BACKGROUND: Research has showed that the abnormal expression of some proteins closely relates to the occurrence and development of cerebral glioma. However, the relationship between the abnormal expression of CyelinD1protein and the occurrence, development and prognosis of glioma is still uncertain which needs further study.OBJECTIVE: To study the expression of CyclinD1 protein in cerebral glioma and relationship between it and the impact of tumor DESIGN: Control study based on pathological specimens.SETTING: Neurosurgery department of a university hospital.PARTICIPANTS: Totally 48 glioma specimens of different malignaut degree were collected from the patients who accepted surgery treatment in Neurosurgery Department of Second Hospital of Xi' an Jiaotong University during January 1990 and December 1995. Twelve normal cerebral specimens were from the non-tumor patients who were conducted intracranial pressure reducing in Neurosurgery Department of Second Hospital of Xi' an Jiaotong University during January 1990 and December 1995.METHODS: S-P immunohistochemical technique was used to detect the abnormal expression of Cyclin D1 protein. Simultaneously, the dyeing results and clinical characters of patients were associated in order to conduct comparison.RESULTS: The positive expression rate of CyclinD1 protein in human cerebral glioma was 54. 12% while in normal cerebral tissue it was about 8.33%. There was significant difference between them(x2 =8. 148 1,P = 0. 004 3 ) . And the positive expression rate in cerebral glioma of low malignancy was 37.04% while in specimens of high malignancy it was 76.19%, there was significant difference (x2 = 7. 294 0, P = 0. 006 9). The positive expression rate of CyclinD1 protein in specimens of patients with long survival period and short survival period after surgery was 70. 37% and 33.33% respectively with significant difference between them (x2 = 6. 5268,P =0.010 6).CONCLUSION: CyclinD1 is closely related to the occurrence and development of human cerebral glioma. It has provided experimental evidence for the prevention to the occurrence of glioma and the estimation of its prognosis by studying the abnormal proliferation of glioma cells targeted on CyclinD1.

Objective To discuss the role of activation of nuclear factor ?appa B(NF-?B) in apoptosis of alveolar macrophages(AM) induced by gadolinium chloride(GdCl3) in acute necrotizing pancreatitis(ANP).Methods Thirty sixty adult SD rats were randomized into three groups: normal control group,ANP group and the group treated by GdCl3.ANP was induced by intraductal administration of 5% sodium taurocholate,while the normal control rats received an infusion of normal saline.In GdCl3 treatment group,GdCl3 was injected into dorsal vein of penis right after ANP model was established.AM were harvested by bronchoalveolar lavage six hours after model was established.The generation of TNF-? and IL-1? in bronchoalveolar lavage fluid(BALF),and the level of myeloperoxidase in lung tissue were evaluated.The expression of NF-?B protein in AM was determined by western blot.The apoptosis of AM was detected by agarose gel electrophoresis and flow cytometer.The histological examination of lung tissue was checked.Results The levels of TNF-? and IL-1? in ANP group were significantly higher than the control group and GdCl3 treatment group(P

Objective To evaluate the effect of three diamension-digital subtraction angiography (3D-DSA) or computed tomography angiography (CTA) on the patients with ruptured multiple intmcranial aneurysm (MIA). Methods A retrospective study on 21 patients with MIA was performed.After scanning with 3D-DSA or 3D-CTA, three-dimensional reconstruction of MIA was carried out by 3D workstation,then the diagnosis was decided and the treatment plan (endovascular treatment or microsurgery) was selected according to stereoscopic image of MIA. Results (1) 3D-DSA or CTA was performed in 21 patients with subarachnoid hemorrhage (SAH),it was revealed these patients carried with 48 aneurysms,including 35 small aneurysms (25 mm).Not only miero-aneurysms and small aneurysms could be precisely showed,also the size of aneurysmal neck,the relationship of the aneurysm and the parent vessel and contiguous branches by stereoscopic image.(2) According to the standard of classification,9 patients with MIA for gradeⅠ(42.9%),10 for gradeⅡ(47.6%),2 for gradeⅢ(9.5%),0 for gradeⅣ.Endovascular treatment was selected prior to microsargery for those high grade patients.In this group,17 patients with 40 aneurysms underwent endovascular embolotherapy with GDC coils.Twenty four anemysms were completely occlusioned,12 beyond 90%,4 were left without treatment because of their small size.In microsurgery group,3 aneurysrus were totally clipped,1 could not be found during operation.No any treatment was accepted in 2 patients with 4 aneurysms. Conclusions 3D-DSA or CTA,which is very useful for the diagnosis and treatment of MIA,could improve the accuracy of diagnosis of MIA and clearly show the stereoscopic image of MIA,also the relation of sac and parent artery.For those patients with high grade MIA,endovascular treatment was selected prior to microsurgery,pro re nata,used to combine with mierosurgery.

Objective To analyze the value of MRI in the diagnosis of giant cell tumor of tendon sheath(GCTTS). MethodsThe MR images of 21 GCTTS cases including 3 cases of recurrences were retrospectively evaluated.All were confirmed giant cell tumor of tendon sheath by surgery and pathology.All the patiens were examined by MRI,and 19 received contrast enhanced MRI.The characteristics of MRI presentations were explored.Results Of the 21 cases,17 were in diffuse form and 4 in localized form.On T1WI,the signal intensities of the giant cell tumor of tendon sheath almost equalled to those of skeletal muscle in 18 cases and were slightly lower than those of skeletal muscle in 3 cases.On T2WI,the signal intensities tended to range between those of skeletal muscle and fat in 7 cases,almost equalled to those of skeletal muscle in 12 cases,and were slightly lower than those of skeletal muscle in 2 cases.Of the 19 cases with gadolinium-enhanced images,17 showed inhomogeneous enhancement and 2 homogeneous enhancement,and all were observed with a fat suppression sequence on T1WI. Conclusion MRI is able to depict the characteristic internal signal of giant cell tumor of tendon sheath,which is a valuable for diagnosis,treatment and follow-up.

Objective To investigate the regularity of intrapulnonary lobar and segmental lymph nodes metastasis in patients with cT1N0M0 stage lung adenocarcinoma.To provide a basis for more accurate determination of N stage and indication for pulmonary segmental resection.Methods A prospective study was performed from March 2014 to December 2015.103 cases of cT1 N0M0 stage lung adenocarcinoma received lobectomy and mediastinal lymph node dissection in the thoracic surgery department of China-Japan Friendship Hospital.Intrapulmonary lobar and segmental lymph nodes were dissected and sorted carefully then sent to the pathological department with the corresponding lung specimen and other lymph nodes.Statistical analysis was carried out considering size of the lesion,imaging features,serum CEA levels,pathological subtypes and so on.Results In total 103 cases,pN0 was confirmed in 82 cases,pN1 in 15 cases,pN1 + N2 in 5 cases,and skipping-pN2 in 1 case.14 cases(93.3％) in pN1 group were detected with station 12-14 lymph node metastasis,while only 5 cases (33.3％) were detected with station 12-14 LSNs metastasis.4 cases(66.7％) in pN2 group were detected with station 12-14 lymph node metastasis,while only 1 case(16.7％) with station 13 and station 7 lymph node metastasis.If LSNs were not detected,the false negative rate of N staging could be as high as 6.1％ (5/82),The rate of missed diagnosis of lymph node metastasis might be 30％ (6/20) to N1 stations alone.41.2％ (7/17)cases with metastasis to the adjacent LSNs had been proved with metastasis to the isolated LSNs.The metastasis rate of the isolated LSNs was significantly lower(P =0.049) in pure GGNs compared with those part-solid/solid nodules.Invasive adenocarcinoma had higher metastasis rate of isolated LSNs,compared with preinvasive lesions or minimally invasive adenocarcinomas,with no statistical difference between groups (P =0.055).No significant difference in isolated LSNs metastasis rate was found between groups with different serum CEA levels(P =0.251) or tumor size(P =0.197).Conclusion Dissection of intrapulmonary lobar and segmental lymph nodes might facilitate a more accurate N stage,reduce the false negative rate of lymph node metastasis,and provide basis for more accurate assessment of prognosis and postoperative adjuvant treatment.The sampling area of lymph nodes during segmental resection should include the adjacent LSNs of the target segment.The isolated LSNs metastasis rate of cT1N0M0 stage lung adenocarcinoma with pureGGN as imaging feature is relative low,which might be suitable for segmentectomy when meeting other criteria.

Objective To investigate the curative effect of the preoperative intervention transcatheter arterial chemoembolization and preoperative intravenous systemic simple chemotherapy for gastric cancer.Methods Retrospective analysis of 55 patients diag-nosed with gastric cancer.These patients were divided into two groups:treatment group and control group (simple chemotherapy group),with treatment group of 35 cases and control group of 20 cases,and cases of two groups all received surgical radical surgery for gastric carcinoma treatment.Preoperative and postoperative clinical symptoms were observed.Data of tumor sizes and tumor vessel changes were analyzed and compared.The difference of curative effect between two groups was observed.Results Compared with control group,degeneration and necrosis of tumor cells in gastric cancer tissue of treatment group were obvious,and tumor ves-sels significantly reduced,with nonuniformed,and became thinner.Number of tumor vessels of treatment group was obviously low-er than that of control group (P <0.05).Conclusion The interventional therapy of gastric cancer has obvious short-term therapeutic effects,and can reduce tumor vessels effectively and improve surgical resection rate.

Objective To explore a rapid,simple and effective therapy for serious pneumothorax which could be used in pre-hospital and in-hospital first-aid.Methods Sixty-seven patients were randomly divided into the observation group and control group .Patients in the observation group were treated using laparoscopic trocar for rapidly closed thoracic drainage,and patients in the control group were treated by using the traditional large caliber drainage tube and the intercostal incision method of conventional closed thoracic drainage.The operation time,remaining time of drainage,length of stay,effective rate,and complications,including of postoperative pain,hemorrhage,subcutaneous emphysema and infection were observed in both groups. Results The total effective rate was 94.1%(32/34) in the observation group,which was significantly higher than that in the control group(90.9%,30/33)(x2=1.876,P＞0.05).No significant difference was found on the remaining time of drainage and length of stay between the two groups(remaining time of drainage:[4.56±1.65]d vs.[6.26±3.45]d;length of stay:(6.0±2.6)d vs.(6.7±2.2)d ,t=1.335 and 0.779,respectively,Ps＞0.05).The operation time of using laparoscopic trocar was significantly lower than that of the control group((5.00±1.28)min vs.(15.00±4.03)min,t=3.031,P＜0.05).The incision length was(0.95±0.11)cm in the observational group,which was significantly lower than that in the control group((2.41±0.52)cm ,t=2.585,P＜0.05).Postoperative pain occurred in 14.7%(5/34) of patients in the observational group,which was significantly lower than that in the control group(87.9%(29/33))(t=2.983,P＜0.05).In the observational group no hemorrhage and infection occurred,whereas in the control group the hemorrhage and infection rate was 36%(12/33) and 33%(11/33),respectively(x2=5.880 and 3.687,respectively,Ps＜0.05). Conclusion The use of laparoscopic trocar for rapidly closed thoracic drainage in the treatment of serious pneu-mothorax is simple,easy,convenient,effective and reliable,with few complications.This therapy is suitable for using in pre-hospital and in-hospital first-aid.

Objective To investigate the diagnostic value of cervical metastatic lymph nodes by T1 perfusion-weighted imaging and analyse the effect of age on perfusion.Methods 18 cases of cervical lymph node metastasis (case group)and 30 healthy people (control group)were performed T1 perfusion-weighted imaging.The semi-quantitative parameters (including in maximum relative enhancement ratio,wash in rate,wash out rate and peak time)and time-intensity curve (TIC)were compared between case group and control group.Moreover,the effect of age on perfusion was investigated by the age of 40 years old.Results The inflow rate was statistically significant difference between the two groups (P<0.05)and that of 23 cases of metastatic lymph nodes was higher than 49 normal lymph nodes.However,the maximum relative enhancement ratio,outflow rate and peak time weren’t statistically signif-icant difference(P>0.05).The time-intensity curve in metastatic lymph nodes and normal lymph nodes were common in typeⅡ. The maximum relative enhancement ratio and wash in rate negatively correlated with the age and the maximum relative enhancement ratio and wash in rate below the age of 40 years old were higher than above the age 40.Conclusion The wash in rate is helpful to dif-ferentiate metastatic lymph nodes and normal lymph nodes.The effect of age on perfusion is considered.

Objective To evaluate the clinical effect of the chest orthosis on patients with multiple rib or(and) sternal fracture in early period of closed chest trauma.Methods Patients with multiple fractured of ribs or (and) sternal fracture were divided into control group (n =16)treated with the traditional fixation methods ( thoracic girdle added with folding towels) and experimental group ( n =30 ) treated with chest orthosis between January 2009 and December 2011.Correlated parameters of these patients in the two groups,including pain,indexes of blood gas analysis,pulmonary complications and hospitalization time were evaluated.Results There were significant differences on visual analogue scale(VAS) [ (4.45 ±2.23) vs (8.15 ±2.02),t =2.921,P ＜0.01 ],blood gas analysis including PaO2 [ 88.16 ± 9.12) mm Hg vs (77.22 ± 6.24 ) mm Hg,t =2.413,P ＜0.05] andPaCO2[ (40.91 ±3.40)mm Hg vs (46.06 ±5.40)mm Hg,t =2.335,P＜0.05] between experimental group and control group.The incidence rate of pulmonary complications in experimental group was significantly lower than that in control group [ 17％ ( 5/30 ) vs 44％ ( 7/16 ),x2 =23.478,P ＜ 0.05 ].And hospitalization time in experimental group was significantly shorter compared with control group[ (7.26 ± 4.17) d vs ( 14.26 ±3.53)d,t =2.430,P ＜0.05].Conclusion The chest orthosis in early treatment of chest trauma can reduce the pain and improve the condition of patients,and it is a simple,effective and cheap method with significant clinical effect.

Objective To analyze the clinical features of differentiated thyroid cancer diagnosed during pregnancy or one year after delivery.MethodsA total of 234 women with differentiated thyroid cancer were treated from January 2001 to January 2011.Cases were divided into three groups according to the time of tumor diagnosis( group 1,no pregnancy history; group 2,during pregnancy or in the first year after delivery;group 3,longer than 1 year after the delivery).ResultsThe thyroid nodule was asymptomatic and discovered on routine examination more often in group 2(78.7％ ) than other two groups (P =0.02).There were no significant difference among three groups in age,hospitalization time,operation time,operation method,tumor type,primary tumor stage and mortality. But more patients in group 2 were suffering from extrathyroid invasion ( P =0.024 ),multi-focal cancer ( P =0.023 ),larger cervical lymph node ( P =0.021 ),later regional lymph node stage (P =0.020 ) and higher local recurrence (P =0.001 ).By stepwise logistic regression analysis,pregnancy is one of the factors impacting on local recurrence rate ( P =0.045 ).ConclusionsPregnancy does not affect the mortality of the differentiated thyroid cancer,but the incidence of extrathyroid invasion,multi-focal cancer,cervical lymph node metastasis,local recurrence is higher in patients with differentiated thyroid cancer diagnosed during pregnancy.