Objective To estimate the expressions of cyclin D1 and Ki67 in esophageal squamous cell carcinomas and their clinical significance. Methods The expressions of cyclin D1 and Ki67 were detected by immunohistochemistry in 28 specimens esophageal squamous cell carcinoma (ESCC) and 33 samples esophagitis tissue. Results The positive expression rate of cyclin D1 in ESCC and esophagitis tissues was 60.7% (17/28) and 33.3% (11/33) respectively (?2=4.573,P=0.032),while the mean Ki67 label index (Ki67 LI) was (49.21?25.15)% and (11.62?9.87)% respectively (t=7.908,P=0.000). The positive expression rate of cyclin D1 in TNM stage I tissues was 14.3% (1/7),which was significantly lower than that in stages Ⅲ and Ⅳ tissues[85.7% (6/7) and 100% (5/5),P=0.029 and 0.015,respectively]. In cases with lymph node metastasis,the positive rate of cyclin D1 expression was 90.9% (10/11) that was significantly higher than that in those without lymph node metastasis (P=0.016). The 28 patients with ESCC were followed up for 6 to 34 months [mean,(25.0?4.2) months],during which 19 patients survived,4 patients died of deterioration of the primary diseases (3 cases) or cerebrovascular affair (1 case),and the other 5 patients was lost to follow-up. Conclusions The expression of cyclin D1 is correlated with advanced tumor and lymph node metastasis. The Ki67 is highly expressed in ESCC tissues; no relationship exists between the level of the expression and the pathological differentiation type and TNM stage of ESCC.

Objective To study the clinical characteristics, diagnosis and treatment of extrahepatic growing hepatocellular carcinoma(HCC). Methods The clinical data of 11 patients with extrahepatic growing HCC were analysed retrospectively. Results The mean diameter of the tumors was (12.4?4.3)cm.All the tumors in the 11 patients had complete capsule formation. The numbers of tumors located in the left, right and caudate lobe of the liver were 6,3 and 2 respectively. Surgical treatment included segmentectomy in 6 cases , lobectomy in 4 cases, and unresectable in 1 case. The 1-, 2-, and 3-year survival rates were 80.1%,62.3%, and 47.6% respectively. Conclusions Although the size of extrahepatic growing HCC is large,the resection rate is high and prognosis is good. The resection of hepatic segments or lobes containing the lesion should be done in radical operation of this tumors.

Objective To evaluate the risk factors for prognosis in liver cirrhotic patients with acute esophageal variceal bleeding (EVB). Methods Retrospective analysis was carried out in patients with liver cirrhosis,who were admitted to the hospital for EVB between January 2000 and December 2006 . All patients were follow-up to August 31st, 2009. The death of the patients was identified as the end of the study. The vital signs and results of laboratory tests were recorded when patients were admitted to the hospital. Child-Pugh score/grade, model for end stage liver disease (MELD) score and Rockall score were calculated. Results Ninty-five cases (66 males and 29 females) were enrolled in the study. Among them, 60 cases died and 35 cases survived for (42. 61±33.21) months (ranged from 2 days to 114 months). Univariate Cox regression analysis showed that age, male, Child-Pugh score/grade, MELD score, Rockall score, white blood cell counts and active hepatitis B were risk factors for death in liver cirrhotic patients with EVB (P＜0.05), while high level of hemoglobin and high hematocrit, endoscopic variceal sclerosis therapy or surgical treatment were protective factors (P＜0.05). Multivariate Cox regression analysis revealed that Child-Pugh grade (RR= 4. 997,95%CI:2. 787～8. 960, P＜0.01),Rockall score (RR= 1. 284,95%CI:1. 062～1. 553,P=0. 010), high counts of white blood cells (RR= 1. 072,95%CI: 1. 001 ～ 1. 148, P= 0. 046) were risk factors for prognosis of liver cirrhotic patients with EVB. Conclusion It is demonstrated that Child-Pugh grade,Rockall score and high counts of white blood cells are risk factors for prognosis of liver cirrhotic patients with EVB.

Objective To explore the clinical significance of typical reflux symptoms in the diagnosis of gastroesophageal reflux disease (GERD).Methods Consecutive patients older than 16 years,who initially visited department of gastroenterology at clinic of Peking University Third Hospital from May 9,2012 to Dec 31,2012,were required to complete a self-reported GERD questionnaire.Upper endoscopy was performed in some selected patients.Results A total of 18 987 patients were enrolled with a response rate of 91.5％.The prevalence of symptom-defined GERD was 13.6％ (2 579/18 987).A total of 4 357 (22.9％) patients underwent the upper endoscopy,and the diagnostic rates of reflux esophagitis,Barrett's esophagus,peptic ulcer disease,and upper gastrointestinal malignancy were 13.1％ (572/4 357),1.8％ (78/4 357),10.5％ (456/4 357),and 1.7％ (75/4 357),respectively.The incidence of reflux esophagitis was 22.7％ (216/951) in patients with reflux symptoms and 10.5％ (356/3 406) (P ＜0.001) in patients without reflux symptoms,2.7％ (26/951) and 1.5 ％ (52/3 406),respectively (P =0.013) for Barrett's esophagus; 6.8％ (65/951) and 11.5％ (391/3 406),respectively (P＜0.001) for peptic ulcer disease; 1.7％ (16/951) and 1.7％ (59/3 406),respectively (P =0.917) for upper gastrointestinal malignancy.Conclusions GERD is one of the major diseases at gastroenterology clinic.Typical reflux symptoms suggest a diagnosis of GERD.But some patients with peptic ulcer disease or upper gastrointestinal malignancy can also present typical reflux symptoms.Upper endoscopy is valuable to avoid the misdiagnosis of other disorders.

Objective To evaluate the feasibility and safety of resection of tumors in hepatic centric area. Methods The clinical data of 36 patients with tumors in hepatic centric area treated by resection in our hospital from Jan 1996 to Dec 2001 were retrospectively analyzed. In this series,there were 26 cases of liver cancer and 10 cases of benign tumor. Of the 36 patients,the tumor involved the first porta hepatis in 13 cases, involved the second porta hepatis in 10 , involved the third porta hepatis in 5 , involved both the first and second porta hepatis in 3, and involved both the second and third porta hepatis in 5 cases. Results During the operation, massive hemorrhage occurred in 4 cases(11.1%). Postoperative complications occurred in 11 patients(30.5%),including liver function failure in 1 case (2.7%), biliary fistula in 2 cases (5.5%), pleural effusion in 6 cases (16.7%), subphrenic infection in 1 case (2.7%),and abdominal incisional hernia in 1 case (2.7%). All patients recovered except that one died of acute hepatic failure after the operation. Conclusions Although the surgery for this tumor is quite difficult and risky, if enough attention is paid to the choice of the patient,and the meticulous surgical technique,the operation safety and therapeutic result of the operation could be improved.

Objective: To investigate the effect of macrophage-capping protein (CapG) on migration and proliferation of human gastric cancer cell line.Methods: Real-time PCR method was used to detect the expression of CapG gene in four gastric cancer cell lines, and AGS cells with low expression and transfection were selected as the research objects.Specific primers were designed for CapG and recombinant plasmids synthesized.A lentivirus packaging system which could express CapG was constructed, and a cell line stably expressing CapG was established by infecting human gastric cancer cell line AGS cells.The effect of overexpression of CapG gene on the growth and proliferation of AGS cells was analyzed by CCK8 assay.Cells cratch and Transwell assay were used to analyze the effect of overexpression of CapG gene on AGS cell migration.Results: After the overexpression of CapG, the growth rate of AGS cells was slightly lower than that of the control group, but there was no significant difference between the two groups (t=2.424, P=0.073).Scratch test showed that the average narrowing distance of the scratches in the CapG experimental group was significantly reduced compared with the control group, the average narrowing distance of the CapG experimental group and the control group was 336.99 μm and 45.54 μm, the difference was statistically significant (t=14.97, P=0.004).The average number of cell penetra-ting membrane in the CapG experimental group and the eGFP control group was 176 and 70, the number of the cells in the CapG experimental group was significantly higher than that of the control group (t=40.00, P<0.001).Conclusion: The overexpression of CapG gene has no significant effect on the growth and proliferation of AGS cells of gastric cancer cell line.Overexpression of CapG gene can promote the migration of AGS cells of gastric cancer cell lines.

Objective:To investigate the therapeutic effects of finger pressing on Hegu acupoint on nausea and to find an optimal method to reduce nausea in first-time complete denture wearers. Methods:Forty-one first-time complete denture wearers who received treatment between June 2016 and December 2019 in Huxi Hospital Affiliated to Jining Medical University were included in this study. They were randomly divided into observation group ( n = 21) and control group ( n = 20). The observation group received finger pressing on Hegu acupoint for 3 minutes before complete denture wearing and before three meals. The control group received self-adaptive therapy. After 3, 7 and 14 days of wearing complete denture, the number of wearers without nausea, the number of wearers with normal swallowing function, and the number of wearers with masticatory efficiency were recorded in each group. Efficacy was compared between two groups. Results:After 3 and 7 days of wearing complete denture, the percentage of complete denture wearers without nausea was 85.71% (18/21) and 95.24% (20/21), respectively, which were significantly higher than those in the control group [45.00% (9/20), 65.00% (13/20), χ2 = 5.58, 4.19, both P < 0.05 ]. After 14 days of wearing complete denture, there was no significant difference in number of wearers without nausea between observation and control groups ( P > 0.05). After 3 days of wearing complete denture, there was significant difference in percentage of wearers with normal swallowing function among total number of complete denture wearers between observation and control groups [57.14% (12/21) vs. 15.00% (3/20), χ2 = 8.16, P < 0.01). After 7 and 14 days of wearing complete denture, there was no significant difference in percentage of wearers with normal swallowing function among total number of complete denture wearers between observation and control groups (both P > 0.05). After 3 and 7 days of wearing complete denture, masticatory efficiency in the observation group was (42.03 ± 5.02)% and (50.34 ± 5.05)%, which were significantly higher than those in the control group [(37.00 ± 4.00)%, (47.13 ± 4.03)%, t = 3.51, 1.65, both P < 0.05]. After 14 days of wearing complete denture, there was no significant difference in masticatory efficiency between the two groups ( P > 0.05). Conclusion:Finger pressing on Hegu acupoint has good clinical effects on alleviating nausea in complete denture wearers and can shorten the adjustment time to first time wearing complete denture.

Objective:To investigate the significance of MLH1 protein expression and MLH1 gene methylation rate between metastatic solid pseudopapillary tumor of pancreas (SPT) and non-metastatic SPT, and to explore the correlation between MLH1 gene methylation and SPT metastasis.Methods:Twelve metastatic SPT patients admitted to Peking University People's Hospital, Rizhao Central Hospital and Chaoyang Central Hospital of Liaoning Province from January 2009 to May 2022 were studied retrospectively, including 3 males and 9 females, with a median age of 47 years old, ranging from 21 to 73 years old. Thirty non-metastatic SPT patients with clear diagnosis, clear medical history and complete follow-up data from pathological database of Peking University People's Hospital from January 2009 to May 2017 were selected as the control group, including 12 males and 18 females, with a median age of 42 years old, ranging from 34 to 69 years old. Clinical data such as gender, age and pathological data were collected. Immunohistochemical expression of MLH1 protein and methylation of MLH1 gene were detected by pathological paraffins.Results:There was no significant difference in general data between the two groups (all P>0.05). Among the 12 metastatic SPT patients, 4 cases metastasized to liver, 2 to spleen, 2 to lung, 2 to lymph nodes, 1 to mediastinum, and 1 to sacrum. Compared with the non-metastatic tissue, the MLH1 protein deletion in metastatic pancreatic lesions (metastatic SPT-P) and metastatic lesions (metastatic SPT-M) were increased [both 33.3%(4/12)], and the difference was statistically significant (both Chi square=5.00, both P=0.041). Compared with 0 (0/30) MLH1 gene methylation rate in non-metastatic SPT tissues, the methylation rate of MLH1 gene in metastatic SPT-M and metastatic SPT-P tissues [both 30% (3/10)] were higher, with statistical significance (both Chi square=0.96, both P=0.032). Conclusion:Compared with non-metastatic SPT, the loss rate of MLH1 protein expression and MLH1 gene methylation are increased in metastatic SPT. MLH1 methylation may occur before metastasis, which can be used as a predictor of SPT metastasis.