Background and purpose: Primary renal marginal zone B-cell lymphomas of mucosa-associated lymphoid tissue(MALT lymphoma) are rare tumors in the kidney.Till now,less than 50 cases have been reported all over the world.This article introduced 2 cases of MALT lymphoma based on the morphological and immunophenotype features,aimed to highlight this rare tumor in terms of clinical characteristics and pathology.Methods:2 cases of renal MALT lymphomas were treated in our hospital.Clinical history were collected,morphological analysis was evaluated based on the HE section,and immunohistochemistry were performed by CD20,CD79a,CD5,CD10,CD43,CD23,BCL10 and cyclinD1 antibodies.Results:2 female patients with the age of 48 and 55,respectively,both of them had a history of chronic pyelonephritis.Under the B ultrasonic and CT scanning,a lump in the kidney was found and whole nephrectomy was performed.In the macroscopic view,tumors were in the renal medulla with dark red color and ill-defined boundary.In the microscopic view,lymphoid cells infiltrate from the pelvis to the medulla of kidney,lymphoid cells mainly consisted of small lymphocytes,centrocyte-like cells,lymphoplasmacytoid and plasma cells.Reactive follicles and lymphoepithelial lesions also could be seen in the tumor.Immunohistochemistry showed that the tumor cells were CD20 and CD79a positive,CD43 was weak positive,but CD5,CD10,CD23,BCL10 and cyclinD1 were all negative.Conclusions:Primary renal MALT lymphomas are very rare diseases.According to the clinical manifestation,it is hard to differentiate from renal cell carcinoma.But the morphological features were consistent with the classic MALT lymphomas in other sites.Immunophenotype profiles were helpful for diagnosis.

Objective To evaluate the antitumor effect of corosolic acid and its impact on CAM and YSM angiogenesis.Methods The effects of CRA on A549 proliferation was studied by MTT method in vitro.Tumor-bruden nude mice model were established by injecting A549 lung cancer cell marked with bioluminescent to nude mice,and the growth of tumor in mice were detected by IVIS small animal in vivo imaging system.Experiment of chicken embryos eggs are used to observe the role of drugs on CAMand YSMblood vessels. Results The value of IC50 of CRA for A549 in vitro was 26.8μg/mL.A tumor-burdened animal experiment results showed that the CRA to A549 solid tumor has a certain therapeutic effect.CAM and YSM blood vessels of chicken embryos eggs treated with CRA were decreased significantly than negative control group.Conclusion CRA has certain therapeutic effect for A549,which may be related to the inhibition of angiogenesis in tumor tissues.

OBJECTIVE:To observe clinical efficacy and safety of Qizhi qushi jianpi prescription in the treatment of chronic synovitis of knee joint in middleaged and elderly patients after debridement under arthroscope. METHODS:A total of 80 mid-dleaged and elderly inpatients with chronic synovitis of knee joint were selected and randomly divided into treatment group and con-trol group,with 40 cases in each group. Clinical efficacy,VAS,swelling score of modified Cincinnati knee joint score system, Lysholm score of knee joint function,the occurrence of ADR were observed in 2 groups. RESULTS:Total effective rate of treat-ment group(92.5%)was significantly than that of control group(77.5%),with statistical significance(P<0.05). Before debride-ment under arthroscope,there was no statistical significance in VAS score of knee joint,swelling score and Lysholm score between 2 groups(P>0.05). On the first day after surgery,VAS score of 2 groups decreased significantly,and there was statistical signifi-cance compared to before surgery (P<0.05). One month after surgery,VAS score of 2 groups decreased significantly,and the treatment group was significantly lower than the control group,with statistical significance(P<0.05). Swelling score of knee joint 1 month after surgery and Lysholm score 3 months after surgery increased significantly in 2 groups,and the treatment group was significantly higher than the control group,with statistical significance(P<0.05). 5 patients of treatment group suffered from stom-ach discomfort,and the symptom was relieved after adding the ingredient of comforting stomach and removing dampness through diuresis. CONCLUSIONS:Qizhi qushi jianpi prescription is effective for chronic synovitis of knee joint in middleaged and elderly patients after debridement under arthroscope,and can relieve pain, remove swelling and recover knee joint function with good safety.

ObjectiveTo classify chronic pancreatitis (CP) based on pathological features and evaluate the benefits of different surgical procedures according to the pathological forms. Methods Forty CP cases during recent 9 years who underwent surgical therapy were retrospectively reviewed in association with clinicopathological analysis. Results Postoperative pain-relief rate was 79.16% in patients treated with longitudinal pancreaticojejunostomy(LPJ). In cases without enlarged pancreatic head or diverticulum of duodenum, postoperative pain-relief rate was 86%.Postoperative pain-relief rate was high by Whipple′s procedure, pylorus-preserving pancreaticoduodenectomy or Beger duodenum-preserving pancreatic head resection,while postoperative diabetes mellitus developed in 22%.Conclusions Both pathological form and operative procedure were factors influencing outcomes of CP.LPJ is still a main surgery for most CP patients with pancreatic fibrosis and dilated pancreatic duct and pancreatic stone.Some patients of CP with enlarged pancreatic head, hyperplasia of pancreatic parenchyma and pancreatic duct epithelia or complicated with diverticulum of the duodenum should be treated with resections targeting at the head of the pancreas.

Objective To observe the effect of preoperative oral administration of carbohydrate on blood glucose,insulin resistance(IR) and inflammatory reaction after gastrointestinal operation.Methods 48 patients receiving gastrointestinal operation were randomly divided into the study group(n =23)and the control group(n =25).Patients in the study group were orally given 25％ glucose solution 300 ml 3 hours before operation.Before anesthesia induction,gastric contents were aspirated through nasogastric tube to examine its volume and pH.Serum high sensitivity C-reactive protein(hsCRP),fasting blood glucose,insulin level and homeostasis model assessment-insulin resistance(HOMA-IR) were detected before operation and on the first morning after operation between the two groups.Results No anesthesia or operation related complications occurred in either groups.Patients had similar gastric contents volume and the PH value of gastric contents.There was no significant difference in serum hsCRP,fasting blood glucose and HOMA-IR between the two groups before operation.But on the first day,fasting blood glucose,HOMA-IR and hsCRP were significantly lower in the study group than in the control group(6.51 ±1.15 vs 7.49 ±0.57 mmol/L,P =0.038;4.34 ± 1.60 vs 6.09 ±2.81,P =0.043;40.45 ± 27.02 vs 80.02 ± 38.98 mg/L,P =0.03).Conclusion Preoperative oral administration of carbohydrate can obviously lower the postoperative blood glucose level and insulin resistance and alleviate postoperative inflammatory reaction.

Objective To analyze postoperative complications of duct-to-mucosa pancreaticojejunostomy and side-to-end or end-to-end pancreaticojejunostomy following pancreaticoduodenectomy.Methods The clinical data of 342 patients who underwent pancreaticoduodenectomy at the West China Hospital of Sichuan University from June 2004 to May 2008 were retrospectively analyzed.All patients were divided into the duct-to-mucosa group (179 cases)and side-to-end or end-to-end group(163 cases)according to the styles of pancreaticojejunostomy.The relationship between the incidence and severity of postoperative complications of the 2 anastomotic styles were analyzed according to the Clavien grading system.The measurement data and the count data were analyzed using the t test or chi-square test.Results The overall complication rate was 48.8％(167/342),and the complication rate was 38.0％(68/179)in the side-to-end group and 60.7％(99/163)in the side-to-end or end-to-end group,with a significant difference between the 2 groups(x2=17.667,P ＜0.05).The incidences of grade Ⅱ and grade Ⅴ complications were 16.8％(30/179)and 1.1％(2/179)in the duct-to-mucosa group,which were significantly lower than 28.2％(46/163)and 5.5％(9/163)of the side-to-end or end-to-end group(x2=6.484,5.316,P ＜0.05).Conclusion Compared with side-to-end or end-to-end pancreaticojejunostomy,duct-to-mucosa pancreaticojejunostomy is a better style with a lower incidence of postoperative complication.

Objective To investigate the correlation between the prognostic nutritional index (PNI) and clinicopathological features and long-term prognosis of gastric cancer patients after radical gastrectomy.Methods The clinical data of 135 gastric cancer patients who underwent radical gastrectomy in this hospital from 2002 to 2006 was analyzed retrospectively.The PNI value was calculated by serum albumin (g/L) + 5 x lymphocyte count (× 109/L).The receiver operating characteristic (ROC) curve and Youden index was used to determine the cutoff value of the PNI.Survival curves were described by the Kaplan-Meier method and compared by the Log-rank test.The univariate and multivariate analyses were performed with the Cox proportional hazard model to identify the prognostic factors.Result The mean PNI value was 47.3 ± 5.9.The mean values of the PNI in age (t =2.909,P =0.004),tumor size (t =2.227,P =0.028),tumor depth (t =3.314,P =0.001),negative lymph node (t =2.381,P =0.019),negative lymphovascular invasion (t =2.781,P =0.006) were significantly higher than those in patients without such factors.When the PNI was 47,the Youden index was maximal,with a sensitivity of 70％ and specificity of 63％.The mean age in high PNI group was significantly lower than that in low PNI group (x2 =6.443,P =0.011).Tumor infiltration depth in high PNI group was less than in low PNI group (x2 =7.394,P =0.007).The proportion of lymphovascular invasion in high PNI group was significantly lower than in low PNI group (x2 =4.540,P =0.033).The overall survival rate in high PNI group was higher than in low PNI group (P =0.002).The univariate and multivariate analyses showed that tumor location (OR,2.144 ; 95 ％ CI 1.239-3.712 ; P =0.006),lymph node metastasis (OR,4.887 ; 95 ％ CI 1.856-12.866 ; P =0.001),lymphovascular invasion (OR,1.842 ; 95％ CI 1.078-3.145 ; P =0.025) and the PNI value (OR,2.282 ; 95 ％ CI 1.344-3.874 ; P =0.002) were independent factors for predicting overall survival rate.Conclusions The PNI value is a simple and useful tool to predict the prognosis of patients with gastric cancer.

Objective To explore the main causes for death due to severe acute pancreatitis (SAP) to improve the level of diagnosis and treatment. Methods The clinical data of 1162 SAP cases treated in our hospital from June 1997 to May 2005 were retrospectively analyzed. Among which, 144patients (12. 39%) died, 82(7.06%)abandoned treatment and 936(80.55%)were cured. Results the APACHE Ⅱ scores and pancreas Balthazar CT scores of the death group were higher than that of the survival group. The percentage of single one organ dysfunction and multiple organ dysfunction syndrome (MODS) was significantly higher in the death group than in the survival group. The mortality rate of SAP without obvious inducing factors was significantly higher than that of SAP with inducing factors. Conclusion Integrated traditional and western non-surgical treatment is effective for SAP.The treatment for SAP without obvious inducing factors is a challenge. The mortality rate of SAP is primarily related to the pathological changes of pancreas and the patient's general condition. Early diagnosis and treatment is important to decrease mortality rate and maintaining the function of important organs is basic to ensure curative effect.

We performed a simultaneous pancreas-kidney transplantation (SPK) for type 2 diabetes complicated with end-staged renal disease (ESRD) in March, 2007. The recipient was a 65-year old male, who suffered type 2 diabetes for 15 years and renal dysfunction for 5 years and other diabetic complications such as retinopathy and peripheral neuropathy. SPK was performed successfully for him, in which the kidney was placed in the left iliac fossa, while the pancreas in the right iliac fossa, with an entedc drainage for pancreas exocrine and a systemic drainage for endocrine. Serum C-peptide, creatinine and blood urea nitrogen reached normal levels on day 1,4 and 11 post-transplant, respectively. Blood glucose became stabilized gradually to normal level and therefore the injected insulin was stopped on day 16 post-transplant. Oral glucose tolerance test (OGTT) showed the function of grafted pancreas was normal after 3 weeks of transplant, and no transplant-related complications occurred. With the recipient followed up for 20 months, both his blood glucose level and renal function maintained normal without using insulin.

BACKGROUND/AIMS: Chronic intestinal pseudo-obstruction (CIPO) is a serious, life-threatening motility disorder that is often related to bacterial overgrowth. Fecal microbiota transplantation (FMT) results in restoration of the normal intestinal microbial community structure. We investigated the efficacy of FMT in the treatment of CIPO patients. METHODS: Nine patients (age 18–53 years) with CIPO were enrolled in this prospective, open-label study. Patients received FMT for 6 consecutive days through nasojejunal (NJ) tubes and were followed up for 8 weeks after treatment. We evaluated the rate of clinical improvement and remission, feeding tolerance of enteral nutrition, and CT imaging scores of intestinal obstructions. Lactulose hydrogen breath tests were performed before FMT and 8 weeks after FMT to evaluate for the presence small intestinal bacterial overgrowth (SIBO). RESULTS: FMT significantly alleviated bloating symptoms, and symptoms of pain were relieved 2 weeks after FMT. Enteral nutrition administered through a NJ tube after FMT was well-tolerated by 66.7% (6/9) of patients. CT scores of intestinal obstructions were significantly reduced after FMT (P = 0.014). SIBO was eliminated in 71.0% (5/7) of patients. CONCLUSIONS: This pilot study demonstrated the safety of using FMT. FMT may relieve symptoms in selected patients with CIPO. FMT may also improve patient tolerance of enteral nutrition delivered via a NJ tube.
Breath Tests ; Enteral Nutrition ; Fecal Microbiota Transplantation* ; Humans ; Hydrogen ; Intestinal Obstruction ; Intestinal Pseudo-Obstruction* ; Lactulose ; Pilot Projects ; Prospective Studies