis (r=0.361,P=0.008) of the patients,respectively.Conclusion High level of IL-35 was detected in serum from breast cancer patients,and its expression was highly correlated with pathological stage and tumor metastasis.Detection of IL-35 could be applied as a valuable potential biomarker for the diagnosis of breast cancer.

Objective To investigate the causes and characterization of hepatic encephalopathy after transjugular intrahepatic portosystemic shunts(TIPSS).Methods 32 cases of patients with recepted TIPSS operation were enrolled in retrospective study.Results 9 of 32 patients suffered from hepatic encephalopathy were detected out after TIPSS. The present of hepatic encephalopathy was associated with the flow direction of blood in portvein after the operation(P

Objective To study the incidence,risk factors and prognosis of stroke-associated infection(SAI) in acute stroke patients.Methods 382 serial acute cerebral stroke patients were retrospectively surveyed.Results The incidence of SAI was 29.3% in all cases,mainly involved lower respiratory tract(63.0%) and urinary tract(28.4%).Escherichia coli,Coagulase negative staph and Streptococcus viridans were the main pathogenic organisms.Developments of SAI were closely related with aging,diabetes mellitus,the application of antimicrobial agents and invasive procedure.The mortality was 10.7%(12/112) in the cases with SAI,but 1.9%(5/270) in the cases without SAI.Conclusion SAI is caused by various factors in acute stroke patients.Controlling SAI can help to succeed in treating stroke.

ObjectiveTo investigate the expression and clinical significance of CD40 in the spleen of cirrhotic portal hypertension. MethodsExpression of CD40 was determined with S-P immunohistochemistry in spleen specimens from 50 cases of cirrhotic portal hypertension and 15 healthy individuals. ResultsThe CD40 positive rates in normal spleen and cirrhotic spleen were 86.7% and 36.0%, respectively. There was a significant difference between the 2 groups (P＜0.05). There was a negative correlation between the expression of CD40 and Child grades of liver function and cirrhotic splenic types(P＜0. 05). Conclusion CD40 might reflect the changes of splenic immune function,which might be one of more exact clinical examination indexes of splenic immune function.

BACKGROUND:Study on antisense drug is still one of hotspots in the current field of biomedicine. Due to high-efficiency and specificity, antisense drug used for gene therapy has been paid more attention by many scholars.OBJECTIVE: To observe the effect of liposome-mediated keratin 14 (K14) antisense oligonucleotide on K14 gene and protein expressions as well as in vitro proliferation activities in human keratinocytes (KC).DESIGN: Single sample observation.SETTING: Department of Dermatology, Xijing Hospital, Fourth Military Medical University of Chinese PLA.MATERIALS: Human KC, K14 oligonucleotide gene fragments (modified with phosphrothioate, and above sequence was synthesized by Shanghai Shenggong Bioengineering Company). Reverse transcriptase and TaqDNA polymerase were purchased from Invitrogen Company, K14 monoclonal antibody was purchased from Antibody Company, and SABC kit was purchased from Boster Company. EPICS-PRO-FILE Ⅱ flow cytometer was purchased from Coulter Company (USA).METHODS: Human epidermal KCs were primarily cultured, and their 3rd to 10th generations were used for the experiment.Artificially synthesized sense and antisense as well as mismatched K14 oligonucleotide gene fragments were introduced into KCs by means of liposome. Blank control group were set. The effects of antisense oligonucleotide on the cell cycle,K14 gene and protein expressions of KCs were detected by flow cytometer, reverse transcription polymerase chain reaction and SABC methods.MAIN OUTCOME MEASURES: Effect of oligonucleotide transfecting human KCs on the proliferation of KCs and K14 expression.RESULTS: [1]The electrophoresis of reverse transcription polymerase chain reaction products: Specific K14 gene band appeared in each group, and K14 gene expression in the antisense group was significantly lower in the sense group,missense group and blank control group. K14/β-actin value was similar among sense group, missense group and blank control group (P ＞ 0.05), But K14/β-actin value was significantly lower in the antisense group than in the above-mentioned 3 groups (F =47.554, P ＜ 0.01). ②K14 protein expression detected by immunohistochemical method:K14 was expressed in all the cultured KCs at different levels, and was obviously reduced after antisense oligonucleotide being added. 20 μmol/L antisense oligonucleotide could markedly inhibit K14 expression; K14 expression did not change in the control group. ③ DNA level change detected by flow cytometer: After being treated by K14 antisense oligonucleotide for 48 hours, human epidermal KCs were significantly increased at G1 stage (74.6%), and were markedly decreased at S stage (19.4%). Such changes were not found in the antisense group, missense group and blank control group.CONCLUSION: Antisense oligonucleotide can specifically inhibit K14 synthesis, and thereby, inhibit the proliferation of human KCs.

ObjectiveTo compare the clinical effects of laparoscopically assisted vaginal hysterectomy (LAVH) and transabdominal hysterectomy (TAH).MethodsOne hundred and twenty-six cases operated with hysterectomy were classified into LAVH group and TAH group by random digits table with 63 cases each.The operation time,intraoperative bleeding amount,exhaust time,hospitalization time and postoperative complications were observed and compared.ResultsThe operation time,intraoperative bleeding amount,exhaust time and hospitalization time was ( 115.6 ± 13.8 ) min,(92.5 ± 11.3 ) ml,(21.8 ±4.8) d and (6.1 ± 1.7) d in LAVH group,( 82.5 ± 8.7) min,( 112.3 ± 17.8) ml,(28.9 ± 6.2) d and (9.6 ±2.2) d in TAH group,there were significant differences between two groups (P＜0.05).The incidence of incision pain,delayed wound healing,vaginal stump infection,thrombophlebitis,and gastrointestinal disorders was 9.5％(6/63),0,1.6％(1/63),0 and 7.9％(5/63) in LAVH group,which was significantly lower than that in TAH group [52.4％(33/63),7.9％(5/63),11.1％(7/63),7.9％(5/63) and 22.2％ ( 14/63 ) ] (P ＜ 0.05).ConclusionCompared with TAH,LAVH can shorten exhaust time,hospitalization time,reduce intraoperative bleeding amount,decrease complication rate,which can be further applied in clinic.