Localization and quantitation of GnRH, somatostatin (SS), and ?-endorphin (?-EP) in human placentalvilla were studied using immunogold-silver staining method. GnRH and SS immunoreactive positive substance existed in the cytotrophoblasts of many placental villi and in syncytiotrophoblasts of few placental villi, ?-EP immunoreactive positive substance localized in syncytiotrophoblasts of many placental villi and in cytotrophoblasts of few placental villi. These results suggest that the cytotrophoblasts and syncytiotrophoblasts are able to synthesize these three kinds of regulatory peptides, however, SS and GnRH may be synthesized mainly in the cytotrophoblasts, ?-EP mainly be synthesized in the syncytiotrophoblasts. The amount of GnRH and ?-EP in placenta villi show obvious change with progress of pregnancy. This change show a negative relationship between the GnRH and ?-EP, which suggested that there may be a functional reciprocal inhibition between the GnRH and ?-EP.

Objective To assess the safety and efficacy of an olive oil-based lipid emulsion for parenteral nutrition in patients after esophagectomy.Methods In the randomized controlled trial,60 patients undergoing esophagectomy were divided into study group(n=30,received olive oil-based lipid emulsion)and control group [n=30,received medium-chain triglyceride/long-chain triglyceride(MCT/LCT)emulsion].The parenteral nutrition Was provided for 7-10 postoperative days.The nutritional formulas were equivalent in nitrogen,calorie,osmotic pressure,and fluid volume.Peripheral venous blood tests were performed before operation and on the first and eighth postoperative days.All the patients were evaluated by nutritional status(weight,body mass index,nutritional risk screening,etc.),safety profiles[full blood test,electrolytes,aspartate aminotransferase(AST),alanine amiotransferase(ALT),total bilirubin and direct bilirubin,blood urea nitrogen(BUN),creatinine,blood glucose,etc.],and efficacy indicators(hemoglobin,albumin,total protein,etc.).Results The albumin and total protein levels returned to the normal ranges in beth groups 8 days after operation,although both levels were significantly higher in study group(P=0.000).Also,the difference of total protein levels between the eighth and first postoperative days Was significantly higher in the study group(P=0.002).In addition,the AST and BUN readings returned to normal ranges 8 days after operation in the study group, which were significantly lower than those in control group (P = 0.025, P = 0.013).No serious adverse events were reported in both groups.Other nutritional parameters, renal and hepatic safety profiels, vital signs, and hematology showed no significant difference between two groups.Conclusions Olive oil-based lipid emulsion is a safe and efficient lipid emulsion for parenteral nutrition in patients undergoing esophagectomy.Compared with MCT/LCT, it has less effect on AST and BUN.

Objective To investigate the features of lymph node metastasis and its effects on the prognosis of patients after radical operation for thoracic esophageal squamous cell cancer, and investigate the reasonable postoperative adjuvant protocol. Methods Multivariate analysis of the clinical data of 204 patients was carried out by Spearman correlation analysis, Cox model and Kaplan-Meier method. Results The lymph node metastasis rate was 40.2% (82/204), and 166 out of 2193 dissected lymph nodes had metastasis with the rate of 7.57%. The analysis of related factors revealed that the invasion depth, tumor length and differentiation grade were significantly associated with the postoperative lymph node metastasis (χ2 = 17.466, 11.494, 6.767, P <0.05), while age, tumor site were not significantly correlated with the postoperative lymph node metastasis (χ2=1.086, 3.897, P > 0.05). Kaplan-Meier analysis showed that the 1-, 3-, 5-year survival rates of patients with < 4 lymph nodes metastasis were significantly higher than those with ≥4 lymph nodes metastasis (χ2=4.493, 4.494, 4.450, P < 0.05). The recurrence and metastasis were more often occurred in patients with lymph node metastasis compared with those without lymph node metastasis (r=-2.060, -4.296, P <0.05). Multivariate analysis confirmed that the pathological stage, tumor differentiation grade, and the postoperative adjuvant treatment were the independent prognostic factors. Conclusions The invasion depth, tumor length and differentiation grade are significantly associated with the postoperative lymph node metastasis. The lymph node metastasis state and the number of involved lymph nodes affect the prognosis of patients. Oral administration of 5-FU is benefit to the patients without lymph node metastasis.

Objective To build a bio-material artificial chest wall and discuss its feasibility and efficiency in reconstruction of huge bony defects of chest wall in mongrels in comparison with traditional "sandwich" procedure. Methods (1) The procine osteal and membranate tissues were treated with epoxy cross linking method and their surfaces were modified with amino acid solutions at various concen-trations and at different temperatures to obtain an artificial pleura and artificial ribs for construction of the artificial chest wall. (2) The huge bony defects (5 cm×5 cm) were created in chest wall of five Chinese mongrels. (3) Three mongrels in test group was repaired with artificial chest wall, while two mongrels in control group was repaired with traditional "sandwich" complex. A follow-up was carried out to observe reconstruction effect and rejection in both groups at 3,6 and 12 months after implantation. Results There was no death found during the perioperative period and at 12 month follow-up in test group, with abnormal contour of chest wall and good thoracic activity after reconstruction. In the meantime, there found no rejection, collapse in the repaired region or paradoxical respiration. The postoperative X-rays at 3,6,12 and 24 months showed a good integrity of the thorax, with no collapse, deformation or abnormal movement. Meanwhile, the follow-up of control group showed a normal contour but slight collapse, with no paradoxical respiration. The Chest X-ray examination revealed that the bone cement in" sandwich" complex was X ray opaque and showed mild abnormal movement with breathing. The common blood test and immune items showed no abnormal. Conclusions The bio-material artificial chest wall is a safe and effective reconstruction technique for bony defects of thoracic wall in mongrels, with no acute or chronic rejection.

Heart ; Heart Transplantation ; Humans ; Lung

Objective To study the significant immunohistochemical marker to identify lung adenocarcinoma(ADC) and squamous cell carcinoma(SCC).Methods Three hundred and twenty-nine Choose 329 cases of nonsmall-cell lung cancer (NSCLC) were chosen.Analysis of the clinical and pathological features.The expression of cell keratin 7 (CK7),thyroid transcription factor-1 (TTF-1),Napsin A,CK5/6,p40 and p63 were detected by using immunohistochemistry.Results (1) Among 329 specimens,containing 129 cases of resections,195 cases of biopsies and 5 cases of pleural effusion specimens.(2)In these cases,187 cases were classified to be ADC,142 cases were classified to be SCC.(3) CK7,TTF-1,Napsin A,CK5/6,p40,p63 sensitivity were 97.9％,87.2％,81.3％,6.4％,3.7％,18.7％ in ADC groups,and 25.4％,11.3％,0,92.3％,95.1％,98.6％ in SCC groups,and the differences of two groups were significant statistically (x2 =190.665,187.432,214.542,242.003,274.407,206.818;P＜ 0.001).(4) In the 3 IHC of ADC,CK7 had the highest sensitivity,Napsin A had the highest specificity.In the 3 IHC of SCC,p63 had the highest sensitivity,p40 had the highest specificity.Conclusion CK7,TTF-1,Napsin A,CK5/6,p40 and p63 can be a markable panel of immunohistochemistry in the differential diagnosis of NSCLC.

BACKGROUNDBecause invasion and metastasis of cancer threaten seriously human's life, it is of more important clinical significance to understand and evaluate the biologic behavior of can-(cer) correctly. Abnormal expression of E-cadherin and β-catenin plays important roles in invasion and metastasis of cancer. The objective of this study is to investigate their expression in non-small cell lung cancer (NSCLC) and to find out their correlation with histological type, cell differentiation, metastasis and prognosis of NSCLC.

METHODSThe expression of E-cadherin and β-catenin was detected in 129 NSCLC tissues by high sensitive S-P immunohistochemical method.

RESULTSThe abnormal expression rate of E-cadherin and β-catenin was 62.0% and 65.1% respectively. The abnormal expression rate of E-cadherin in squamous cell carcinoma was much higher than that in adenocarcinoma (P < 0.05). The abnormal expression rate of E-cadherin and β-catenin in poorly differentiated cells was significantly higher than that in well and moderately differentiated cells (P < 0.05, P < 0.05). Stage III/IV NSCLC showed markedly higher abnormal expression rate of E-cadherin and β-catenin than stage I/II NSCLC did (P < 0.01, P < 0.01). The abnormal expression rate of E-cadherin and β-catenin in patients with lymphatic metastasis was significantly higher than that in those without lymphatic metastasis (P < 0.05, P < 0.01). The mean survival duration and 5-year survival rate in patients with normal E-cadherin and β-catenin expression were remarkably higher than those in patients with abnormal expression (P < 0.05, P < 0.01).

CONCLUSIONSThe abnormal expression of E-cadherin and β-catenin is closely related to histological type, differentiation and metastasis in NSCLC. Detection of their expression might be helpful to predict prognosis of NSCLC.

Objective:To analyze the relationship between the circumferential resection margin status and prognosis and clinicopathological features of esophageal squamous cell carcinoma.Methods:The information of esophageal squamous cell carcinoma patients who underwent radical resection at the Fourth Hospital of Hebei Medical University from October 2017 to March 2019 were collected. All patients were diagnosed with advanced squamous cell carcinoma by postoperative pathology. Demographic data including sex, age, T stage, N stage, tumor location, lesion length, gross pathological type, vascular tumor embolization, nerve invasion and circumferential resection margin were collected and analyzed. The circumferential resection margins were evaluated using the College of American Pathologists(CAP) criteria. A total of 328 cases were included in this study according to the inclusion criteria. Using SPSS 20.0 statistical software, univariate survival analysis was assessed by Kaplan- Meier survival curves, survival curves were compared using Log- rank tests, and multivariate analysis was carried out by Cox regression. The Fisher exact and Chi- square tests were used to compare counting data. Results:As of the follow-up date, the 1-year and 2-year overall survival rates of 328 patients with esophageal squamous cell carcinoma were 91.9% and 84.8%, respectively. The median overall survival was 16 months(range 2-25 months). Univariate analysis showed that T stage, vascular embolism and nerve invasion were the influencing factors of overall survival, multivariate analysis showed that nerve invasion was an independent risk factor for overall survival, stratified analysis showed that the circumferential resection margin was related to overall survival in patients less than 60 years old( P=0.006), patients with ulcerative type of gross pathology( P=0.002) and patients with tumor length ≥4 cm( P=0.046). The 1-year and 2-year disease-free survival rates of the whole group were 89.7% and 67.8%, respectively. The median disease-free survival was 16 months(range 2-25 months). Univariate analysis showed that N stage was the influencing factor of disease-free survival in patients with esophageal squamous cell carcinoma, and stratified analysis showed that the disease-free survival rate of patients with ulcerative type( P=0.002), tumor length ≥4 cm( P=0.015) and circumferential resection margin negative group were better than that of circumferential resection margin positive group. There were 66 patients with positive circumferential resection margin in the whole group, and the positive rate of circumferential resection margin was 20.1%. Univariate analysis showed that T stage, N stage, vascular embolism, nerve invasion and gross pathological type were the influencing factors of circumferential resection margin, while multivariate logistic regression analysis showed that T stage, vascular embolism and gross pathological type were the influencing factors of circumferential resection margin. Conclusion:According to CAP criteria, circumferential resection margin is not related to the prognosis of patients with esophageal squamous cell carcinoma.Positive circumferential resection margins of esophageal squamous cell carcinoma correlate with T stage, vascular embolism, and gross pathologic type, but not with other clinicopathologic features.

Objective To study the expression of amplified in breast cancer 1 (AIB1) protein in the tissues of ovarian carcinoma and its relationship with clinicopathological factors,and to analyze the predictive value of AIB1 in clinical prognosis of patients with ovarian carcinoma.Methods Immunohistochemistry was used to detect the expression of AIB1 protein in the tissues of 112 patients with ovarian carcinoma,and compare the AIB1 protein expression levels of patients with various clinicopathological features.The survival analysis was conducted by Kaplan-Meier method.The multivariate analysis was performed to explore the relationship between the expression of AIB1 protein and clinical prognosis of the patients with ovarian carcinoma.Results The positive expression rate of AIB1 protein in the tissues of ovarian carcinoma was 67.9％ (76/112).The positive expression rate of AIB1 protein was associated with the degree of the tumor differentiation (x2 =32.483,P ＜0.001) and the International Federation of Gynecology and Obstetrics (FIGO) staging (x2 =14.324,P ＜0.001),but not with the age (x2 =0.001,P =0.989) or pathological type (x2 =0.106,P =0.745).Compared with the patients with the higher expression of AIB1,the median disease-free survival of patients with the lower expression of AIB1 was longer (48.7 months vs.36.7 months,x2 =3.026,P =0.022),and there was also extended trend in the median overall survival (60.2 months vs.43.6 months,x2 =0.916,P =0.055).The multivariate survival analysis showed that FIGO staging (RR =3.396,P =0.021) and AIB1 expression status (RR =1.407,P =0.049) were independent prognostic factors affecting the survival of patients.Conclusion The overexpression of AIB1 protein is correlated with the degree of differentiation and FIGO staging.Patients with a high expression of AIB1 have poor predicted prognosis.The expression of AIB1 protein can be considered as one of the prognostic indicators in the patients with ovarian carcinoma.

Objective To compare the therapeutic effects between three-dimensional conformal radiotherapy (3DCRT) and intensity-modulated radiotherapy (IMRT) in patients with stage Ⅱ/Ⅲ esophageal cancer and investigate the prognostic factors.Methods Medical record of 2 132 patients with stage Ⅱ/Ⅲ esophageal cancer who underwent definitive radiotherapy with/without chemotherapy in 10 hospitals from January 2002 to December 2016 from were retrospectively analyzed.Among these patients,37.9％ of them were aged ≥ 70 years,33.9％ with neck and upper esophageal tumors and 66.1％ with middle and lower esophageal and borderline tumors.The median gross tumor volume (GTV) and lymph node gross tumor volume (GTVnd) was 41.6 cm3.Among them,32％ were stage Ⅱ] and 68％ were stage Ⅲ.A total of 723 patients received 3DCRT and 1 409 cases received IMRT.Patients received an equivalent dose in 2 Gy (EQD2) ≥ 60 Gy accounted for 86.1％,and 41.1％ of them received concurrent chemoradiotherapy.Results The median follow-up time was 60.8 months.The 1-,3-and 5-year overall survival (OS) of all patients was 73.9％,41.7％ and 32.6％,and the 1-,3-and 5-year progression-free survival (PFS) was 62.2％,37.3％ and 32％,respectively.Multivariate analysis demonstrated that age,primary tumor location,clinical stage,tumor target volume,EQD2 and concurrent chemoradiotherapy were the independent prognostic factors for OS.Age,primary tumor location,clinical stage,tumor target volume and EQD2 were the independent prognostic factors for PFS.The OS and PFS did not significantly differ among the low-risk,low-/moderate-risk,moderate-/high-risk and high-risk groups according to age≥70 years,tumor diameter＞5 cm,tumor volume ≥41.6 cm3 and stage Ⅲ (P＜0.001).After the propensity score matching (PSM) method,neither 3DCRT nor IMRT yielded significant advantages in OS or PFS (P=0.971;P=0.658).However,IMRT tended to yield survival benefits in low-risk patients (P=0.125).Conclusions Both 3DCRT and IMRT yield relatively high OS rate in patients with stage Ⅱ/Ⅲ esophageal cancer.The prognosis model established in this investigation can properly predict the survival of patients.Low-risk patients tend to obtain survival benefits from IMRT.