Objective To investigate the clinicopathological features of primary gastric malignant lymphoma.Methods 32 cases of primary gastric non Hodgkin's malignant lymphoma(NHL)were studied by clinicopathology,immunohistochemistry and ultrastructure.Results 3 cases of NHL arose from fundus of stomach,7 cases from body of stomach,8 cases from gastric angle,and 14 cases from gastric antrum.The paraffin sections of all cases were stained.There were 31 cases(96\^9%)exhibiting B cell phenotype,only 1 case(3\^1%)exhibiting T cell phenotype.11 cases of NHL and 6 cases of undifferentiated carcinoma(UC)in stomach were observed comparatively under electron microscope(EM).The ultrastructural characteristics of NHL were much different from those of UC.Conclusion Most primary gastric malignant lymphoma are B cell lymphomas.Immunohistochemistry and ultrastuctural observation are much helpful in the diagnosis and differential diagnosis between NHL and UC.

Objective To evaluate the impact of mesoreetal margin micrometastasis on local recurrence of rectal carcinoma after total mesorectal excision, and the relation between mesorectal margin mierometastasis and local recurrence. Methods Mesorectal margin specimens from 52 cases of rectal cancer after total mesorectal excision were studied by reverse transcriptase-polymerse chain reaction (RT-PCR) to detect the expression of CK20 mRNA. These patients were divided into CK20 mRNA positive and negative group and followed up for 3 years until local recurrence developed. Results In 52 patients with rectal cancer,21 cases were found to express CK20 mRNA in mesorectal margin, the expression rate of CK20 mRNA in Dukes A,B and C was 17% ,30% and 54% (P<0.05), respectively. The positive rate of well differentiated, moderately differentiated, poorly differentiated and undifferentiated carcinomas were 43%, 38% ,40% and 50% ,respectively(P>0.05 ). The incidence of local recurrence in CK20 mRNA positive and negative group was 24% and 3% , respectively. The difference was statistically significant between the two groups (P <0.05 ). Conclusion Detection of mesorectal margin CK20 mRNA as micrometastasis by RT-PCR in rectal carcinoma patients was a sensitive and effective way in predicting local recurrence. It is necessary for patients with positive mesorectal margin CK20 mRNA to undergo postoperative radiotherapy after total mesorectal excision.

Objective To observe the effects of Hedan tablet on cytokines and oxidation factors in APOE-/-mouse, and to explore its effect on atherosclerosis and to explore its behind mechanism. Methods APOE-/-mice (n=50) were randomly divided into control group, model group, low dose Hedan tablet treatment group, high dose Hedan tablet treatment group and simvastatin treatment group. Mice in control group were given normal feed while mice in other groups were fed with high cho?lesterol diet. Hedan or Simvastatin was administrated intra-gastrically while normal saline was given to model group in the same route. After 12 weeks, mice were sacrificed to observe the mRNA level of tumor necrosis factor-α(TNF-αmRNA) in aorta by RT-PCR. Mean while, serum levels of interleukin-1 (IL-1), interleukin-10 (IL-10), malonaldehyde (MDA) and su?peroxide dismutase (SOD) were determined in different groups. Results Compared with control group, TNF-αmRNA tran?scription level as well as serum levels of IL-1 and MDA significantly increase while serum levels of IL-10 and SOD de?creased remarkably in model group, (P<0.01). Compared with model group, mRNA levels of TNF-αas well as serum levels of IL-1 and MDA were significantly decreased while serum levels of IL-10, SOD were greatly increased in low dose and high dose Hedan tablet treatment groups as well as in simvastatin treatment group (P<0.01). Conclusion Hedan tablet inhibit the formation of atherosclerosis through its anti-oxidation role and anti-inflammation role.

Objective:To evaluate the clinical efficacy of paclitaxel combined with epirubicin neoadjuvant chemotherapy in the treatment of triple negative breast cancer and the effect on the Ki-67,p53,P-glycoprotein (P-gp) and glutathione transferase (GST-π).Methods:84 patients with triple-negative breast cancer admitted in our hospital from June 2010 to June 2012 were selected and divided into the observation group and the control group according to the order of admission.The control group was treated with epirubicin,and cyclophosphamide.The observation group was given paclitaxel neoadjuvant chemotherapy combined with epirubicin.The clinical efficacy,expressions of Ki-67,p53,P-gp and GST-π were compared between the two groups.Results:After treatment,the total remission rate of observation group was significantly higher than that of the control group [76.19％(32/42) vs 45.24％(19/42)] (P ＜0.05).Before chemotherapy,the positive expression rates of Ki-67,p53,P-gp and GST-π in the two groups showed no statistical difference(P＞0.05).After chemotherapy,the positive expression rates of Ki-67,p53,P-gp and GST-π in the observation group were significantly lower than those of the control group (P＜0.05),but the positive expression rates of Ki-67,p53,P-gp and GST-π in the control group had no significant difference compared with those before chemotherapy (P＞0.05).The positive expression rates of Ki-67,p53,P-gp and GST-π in the observation group were significantly lower than those of the control group (P ＜0.05).There was no significant difference in the incidence of adverse reaction rate between the observation group and the control group (P＞ 0.05).Conclusion:Paclitaxel combined with Epirubicin neoadjuvant chemotherapy could effectively reduce the expression of Ki-67,p53,P-gp and GST-π in triple-negative breast cancer with exact clinical efficacy.

Objective To explore the effects of Buyang Huanwu decoction(BYHWD)on expressions of nuclear factor-κB p65(NF-κBp65)and its inhibitor( I-κB)in signal transduction of NF-κB in brain tissue of rats with focal cerebral ischemia injury. Methods 180 Sprague-Dawley(SD)rats were randomly divided into normal group,sham-operated group,model group,pynolidine dithiocarbamate(PDTC)group,minocycline(MC)group and BYHWD treatment group,each group 30 rats. The rats of PDTC group were given PDTC 100 mg?kg-1?d-1 by intra-peritoneal injection. In MC group,MC was given by filling the stomach,the dose was 2.35 g?kg-1?d-1,the drug solution was prepared by adding the distilled water,and the total volume of drug solution to fill the stomach was kept at the same volume in various groups,thus the concentration of the drug was different. In BYHWD group,BYHWD was given,the dose was reduced to 5 g?kg-1?d-1 according to the body surface area dose conversion formula about people and animals. In sham-operated group and model group,the distilled water was given in the same volume as other drug solution. The protein expression levels of NF-κBp65 and I-κB in ischemic tissues were examined by using immunohistochemical method on the time points 7,14 and 21 days after treatment in each group. Results Compared with model group, the cell numbers with expression of NF-κBp65 in PDTC group,MC group and BYHWD group were significantly decreased along with the prolongation of therapy time,the decrease in number was more and more,until 21 days,it reached the valley level(cell/400 times HP:44.00±6.91,45.33±6.55,18.67±2.14 vs. 126.00±5.78,all P<0.05);the number of cells with expression of I-κB was obviously increased,the differences being statistically significant(all P<0.05),but the differences in expression of NF-κBp65 among the treatment groups at the different time points were not statistically significant(all P>0.05). After treatment for 7 days,the number of cells with positive expression of I-κB protein in BYHWD group was less than that in MC group(cell/400 times HP:55.00±3.40 vs. 72.50±4.29,P<0.05);after treatment for 14 days,the number in BYHWD group was approximately the same as that in the MC group, the difference being not statistically significant(93.50±6.15 vs. 93.00±6.20,P>0.05),and after treatment for 21 days,the number in BYHWD group was significantly higher than that in MC group(88.83±4.95 vs. 71.17±7.16, P<0.05). Conclusion BYHWD can regulate the expressions of inflammatory cytokine I-κB and NF-κB in signal transduction of NF-κB in ischemic brain tissue to inhibit the inflammatory reaction,thus it has the protective effect on cerebral ischemia.

Objective:To evaluate the efficacy and safety of cytoreductive surgery (CRS) in conjunction with hyperthermic intra-peritoneal chemotherapy (HIPEC) for treating patients with peritoneal carcinomatosis (PC) from colorectal cancer (CRC). Methods:A total of 62 CRC patients with complication of PC were divided into the CRS group, namely, Group One (n=29, CRS and systemic adju-vant chemotherapy) and the CRS+HIPEC group, namely, Group Two (n=33, CRS+HIPEC). The primary end point of the study was overall survival (OS) and the secondary end point was serious adverse events (SAE). Results:Patients' clinicopathologic characteris-tics, peritoneal carcinomatosis index, and completeness of cytoreduction therapy were well balanced and comparable between the two groups. The median follow-up was 41.9 mo (6.5 mo to 110.0 mo) in Group One and 32.0 mo (10.5 mo to 95.9 mo) in Group Two. The median OS was 8.5 mo (95%CI:4.9 mo to 12.1 mo) in Group One and 14.5 mo (95%CI:11.9 mo to 17.1 mo) in Group Two (P=0.007). Within 30 days after the surgery, SAE occurred in 3 of the 29 patients in Group One, and 9 of the 33 patients in Group Two (P=0.126). Multivariate analysis revealed that HIPEC, CC0-1 score, and chemotherapy over six cycles were the independent factors for OS improvement. Conclusion:The CRS+HIPEC method improves the OS of patients with PC from CRC, suggesting an acceptable safety.

The effect of anisodine on brain monoamine was studied in 30 rats. The brain monoamine levels of caudate nucleus, hippocampus, diencephalon, brain stem and cerebral cortex were estimated by fluoro-metric method in drug-treated rats and saline-treated controls. Only the NE level of the brain stem was significantly increased in anisodine-treated animals 48 hours after injection. There were no significant differences in the dopamine values between anisodine-treated rats and saline-treated controls, while the 5HT and 5HIAA levels were significantly increased in anisodine-treated animals. The relation of brain monoamines to learning and memory is discussed. The increased 5HT and 5HIAA levels caused by anisodine may play a role in the impairment of memory.

Objective To understand time-effect relationship in prehospital emergency care of trauma patients so as to cut down mortality. Methods The data of pre-hospital deaths of trauma pa-tients were collected from 67 Shenzhen Emergency Network Hospitals during 2002-2004 and input into a database established by using Foxpro 6.0.Then, the data were analyzed by software SPSS 11.0. Re-sults A total of 161 364 trauma patients received prehospital emergency call service during 2002-2004 and 3 967 patients died prehospital or in hospital.There were 360.528 and 645 trauma patients died pre-hospitsl in 2002, 2003 and 2004 respectively, accounting for 32.57%, 37.69% and 44.25% respec-tively of whole trauma emergency patients in corresponding year.In 2002, 2003 and 2004 respectively, pre-hospital mortality was 1.15%, 0.88% and 0.99%, ratio of male to female 79.17/20.83, 77.65/22.35 and 71.63/28.37, the death age(29.04 ±13.98), (27.84±18.54)and(29.25±17.06)years old, ratio of traffic trauma to non-traffic trauma 48.33/51.67.26.14/73.86 and 37.98/62.02, the median response time of ambulance in hospital 2, 2 and 1 minute, the median time of ambulance arri-ving at the accident scene 5, 8.5 and 7 minutes and the median time of ambulance to and fro was 15.35 and 30 minutes. Conclusions There is a tendency that the number of the pre-hospital deaths of trauma patients increases, but that the ratio of traffic to non-traffic trauma and mortality decrease.The average age of dead trsuma patients is 10 years younger than that of whole emergency patients in the city of Shenz-hen.The response time of ambulance in hospital shortens, but the time of ambulance arriving accident 8cene and to and fro time of ambulance prolong.

Purpose: The goal of this study was to describe the current status of oncology nurses' behaviors toward end of life (EOL) care in China and to explore the factors associated with oncology nurses’ behaviors toward EOL care. Methods: A cross-sectional design was applied and a convenience sample of 1038 oncology nurses from 22 grade A hospitals were recruited into this study. A general social demographic data questionnaire was administered, and the Chinese version of Nurses’ Behaviors of Caring for Dying Patients Scale was used to assess nurse behavior toward EOL care. The total score ranges from 40 to 200 points. Data were analyzed with SPSS 26.0 software. Results: Chinese oncology nurses' average score of holistic EOL care behaviors was 2.97 ± 0.59. Oncology nurses provide physical care most (3.81 ± 0.76), followed by family care (3.02 ± 0.86), and spiritual care (2.37 ± 0.67). Multiple regression analysis showed that a higher frequency of sharing EOL care experience with colleagues, in-service palliative care education, higher level of head nurse support for EOL patient care, more cases of EOL care, higher working position, and nurse's perceived high level of support were positively associated with behavior toward EOL care. These six factors explained 16.2% of the total variance. Conclusions The results may help provide a basis for converting behavior for EOL care among oncology nurses and design interventions to better improve quality of life for EOL patients with cancer in China.

Chronic obstructive pulmonary disease (COPD) is an important healthcare problem worldwide. Often, glucocorticoid (GC) resistance develops during COPD treatment. As a classic hypoglycemic drug, metformin (MET) can be used as a treatment strategy for COPD due to its anti-inflammatory and antioxidant effects, but its specific mechanism of action is not known. We aimed to clarify the role of MET on COPD and cigarette smoke extract (CSE)-induced GC resistance. Through establishment of a COPD model in rats, we found that MET could improve lung function, reduce pathological injury, as well as reduce the level of inflammation and oxidative stress in COPD, and upregulate expression of nuclear factor E2-related factor 2 (Nrf2), heme oxygenase-1 (HO-1), multidrug resistance protein 1 (MRP1), and histone deacetylase 2 (HDAC2). By establishing a model of GC resistance in human bronchial epithelial cells stimulated by CSE, we found that MET reduced secretion of interleukin-8, and could upregulate expression of Nrf2, HO-1, MRP1, and HDAC2. MET could also increase the inhibition of MRP1 efflux by MK571 significantly, and increase expression of HDAC2 mRNA and protein. In conclusion, MET may upregulate MRP1 expression by activating the Nrf2/HO-1 signaling pathway, and then regulate expression of HDAC2 protein to reduce GC resistance.