Objective:To examine the serum proteomic spectra of human esophagial carcinoma by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS),so as to set up a diagnostic model of esophagial carcinoma and to investigate its clinical value. Methods:Thirty-two esophagial carcinoma patients and 28 healthy controls were obtained from Fourth Affiliated Hospital of Hebei Medical University during May to September of 2008. Serum protein was extracted by weak cation exchange (WCX) protein chip system,and proteomic spectra was examined by MALDI-TOF MS. The obtained data were analyzed by ZUCI-protein chip data analyze system (ZUCI-PCDAS) and an esophagial carcinoma diagnostic model was established by genetic arithmetic (GA) combined support vector machine (SVM). The above 60 samples were randomly divided into training set and blinding test set,with training set including 21 esophagial carcinoma patients and 19 healthy controls and blinding test set including 11 esophagial carcinoma patients and 9 healthy controls,so as to examine the specificity and sensitivity of this diagnostic model. Results:Serum proteomic spectra of esophagial carcinoma patients and healthy controls were obtained by MALDI-TOF MS,and m/z (mass to charge) peaks of 44 differential proteins were obtained after analyzed by ZUCI-PCDAS software package (P

AIM: To know the variations of the cytochrome b gene in cancer tissue, paracarinoma tissue and normal tissue and to inquire into the relationship between mutations of mitochondrial genome and carcinogenesis. METHODS: Cellular total DNA was extracted.The cytochrome b genes of three tissues were amplifyed with polymerase chain reaction(PCR). PCR products were analysed by DNA auto-sequencing method. RESULTS: The cytochrome b gene of cancer tissue had the C to G mutation at nt 14931, the C to G mutation at nt 15004 and the T to C mutation at nt15435,respectively. The cytochrome b gene of paracarinoma tissue had the A to C mutation at nt 15436. The cytochrome b gene of normal tissue had not mutation. CONCLUSION: Mitochondrial DNA mutations could be the endogenous factors that induce nuclear genome mutation. It could promoto carcinogenesis. The paracarinoma tissue was abnormal in DNA molecular level.

Objective The incidence of post-operative hyperbilimbinemia, which is associated with poor outcomes in patients, was reported to be increased in recent years though it has been a rare complication for cardiac operations. Post-opera-tive impairment of liver function is highlighted. We evaluated the incidence and prognosis of post-operative hyperbiliruhinemia in adult patients who underwent cardiotomy with extracorporeal membrane oxygenation (ECMO) support. Methods Sixty-five adult patients who had received ECMO support after cardiac surgery from 2004 to 2008 were enrolled and evaluated retrospec-tively. Post-oporative hypethilirubinemia was defined as the serum level of the total bilirubin more than 51.3 μmol/L during postoperative period. Demographic and clinical data included gender, age, types of surgery, perioperative hemodynamic param-eters, biochemical variables, duration of the ventilation support, ICU stay and outcomes. Results The mean age of the pa-tients was (50.1 ± 13.9) years, forty-six patients(70.8%) were male. The main cardiac procedures were heart transplanta-tion for 9 patients, coronary artery bypass grafting and/or valve operations for 47 patients, congenital heart disease correction for 4 patients and other operations for 5 patients. Among all patients, fifty-one patients(78.5%) were weaned from ECMO succeas-fully and thirty-thrce patients were discharged from hospital. The overall mortality rate was 49.2%. Overall incidence of post-operative hyperbilirubinemia was 55.4%. In patients with postoperative hyperbilirubinemia, the mean peak value for serum to-tal bilirubin was 104.8 (68.5-156.7) μmol/l. The hospital mortality in the hyperbilirubinemia group was significantly higher than that in the non-hyperbilirubinemia group(66.7% vs. 27.6%, P <0.01). Moreover, postoperative hypethilirubinemia (adds ratio = 3. 895, 95% confidence interval, 1.088 - 13.947 ; P = 0.037) and SOFA score (odds ratio = 1.214, 95% confidence interval, 0.987 - 1.494, P = 0.047) and APACHE Ⅲ score (odds ratio = 1.096, 95% confidence interval, 1.028 - 1.169 ; P = 0.004) were associated with hospital mortality after adjusting for preoperative levels of the total bilirubin, direct bilirubin, gender and age. Conclusion Postoperative hyperbilirubinemia is one of the complications in adult patients who undergo cardiotomy with ECMO support, and is associated with increased hospital mortality.

Objective Extracorporeal membrane oxygenation (ECMO) provides a treatment for patients with acute heart-lung failure. However, as an invasive procedure, it associated with high incidence of complications. It is important to a-vert and reduce the complications for improving the success rate in critically ill patients. We investigate the complications associated with ECMO after cardiac surgery and their management. Methods Clinical data from 117 postoperative patients[32 male, mean age (48.7 ± 16.5) years]supported with ECMO in the cardiovascular intensive care unit( ICU) from March 2005 to June 2008 were analyzed retrospectively. The cardiac operations they had undergone included coronary artery bypass grafting (n = 20), coronary artery bypass grafting and remodeling of left ventricle(n =9), coronary artery bypass grafting and valvular operation(n =5), repair of ventricular septal perforation following acute myocardial infarction(n =2), valvular operation( n = 46), heart/lung transplantation (n = 20/1), correction of congenital heart defects ( n = 10), and aortic operations ( n = 4). Venoarterial bypass was established in 110 patients by cannulation of the right atrium and femoral artery, and that of the right atrium and ascending aorta in 5 cases. Left atrial drainage to ECMO was added in 2 cases. Venovenous bypass was established in 2 patients with hypoxemia following cardiac surgery. Heparin was infused for maintaining the activated coagulation time (ACT) at 160 to 200 seconds for centrifugal pump(114 cases),and 200 to 250 seconds for roller pump(3 cases) to avoid thrombotic events until decannulation was achieved. Results The mean ECMO duration was 61 hours (range 3 to 225 hours). 48(41.0% ) patients died, 18 of them died of complications after weaning from circulatory assistant successfully. Complications occurred in 74 (63.2% ) patients included reoperation for hemostasis (n = 24), renal failure requiring renal replacement therapy (n =29), nosocomial infections ( n = 32) , ischemia in the extremities(n = 5), plasma leakage of oxygenators ( n = 29), gastroenteral hemorrhage ( n = 14), hemolysis ( n = 7 ), neurological complications ( n = 4) and centrifugal pump failure (n =1). Conclusion Bleeding is an early complication associated with ECMO support. The risk of nosocomial infection, renal failure and plasma leakage of oxygenators increases with the duration of ECMO support.

Objective To discuss the effect of hemodilution on brain tissue oxygen pressure and prognosis in patients with severe craniocerebral trauma. Methods A total of 42 cases of severe craniocerebral trauma were randomized divided into two groups, ie, control group and treatment group, to observe the changes of brain tissue oxygen pressure ( PbtO2 ) , hematocrit (HCT) and 6-month Glasgow outcome scale (COS) after injury. Then, PbtO2, HCT and GOS were compared between two groups. Restilts ( 1 ) There was a positive correlation between PbtO2 and HCT when HCT was lower than 0.25( r =0. 732 ,P ＜0. 001 ) in the treatment group; while a negative correlation was found between PbtO2 and HCT when HCT was higher than 0.25(r = - 0. 698 ,P＜0. 001 ). (2) Compared with control group, the index of brain tissue oxygen in treatment group was obviously higher ( t = 2.27, P = 0. 029 ) , with better prognosis (X2= 5.09, P ＜ 0.05 ). Conclusion Hemodilution can significantly increase brain tissue oxygen supply and improve the prognosis of cases of severe craniocerebral trauma.

Objective To study the expression of PI3K and MMP-7 in esophageal carcinoma and the rela-tionship between the expression of PI3K and MMP-7 and carcinogenesis and progression of esophageal carcinoma. Methods PI3K and MMP-7 expression were detected in 24 normal esophageal mucosa,94 primary tumor tissues with SP immunohistochemistal method. Results There were significant differences of PI3K and MMP-7 expressions between esophageal carcinoma and normal mucesa epithelium ( all P < 0.01 ) [71.28% (67/94) vs 4.17% ( 1/24 ) and 52.13% (49/94) vs 0% (0/24)]. There were significant correlations between PI3K expression and the degrees of differentiation,invasive depth,clinical staging and the metastasis of lymph node (all P <0.01 ). The positive ex-pression rate of MMP-7 had the relationship with metastasis of lymph node (P < 0.05 ), the degrees of differentiation ( P < 0.05 ) invasive depth ( P < 0.01 ), and clinical staging( P < 0.05 ) . There was a positive relationship between PI3K and MMP-7 expression in this study (r = 0. 232 ,P = 0.025). Conlusions PBK and MMP-7 play an impor-tant roles in carcinogenesis and progression of esophageal carcinoma and can be used as valuable biomarkers to eval-uate biological characteristics in esophageal squamous cell carcinoma.

Objective To research the fibrosis characteristics of Atrial Fibrillation(AF) patients under microscope and its effect to post-operative sinus conversion of Radiofrequency ablation treatment.Methods Based on Lefi Atrial Dimension (LAD).Left atrial appendage tissue samples of 60 AF patients who received bipolar radiofrequency ablation treatment during open heart surgery between July and December 2011,were divided into 4 groups:group a (LAD≤50 mm),group b (50 mm ＜ LAD≤60 mm),group c (60 mm＜ LAD ≤70 mm),group d (LAD ＞ 70 mm),15 patients in each group.The levels of atrial muscle fibrosis and cell size differences are compared for colored slides of samples.Research are done for the difference of sinus rhythm restoration rate among the 4 groups based on ECG records at immediate,leaving hospital,and 3,6,12 months postoperative are collected for all groups.Results Differences of CVF and atrial muscle cell size measured under microscope are statistically meaningful(P ＜ 0.001).Sinus rhythm restoration rate differences at 6 month(P =0.039) and 12 month (P =0.037) post-operative are statistically meaningful.Further,immediate,leaving hospital,and 3,6,12 months postoperative sinus rhythm restoration rates are 93.3％,93.3％,93.3％,100％,100％ for group a,80.0％,73.3％,80.0％,80.0％,80.0％ for group b,66.7％,66.7％,66.7％,73.3％,66.7％ for goup c,and 53.3％,53.3％,53.3％,60.0％,60.0％ for group d respectively.Conclusion For rheumatic heart valve diseases patients who at 6 and 12 month post-operative,the greater the LAD,the higher the atrial fibrosis level,the greater the cell size,the lower the sinus rhythm restoration rate is.

ObjectiveTo investigate the experience of resection of superior sulcus tumors using the improved antero-cervical parastemal approach.MethodsThe clinical data of 3 patients with superior sulcus tumor from July 2005 to May 2010 were analyzed retrospectively.Three patients with superior sulcus tumor underwent en bloc resection using the improved antero-cervical parastemal approach.The 1st to 3rd rib were excised,1 case with 1/5 centrum vertebra excision,1 case with the 1st transverse process of thoracic vertebra excision,1 case with the 1 st and 2nd transverse process of thoracic vertebra excision,1 case with T1 nerve root and sellate ganglion excision.ResultsAll the patients recovered well after operation.There was no serious complication except for 1 case with secondary Horner syndrome.The mild paradoxicalbreathing was found in 3 cases postoperative dressing change,but they had no dyspnea and tolerance well.The paradoxical breathing was disappeared when the mediastinum was fixed after 14 d thoracic wall pressure dressing.The pathological diagnosis after operation:2 cases with squamous-celled carcinoma,1 case with adenosquamous carcinoma,there was no mediastinal lymph node metastasis,cutting edge was negative.Stage:2 cases with T3N0M0,1 case with T4N0M0.Three cases were treated with chemotherapy (NP plan) for 4 cycles after operation without radiotherapy.Three cases were followed up for 53,37, 13 months after operation,they were all survival without recurrence and good quality life.ConclusionsFor the treatment of especially anterior and middle seated superior sulcus tumors,improved antero-cervical parasternal approach provides a safe and effective exposure.The improved antero-cervical parasternal approach is worthy of promotion.

OBJECTIVETo study the pathological characteristics of severe acute respiratory syndrome (SARS) and its relationship to clinical manifestation.

METHODSTissue specimens from 3 autopsies of probable SARS cases were studied by microscope, and the clinical data was reviewed.

RESULTSThe typical pathological changes of lungs were diffuse hemorrhaging on the surface. A combination of serous, fibrinous and hemorrhagic inflammation was seen in most of the pulmonary alveoli with the engorgement of capillaries and detection of micro-thrombosis in some of these capillaries. Pulmonary alveoli thickened with interstitial mononuclear inflammatory infiltrates, suffered diffuse alveolar damage, experienced desquamation of pneumocytes and had hyaline-membrane formation, fibrinoid materials, and erythrocytes in alveolar spaces. There were thromboembolisms in some bronchial arteries. Furthermore, hemorrhagic necrosis was also evident in lymph nodes and spleen with the attenuation of lymphocytes. Other atypical pathological changes, such as hydropic degeneration, fatty degeneration, interstitial cell proliferation and lesions having existed before hospitalization were observed in the liver, heart, kidney and pancreas.

CONCLUSIONSevere damage to the pulmonary and immunological systems is responsible for the clinical features of SARS and may lead to the death of patients.

Aged ; Humans ; Lung ; pathology ; Lymph Nodes ; pathology ; Male ; Middle Aged ; Severe Acute Respiratory Syndrome ; pathology ; Spleen ; pathology

Objective To explore the value of serum circulating immune complex C 1q(CIC-C1q),comple-ment C3and C4in the diagnosis and treatment of patients with rheumatoid arthritis(RA).Methods From June 2014 to June 2016,60 cases of rheumatoid arthritis treated in Luoyang Central Hospital Affiliated to Zhengzhou University were selected as the observation group.Meanwhile,60 cases who under went healthy physical examination were chosen as control group.The levels of CIC-C1q,C3and C4in serum of two groups were detected by C1q solid-phase ELISA and immunoturbidimetry respectively,and the differences were com-pared.Results The level of CIC-C1q in the observation group was significantly higher than that in the control group,the level of C4was lower than control group,and there was statistical significance in the differences (P<0.05).But there was no statistical difference between the two groups of the C3level(P>0.05).The level of CIC-C1q was ascending in control group,quiescent phase RA group and active phase RA group,the statisti-cal significance was existed(P<0.05).The level of C4was successively decrease in the three groups,and there was a statistically significant difference(P<0.05).There was no significant difference in the level of C3the three groups(P> 0.05).Conclusion The detection of CIC-C1q and C4has a good application value in the treatment evaluation for patients with RA.